Chang Laboratory
Principal investigator
- Lin Chang, MD
Investigating the cause and treatments of IBS and other disorders of gut-brain interaction
Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) disorder characterized by recurrent or chronic abdominal pain associated with diarrhea and/or constipation. IBS has been redefined as a disorder of gut-brain interaction (DGBI), which is classified by GI symptoms related to any combination of the following: motility disturbance, visceral hypersensitivity, altered mucosal and immune function, altered gut microbiota, and altered central nervous system (CNS) processing. Other DGBI include, but not limited to, functional dyspepsia (epigastric pain syndrome and postprandial distress syndrome), chronic constipation, and chronic diarrhea. These conditions are among the most common in primary care and gastroenterology practices. They are diagnosed based on predominant symptoms. The cause of IBS is multifactorial but is not well understood. There are a number of over-the-counter, prescription medications and brain-gut behavioral therapies that can reduce symptoms of IBS and other DGBI and improve quality of life.
Dr. Chang is vice-chief of the Vatche and Tamar Manoukian Division of Digestive Diseases. She is a gastroenterologist and physician scientist who serves as co-director of the G. Oppenheimer Center for Neurobiology of Stress and Resilience (CNSR), an interdisciplinary center with a research and clinical focus on the interactions of pain, stress and emotions in health and disease. She helped to lead the CNSR’s NIH Specialized Centers of Research Excellence (SCORE), which has been funded since 2012. The SCORE grant focuses on sex differences in brain-gut interactions mainly with regard to IBS. Dr. Chang is multi-PI of current SCORE grant, which focuses on sex differences in brain-gut microbiome interactions in IBS and chronic constipation. She has been performing clinical and translational research studies, including clinical treatment trials for over 25 years. Her research has focused on brain-gut interactions, specifically the role of sex, stress, epigenetics, clinical symptoms, health outcomes, and treatment in IBS. Her clinical expertise is in disorders of gut-brain interactions, including IBS, functional dyspepsia, chronic constipation or diarrhea, and chronic abdominal pain. Her other leadership experience includes serving as program director of the UCLA GI Fellowship Program, past clinical research councilor of the AGA Governing Board, past president of the American Neurogastroenterology and Motility Society (ANMS), and member of the Rome Foundation Board of Directors. She is also a member of the GI division’s T32 NIH training grant selection committee.
Affiliate groups
- G. Oppenheimer Center for Neurobiology of Stress and Resilience (CNSR)
- UCLA Goodman-Luskin Microbiome Center
Key collaborators
- Arpana Church, PhD
- Tien S. Dong, MD, PhD
- Jonathan P. Jacobs, MD, PhD
- Nancee Jaffe, MS, RDN
- Jennifer Labus, PhD
- Muriel Larauche, PhD
- Swapna Mahurkar-Joshi, PhD
- Emeran A. Mayer, MD
- Bruce Naliboff, PhD
- Arpan A. Patel, MD, PhD
- Jenny Sauk, MD
- Alireza Sedarat, MD
- Catia Sternini, MD
- Yvette Taché, PhD
- Elizabeth Videlock, MD, PhD
- Guy Weiss, MD
- Pu-Qing Yuan, PhD
Extramural funding
- NIH: NIDDK, ORWH, SPARC
- UCLA Technology Development Group
- Philanthropy
- Industry
Current research projects
Specialized Center for Neurovisceral Sciences & Women’s Health (SCORE Center funded by NIDDK)
- Sex differences in brain-gut-microbiome interactions in irritable bowel syndrome (IBS) and chronic constipation
- Differences between post-menopausal women vs pre-menopausal women with and without IBS
- Effect of menstrual cycle phase in IBS symptoms
- Differences between male and female patients with IBS and healthy controls
- Effect of digital cognitive behavioral therapy (CBT) program
- UCLA Health is the only institution awarded two NIH SCORE grants; both focus on the understudied area of sex differences. Read article in UCLA Health News & Insights (June 2024)
Disorders of Gut-Brain Interaction (Functional GI) Program
- Diet in IBS, including low FODMAP and Mediterranean diet, and association with symptoms and microbiome
- Genetic and genomic biomarkers in blood and colon tissue in IBS (SNPs, DNA methylation, microRNA)
- Diagnostic test for IBS
- Role of early life adversity and resilience in IBS
- Efficacy of neurostimulation for abdominal pain in adult patients with IBS
- 3-dimensional imaging and computational quantification of extrinsic and intrinsic innervation and nerve-mast/glial cell spatial relationship in the colonic mucosa of patients with IBS
- Feasibility study evaluating utility of magnetic gastric capsule in gastroparesis and functional dyspepsia
- Visceral sensitivity index in inflammatory bowel disease (VSI-IBD) to measure GI symptom related anxiety in IBD patients
- Vibrating colon capsule for chronic constipation
Awards
- Healio Disruptive Innovators Award for Clinical Innovation (2024)
- This award goes to a physician or institution that has changed the face of gastroenterology practice. The awardee is seen as an example of how patient care can be bettered through changes in administration, technique or the delivery of value-based care. Dr. Chang was recognized for her work on the Joint Guidelines for chronic constipation.
Key publications
The role of sex differences in the clinical presentation and pathophysiology of IBS
- Lee AH, Mahurkar-Joshi S, Naliboff B, Gupta A, Labus J, Tillisch K, Mayer E, Chang L. Role of sex, anxiety, and resilience in the association between adverse childhood experiences and irritable bowel syndrome. Clinical Gastroenterology and Hepatology. June 13, 2024
- Kilpatrick LA, Gupta A, Tillisch K, Labus JS, Naliboff BD, Mayer EA, Chang L. Neural correlates of perceived and relative resilience in male and female patients with irritable bowel syndrome. Neurogastroenterol Motil. 29 November 2023
- Lenhart A, Naliboff B, Shih W, Gupta A, Tillisch K, Liu C, Mayer EA, Chang L. Postmenopausal Women with Irritable Bowel Syndrome (IBS) Have More Severe Symptoms Than Premenopausal Women with IBS. Neurogastroenterol Motil. 2020;00:e13913. https:// doi.org/10.1111/nmo.13913. PMC7529855
- Videlock EJ, Shih W, Adeyemo M, Mahurkar-Joshi S, Presson AP, Polyartchou P, Alberto M, Iliopoulos D, Mayer EA MD, Chang L. Effect of IBS and sex on HPA axis response and peripheral GR expression. Psychoneuroendocrinology 2016;69:67-76. PMC4977028
- Chang L, Adeyemo M, Karagiannides I, Videlock EJ, Bowe C, Shih W, Presson AA, Yuan PQ, Gong H, Singh S, Cortina G, Licudine A, Tache Y, Pothoulakis C, Mayer EA. Serum and colonic immune markers in irritable bowel syndrome. American Journal of Gastroenterology 2012;107(2):262-72. PMC3297737
- Chang L, Mayer EA, Labus J, Schmulson M, Lee OY, Olivas TI, Stains J, Naliboff BD. Effect of sex on perception of rectosigmoid stimuli in irritable bowel syndrome. Am J Physiol-Regulatory, Integrative and Comparative Physiology Am J Physiol Regul Integr Comp Physiol. 291:R277-R284, 2006
The role of chronic stress and early adverse life events in IBS
- Grover M, Vanuytsel T, Chang L. Intestinal permeability in disorders of gut-brain interaction (DGBI): From bench to bedside. Gastroenterology. September 3, 2024
- Parker CH, Naliboff BD, Shih W, Presson AP, Kilpatrick LA, Gupta A, Liu C, Keefer L, Sauk J, Hirten R, Sands BE, Chang L. Resilience in irritable bowel syndrome is lower compared to the general population and other chronic gastrointestinal conditions. Clin Gastroenterol Hepatol. 2020 Aug 21:S1542-3565(20)31152-6. doi: 10.1016/j.cgh.2020.08.043. PMC7897330
- Parker CH, Naliboff BD, Shih W, Presson AP, Videlock EJ, Mayer EA, Chang L. Negative Events During Adulthood are Associated with Symptom Severity and Altered Stress Response in Irritable Bowel Syndrome. Clinical Gastroenterology and Hepatology 2019;17:2245-2252. PMC6609507
- Park SH, Videlock EJ, Shih W, Presson AP, Mayer EA, Chang L. Adverse Childhood Experiences are Associated with Irritable Bowel Syndrome and Gastrointestinal Symptom Severity. Neurogastroenterology and Motility 2016;28:1252-1260. PMC4956522
- VidelockE, AdeyemoM, Licudine A, HiranoM, OhningG, MayerM, MayerEA, Chang L. Childhood trauma is associated with increased hypothalamic-pituitary-adrenal (HPA) axis responsiveness in irritable bowel syndrome. Gastroenterology 2009;137:1954-1962. PMCID: PMC2789911
Mechanisms underlying pain perception in IBS
- Choo C*, Mahurkar-Joshi S*, Dong TS, Lenhart A, Lagishetty V, Jacobs JP, Labus JS, Jaffe N, Mayer EA, Chang L. Colonic mucosal microbiota is associated with bowel habit subtype and abdominal pain in patients with irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol. 2022 Aug 1;323(2):G134-G143. PMC9359639
- Mahurkar-Joshi S, Rankin CR, Soroosh A, Videlock EJ, Verma A, Khandadash A, Iliopoulos D, Pothoulakis C, Mayer EA, Chang L. The colonic mucosal microRNAs miR-219a-5p and miR-338-3p are downregulated in irritable bowel syndrome and are associated with barrier function and MAPK pathway. Gastroenterology 2021 Feb 19;S0016-5085(21)00430-3. doi: 10.1053/j.gastro.2021.02.040. PMC8169529
- Videlock EJ, Mahurkar-Joshi S, Hoffman J, Iliopoulos D, Pothoulakis C, Mayer EA, Chang L. Sigmoid mucosal gene expression supports alterations of neuronal signaling in irritable bowel syndrome with constipation. American Journal of Physiology – Gastrointestinal and Liver Physiology 2018;315(1):G140-G157. PMC6109711
- Chang, L, Berman S, Mayer EA, Suyenobu B, Derbyshire SWG, Naliboff BD Vogt B, FitzGerald LZ, Mandelkern MA. Brain responses to acute visceral and somatic stimuli in patients with irritable bowel syndrome and fibromyalgia. Am J Gastroenterol 2003;98:1354-1361.PMID: 12818281
Health outcomes in IBS
- Chang L, Chey W, Amdad A, Almario C, Bharucha A, Diem S, Greer KB, Hanson B, Harris L, Ko C, Murad MH, Patel A, Shah ED, Lembo A, Sultan S. American Gastroenterological Association-American College of Gastroenterology Clinical Practice Guideline: Pharmacological Management of Chronic Idiopathic Constipation. The American Journal of Gastroenterology. May 19, 2023
- Zia J, Lenhart, A, Yang P, Heitkemper MM, Baker J, Keefer L, Saps M, Cuff, C, Hungria G, Videlock EJ, Chang L. Risk Factors for Abdominal Pain-Related Disorders of Gut-Brain Interaction in Adults and Children: A Systematic Review. Gastroenterology 2022 Jun 16:S0016-5085(22)00646-1. doi: 10.1053/j.gastro.2022.06.028. MID: 35716771
- Lee AD, Spiegel BM, Hays RD, Melmed GY, Bolus R, Khanna D, Khanna P, Chang L. Gastrointestinal Symptom Severity in Inflammatory Bowel Disease, Irritable Bowel Syndrome and the General Population. Neurogastroenterology and Motility 2017 May;29(5). doi: 10.1111/nmo.13003. PMC5393974
- Naliboff BD, Kim S, Bolus R, Bernstein CN, Mayer EA, Chang L. Gastrointestinal and Psychological Mediators of Health Related Quality of Life in IBS and IBD: A Structural Equation Modeling Analysis. The American Journal of Gastroenterology 2012;107:451–459. PMC3855477
- Spiegel BMR, Strickland A, Naliboff BD, Mayer EA, Chang L. Predictors of patient-assessed illness severity in irritable bowel syndrome. American Journal of Gastroenterology 2008;103(10):2536-43. PMCID: PMC2949074
Web of Science ID AAI-4333-2021
Current residents and GI fellows
- Preetha Iyengar, MD
- Rahul Kamath, MD
- Wendi LeBrett, MD
- Anna H. Lee, MD
- Rachel Sarnoff, MD
Past GI fellows
- Ellie Chen, MD
- Frank Chen, MD
- Ashwinee S. Condon, MD
- Dean Ehrlich, MD
- Adrienne Lenhart, MD
- Lisa D. Lin, MD, MS
- Rusha Modi, MD
- Benjamin Nulsen, MD
- Sarah Park, MD
- Saumya Pathak, MD
- Lynn Shapiro Connolly, MD, MSCR
- Kim Trieschmann, MD
- Trinh Troung, MD
- Elizabeth Videlock, MD, PhD