The UCLA Specialized Center of Research and Education (SCORE)


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By Lin Chang, MD

The UCLA Specialized Center of Research and Education (SCORE) has been funded by a grant from the NIH Office of Research on Women’s Health (ORWH) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) since 2002.

Our unique research program is looking into how the bacteria in our gut and female hormones can influence the way our brain and gut communicate. This research focuses on two common gut issues: irritable bowel syndrome (IBS) and chronic constipation. Both conditions can affect children and adults and men and women, although women are more often affected.

IBS is a common digestive disorder where people often experience abdominal (gut) discomfort or pain and changes in their bowel habits—this could mean having diarrhea, constipation, or sometimes both. While the exact cause of IBS isn’t well understood, we know that it involves a combination of how your gut, brain, and the communication between the two functions. Certain foods and stress can often trigger symptoms. Chronic constipation is also very common and refers to having infrequent bowel movements or difficulty passing stool. It can be associated with bloating and discomfort. The gut microbiome appears to play an important role in both conditions.

Female and male sex hormones can affect brain and gut function. Women with IBS tend to have more gut symptoms around the time of menstruation when estrogen and progesterone levels fall. Postmenopausal women can also have more severe symptoms. For example, in our studies on IBS, we consider how sex might be an important factor. We’re exploring how the brain and gut communicate back and forth, including how the gut’s microbes and the female hormones such as estradiol play a role. At the level of the brain, this two-way communication involves both the structure and function of the brain.

Our disease model for IBS with sex as a biologic variable demonstrates the two-way interactions between brain, gut, gut microbiome and the female sex hormones. The aspects of the model addressed by the 3 SCORE research projects are shown below.

Our goal is to better understand why people have IBS and chronic constipation, why women are more at risk of getting these two conditions, and how we can find new and better treatments to relieve symptoms and improve patients’ lives.

Sex-related differences in the interactions within the Brain Gut Microbiome axis are being studied to find better treatment targets at different levels (gut microbiome, gut anatomy and function, brain) for personalized interventions optimized for women and men with IBS and chronic constipation.