Beyond the Scope A REPORT OF THE VATCHE AND TAMAR MANOUKIAN DIVISION OF DIGESTIVE DISEASES

Inflammatory Bowel Disease

Cancer

Interventional Endoscopy Research Strengths at UCLA Digestive Diseases Page 1 UCLA at DDW® Page 16 Brain Gut Microbiome

Metabolism & Obesity Liver

IN THIS ISSUE | LETTER FROM THE RESEARCH COUNCIL DIRECTOR P. 1 SPRING IBD BASIC RESEARCH PROGRAM AND CLINICS P. 2 | CANCER RESEARCH P. 4 | METABOLISM AND OBESITY P. 6 2017 UCLA MICROBIOME CENTER P. 9 | BRAIN GUT MICROBIOME INTERACTIONS P. 10 | LIVER DISEASE P. 12 BeyondINTERVENTIONAL the Scope ENDOSCOPY P. 14 | UCLA PRESENCE AT DDW® P. 16 iii FROM THE DIVISION CHIEFS Going Beyond the Scope

Research has been a mainstay of our division since it was established in 1953, and over the course of our 64-year history we have grown to become a world leader in contributing new digestive diseases-related knowledge through scientific studies. Our faculty publish extensively and play prominent roles in national meetings, advancing the state of the science and ushering in cutting-edge treatments that improve and save lives. We also benefit from a strong infrastructure, which is supported by a significant endowment— most recently bolstered by the landmark philanthropic gift from Vatche and Tamar Manoukian.

With this strong underpinning and the vast potential for our division to conduct groundbreaking studies Gary Gitnick, MD, FACG Fran and Ray Stark in the years ahead, we felt it was only appropriate to establish a mechanism for guiding our research Foundation Chair effort, ensuring that we make strategic decisions on issues such as recruitment, training, utilization Professor of Medicine of space and investment of resources. And so we have established a Research Council to serve as our closest advisers in directing the future of our scientific efforts. Chaired by Dr. Emeran A. Mayer— internationally renowned for his research in brain-gut interactions in health and disease— the Research Council meets quarterly and includes a mix of senior and junior faculty.

Because we have such a large group of talented scientists, as well as ample space, we are uniquely positioned to foster internal as well as external collaborations. We can enhance our training programs to maximize our ability to train top new scientists. But we can only do this well if we undertake it in an organized fashion, and with significant input from the men and women closest to the work— the Eric Esrailian, MD, MPH scientists on the front lines. We established the Research Council for that very purpose. This shared Lincy Foundation Chair governance approach will allow us to receive regular input from our own internal scientific community in Clinical Gastroenterology as well as from external advisers so that we can continue to grow our research in ways that are best Associate Clinical Professor suited to our strengths and the needs of digestive disease patients. of Medicine This issue of Beyond the Scope showcases the extraordinary research activities that are ongoing in the six core areas of strength within our division. Through the guidance of our Research Council, we are setting a purposeful direction that ensures we will work in concert to make the most of the considerable opportunities before us.

uclahealth.org/gastro LETTER FROM THE RESEARCH COUNCIL DIRECTOR Showcasing Our Division’s Research Strengths

program. Moreover, our themes coincide parts of DGSOM and the UCLA campus, Emeran A. Mayer, MD, PhD with the gastroenterology research enabling them to draw from the full Director, UCLA G. Oppenheimer Center for Neurobiology of Stress and Resilience funding priorities of the National spectrum of expertise needed to tackle Co-director, CURE: Digestive Diseases Institutes of Health (NIH). a problem. These efforts are bolstered Research Center by a prestigious CURE: Digestive Professor, UCLA Vatche and Tamar By all measures, these research Disease Research Center grant from Manoukian Division of Digestive Diseases programs are thriving. We are funded the NIH, which provides critical with active NIH grants that total infrastructure through core services, more than $50 million. This support, along with a pilot feasibility program. along with substantial funding A s director of the UCLA Vatche and from philanthropic individuals and Of course, it is the investigators Tamar Manoukian Division of Digestive foundations, provides fuel for robust themselves who set these programs Diseases Research Council, I am proud basic, clinical, and translational apart. All of our core research areas are to introduce a special issue of Beyond activities leading to important anchored by senior faculty members the Scope that highlights the progress discoveries that are contributing to who are internationally recognized and ongoing investigations within a better understanding of the causes leaders in their fields. Surrounding these our division’s six core research areas: of digestive diseases and paving renowned distinguished individuals are inflammatory bowel disease (IBD) basic the way for new treatments and talented junior-level investigators, many research program and clinics, cancer, prevention strategies. Our leadership of them produced by DGSOM’s Specialty metabolism and obesity, brain-gut in digestive disease research will Training and Advanced Research (STAR) microbiome interactions, liver disease be on full display in Chicago May program, which prepares physician- and interventional endoscopy. 6-9 at the 2017 Digestive Disease scientists. The ability of these young Week®, the world’s largest gathering investigators to work with established Notably, there is significant overlap of physicians and researchers in the professors is among the reasons that between our division’s research strengths fields of gastroenterology, hepatology, the future of our division’s research and the six unified research themes of endoscopy and gastrointestinal surgery enterprise is so bright. the David Geffen School of Medicine (see page 16). (DGSOM) at UCLA, as recently identified The pages that follow offer a glimpse of by Dr. Stephen Smale, DGSOM’s vice Part of what makes our core research the ongoing research within our six core dean for research. Our IBD research areas so strong are the extensive areas of strength. Even though each corresponds with the DGSOM theme interactions among investigators, article highlights a senior-level and a of immunity/inflammation/infection/ both within the programs and outside junior-level faculty member within that transplantation; our cancer research of them. In an era when scientific research area. I hope that after reading matches DGSOM’s cancer theme; our complexity demands forgoing silos in these summaries, you will share my metabolism and obesity work fits with favor of interdisciplinary approaches, enthusiasm for the exciting prospects DGSOM’s metabolism theme; and our our researchers benefit greatly from for advances that will lead to healthier brain-gut microbiome research is an the ability to collaborate with colleagues and longer lives for the patients we see. important part of DGSOM’s neuroscience both within the division and in other

Beyond the Scope 1 IBD BASIC RESEARCH PROGRAM AND CLINICS

Using Systems Biology, Other Innovative Approaches to Understand and Treat Inflammatory Processes of the Gut

The UCLA Vatche and Tamar Manoukian Division of Digestive Disease’s inflammatory bowel disease (IBD) basic research program and clinics are characterized by a systematic approach to understanding the mechanisms by which IBD develops, including a focus on systems biology and exploring the complex microbial ecosystems involved in Crohn’s disease and ulcerative colitis, which affect approximately 1.5 million people in the United States.

The UCLA Inflammatory Bowel Disease Research Center, established in 2007, focuses on multiple aspects of the pathophysiology, therapy, and diagnosis of IBD with funding from the National Institutes of Health (NIH), the Broad Foundation for Medical Research and the Blinder Foundation. The center is directed by Dr. Charalabos “Harry” Pothoulakis, whose work targets aspects of the inflammatory process, including the role of neuropeptides and hormones in mediating inflammation and post-inflammation healing in IBD, as well as the role of fat signaling and obesity in IBD pathogenesis. “Because neuropeptides and hormones regulate appetite and metabolism during obesity, neuropeptide-adipose tissue interactions are important components of the inflammatory response in IBD, since in many instances obesity worsens IBD outcomes,” Dr. Pothoulakis explains.

Most recently, the center has been a leader in an innovative research approach that looks at the role of neuropeptides in the epigenetic changes that occur in the IBD intestine. Dr. Pothoulakis and his colleagues are collaborating closely on this research with

2 uclahealth.org/gastro Dr. Dimitrios Iliopoulos, an associate professor and director On the clinical side, Dr. Christina Ha, an assistant clinical of the Center for Systems Biomedicine in the division. professor in the division and associate director of clinical affairs for the UCLA Center for Inflammatory Bowel Dr. Jonathan Jacobs, who joined the division faculty in 2015, is Diseases, is working with Dr. Jacobs and two other division studying the impact on IBD of the intestinal microbiome — the faculty members, Dr. David Padua and Dr. Jenny Sauk, to bacteria that live in the digestive tract, particularly the colon develop biobanking protocols that will facilitate studies of and small intestine. His lab is interested in how these bacteria the microbiome and genetic signatures of the UCLA IBD interact with the immune system, and how in certain cases the patient population. bacteria in patients who develop IBD might contribute to that inflammation. Using stool and tissue samples from IBD patients Meanwhile, Dr. Iliopoulos and researchers at the UCLA Center and healthy comparisons, Dr. Jacobs and his colleagues are for Systems Biomedicine are leaders in applying the systems determining what microbial features distinguish IBD, based approach to IBD, which they are using to dramatically expedite on the premise that these microbes and some of the products the pace of IBD drug discovery. Current IBD therapies — the they make play a role in driving inflammation. most effective of which are tumor necrosis factor (TNF)-alpha inhibitors — take aim at the inflammatory process, but Dr. In addition, Dr. Jacobs’ team is conducting translational Iliopoulos notes that after a certain period of time, 30-40 studies in both mice and humans aiming to mechanistically percent of patients no longer respond to the therapy. “There define how genes interact with the bacteria to contribute is a great need for new drugs,” he says. The multidisciplinary to disease. “A healthy person can have the same bacteria team of experts at the Center for Systems Biomedicine as an IBD patient, but the person with IBD had genetic employs innovative robotic and computational tools in an susceptibility that worked in combination with the bacteria effort to identify key pathogenic processes and hasten the to promote inflammation and allow the disease to develop,” drug discovery process for IBD, as well as other multifactorial Dr. Jacobs explains. His group uses genetically manipulated diseases. Drawing from large numbers of patient tissue mice to study how the process occurs in humans. “Ultimately, samples, the center uses what Dr. Iliopoulos describes as we want to identify people who are at risk for developing an “unbiased strategy” to learn about the most important IBD based on their intestinal bacteria and genes,” Dr. Jacobs factors in the disease process, as opposed to the traditional says. A study he published last year showed that some hypothesis-driven method. Using this approach, he and healthy relatives of IBD patients have distinct microbial his team have identified novel molecular mechanisms and features that resemble those of IBD patients, despite the lack developed new IBD drugs targeting the human epigenome. of any evidence of disease. “We are now introducing bacteria from these healthy relatives into mouse models to show that One such discovery was an epigenetic factor called microRNA these bacteria promote disease. Once we’ve established this, (miR) — a small RNA molecule capable of simultaneously we can then go back to humans to identify who is at risk regulating the function of multiple genes — that appears and potentially find ways to reduce this risk by changing the to play a central role in the initiation and progression of bacteria,” Dr. Jacobs explains. ulcerative colitis. Dr. Iliopoulos and his colleagues recently received a five-year, $1.7 million grant from the NIH to Dr. Jacobs started much of this work in the laboratory of characterize this molecular mechanism in IBD pathogenesis, Dr. Jonathan Braun, chair of Pathology and Laboratory and to evaluate the therapeutic potential of a new drug for IBD Medicine, where he was mentored as a UCLA GI fellow patients targeting this process. “Early experimental evidence in conjunction with the Specialty Training and Advanced has shown us that this drug is very effective in suppressing Research (STAR) program, which trains physician-scientists colitis in animal models, without any toxicity,” Dr. Iliopoulos at the David Geffen School of Medicine at UCLA. Dr. Braun is says. “Because miR-24 is found in high levels in patients with part of large consortia using various “omics” technologies to inflammatory bowel diseases and in very low levels in healthy conduct detailed phenotyping of microbiota in IBD patients. patients, we are hopeful that blocking this molecule will have Dr. Braun is a leader of the proteomics component of the NIH’s great therapeutic value.” multicenter Human Microbiome Project 2 study of IBD.

Beyond the Scope 3 CANCER RESEARCH

Program Spans from Laboratory Studies to Community Outreach

This year more than 300,000 new cancers of the gastrointestinal tract will be diagnosed, making the digestive system the most common cancer site. Pancreatic cancer has surpassed breast cancer as the third-leading cause of cancer death in the United States; colorectal cancer is second. Approximately 160,000 people will die from GI cancers. “This is one of the most challenging problems facing gastroenterologists,” says Dr. Enrique Rozengurt, the Ronald S. Hirshberg Chair in Translational Pancreatic Cancer Research in the UCLA Vatche and Tamar Manoukian Division of Digestive Diseases. “There is an intense need for basic and clinical research to better understand the process and become more successful at prevention and therapy.”

Cancer research within the division runs the gamut from basic and translational to clinical studies. The two major areas of focus, pancreatic and colorectal cancer, call for fundamentally different approaches. Because pancreatic cancer is typically not found until it has progressed, and treatment has been relatively ineffective, the focus is on basic science to learn more about the mechanisms involved. For colorectal cancer, effective screening tools allow for early diagnosis and curative treatment, but given that a significant portion of the population isn’t taking advantage of them, much of the focus is on improving screening rates.

Dr. Rozengurt, a pioneer in the area of signal transduction and cell growth regulation, serves as the director of CURE: Digestive Diseases Research Center, a National Institutes of Health (NIH)- funded center that has consistently promoted studies on pancreatic inflammation and cancer. Epidemiological studies in recent years have linked obesity and longstanding type 2 diabetes with increased risk for developing clinically aggressive pancreatic cancer. In a series of studies that have opened up a new field of pancreatic cancer research, Dr. Rozengurt’s group has shown that metformin, the most widely prescribed drug for the treatment of type 2 diabetes, inhibits pancreatic cancer growth in preclinical scientific models, and the proliferation of human pancreatic cancer cells in culture. The team has advanced these studies by using imaging of single human pancreatic cells and experiments in preclinical models of pancreatic cancers. “Because metformin is an FDA-approved drug widely used in the treatment of type 2 diabetes and other conditions, including pre-diabetic states, rapid translational research is a tangible possibility,” Dr. Rozengurt says.

Dr. Rozengurt’s group is also focusing on other pancreatic cancer pathways, including a pursuit of the hypothesis that the pro-oncogenic protein YAP could play a critical role in promoting pancreatic cancer and in mediating crosstalk signaling. Using high-throughput screens of compounds capable of altering the subcellular localization of YAP, Dr. Rozengurt identified statins as potential YAP inhibitors. He and his colleagues have found that the statins potently block YAP-regulated genes

4 uclahealth.org/gastro in pancreatic cancer cells, and that various statins inhibit the multiplication of pancreatic ductal adenocarcinoma cells — as well as acting synergistically with metformin.

In colorectal cancer, the U.S. Centers for Disease Control and Prevention estimates that one-third of adults ages 50-75 are not screened. Dr. Folasade P. May, an assistant professor in the division, is helping to spearhead multiple efforts to increase screening — within the UCLA Health system, with the U.S. Department of Veterans Affairs (VA), and in a low-income, under-resourced community in Los Angeles.

As part of the National Colorectal Cancer Roundtable (NCCR) initiative “80% by 2018,” more than 1,000 organizations have committed to substantially reducing colorectal cancer as a major public health problem by working toward the shared goal of 80 percent of adults 50 and older being regularly screened by next year — an increase of 2 million people over current levels. “Even at an advanced center like UCLA, the rates are in the mid-60s,” Dr. May notes. Through the Department of Medicine and UCLA Health Quality Initiative team, Dr. May has worked with call centers to contact patients who haven’t been screened, explain the benefits, and encourage them to make appointments to schedule screening. These patients are also being offered home-based screening tests as an alternative to colonoscopy. In addition, Dr. May has helped to develop UCLA Health’s outreach to providers and patients, including presentations and professional-level videos on screening’s value.

The VA has high colorectal cancer screening rates — recently recognized by the NCCR for achieving an 82 percent rate. But among the 8-10 percent of patients whose fecal immunochemical test (FIT) is positive, only about 50-60 percent obtain a colonoscopy within a year. Working with a team both at the VA Greater Los Angeles Healthcare System and nationally, Dr. May is investigating the causes of the poor follow-up and what can be done to move FIT-positive patients to colonoscopy screening more rapidly.

Dr. May also has a seed grant from the UCLA Jonsson Comprehensive Cancer Center to develop a partnership with T.H.E. (To Help Everyone) Health and Wellness Center to improve colorectal cancer screening. The T.H.E. clinic in Watts, which primarily cares for African-American and Latino patients, has screening rates of approximately 30 percent. Through patient and provider outreach, Dr. May and colleagues hope to improve access to care and screening rates. “Community health centers have the lowest screening rates in the nation,” Dr. May says. “With very small interventions, we believe we can make a big impact.”

The vast differences in the approaches of Drs. Rozengurt and May — from basic science in the laboratory to outreach in the community — are characteristic of the breadth of the division’s cancer research effort as a whole. For example, the laboratory of Dr. Dimitrios Iliopoulos, an associate professor in the division, seeks to understand the epigenetic processes involved in inflammation, which plays an important role in pancreatic cancer. Dr. V. Raman Muthusamy, director of interventional endoscopy for the division, has been a leader in clinical studies to treat Barrett’s esophagus, both to prevent the development of esophageal cancer and to treat early cancers and avoid the need for surgery. “What’s so powerful about the cancer research in our division is that we have researchers who cover the entire spectrum of the disease, from the first cells that are predisposed to cancer all the way to treatment,” Dr. May says. “It’s very valuable to work in a division where we are covering that complete cancer care continuum.”

Beyond the Scope 5 METABOLISM AND OBESITY

Research on Genetic, Hormonal and Microbial Mechanisms Pave the Way Toward New Prevention and Treatment Strategies

How do genetics, hormones, and the microbes in the gut contribute to obesity and metabolic syndrome?

At a time when more than one-third In the laboratory, Dr. Pisegna and Human Genetics faculty, Dr. Paivi of U.S. adults are obese and effective colleagues have found that a Pajukanta. Their study utilizes the long-term therapies for obesity and high-protein diet regulates certain Million Veteran Program cohort, fatty liver disease are lacking, cutting hormones involved in satiety, a U.S. Department of Veterans edge research being pursued in the including vasoactive intestinal Affairs-funded population study that UCLA Vatche and Tamar Manoukian polypeptide and pituitary adenylate has thus far collected full-exome Division of Digestive Diseases into cyclase-activating polypeptide. “We sequencing data on approximately the contributing mechanisms carries think that the high-protein diet turns 400,000 veterans. major public health implications. on hormones that lead to satiety, but that these hormones may also have Dr. Pisegna and other faculty in A group headed by Drs. Joseph a direct effect on adipose tissue the division are part of the UCLA Pisegna and Yvette Taché, professors and the liver,” Dr. Pisegna explains. Center for Obesity and METabolic in the division, is funded by the U.S. “They are operating through two Health (COMET), a leader in clinical Department of Veterans Affairs for different mechanisms — one through and basic research on obesity and research looking at the potential for the brain and how it sends out metabolic syndrome. COMET’s diets high in protein to positively signals for satiety, and the other investigative efforts are directed by affect metabolism and therefore be more directly, either on the liver or a member of the division faculty, used to treat obesity and fatty liver adipose cells.” Dr. Simon Beaven, who focuses on disease. Dr. Pisegna, an expert in how how alterations of lipid metabolism gastrointestinal hormones regulate In addition to studying these promote liver damage and diabetes. physiologic function, currently heads questions at the hormone level Dr. Beaven and his colleagues are industry-funded clinical trials on in humans and mouse models, examining the role of endogenous drugs for treating fatty liver; his Dr. Pisegna is looking into the nutrient receptors, called nuclear group also conducts parallel studies genetic signatures of obesity and receptors, in the development of in mouse models of obesity and fatty fatty liver in collaboration with a the component conditions of the liver disease. member of UCLA’s Department of metabolic syndrome — fatty liver,

6 uclahealth.org/gastro diabetes, high cholesterol, obesity, of cognitive behavioral therapy in gut metabolites and changes in and atherosclerosis. They recently reversing altered ingestive behavior appetite and food preferences after made a major discovery with the and promoting weight loss. the surgery, along with resulting observation that lipid metabolism, changes in brain function. “These through liver X receptor signaling, Dr. Claudia Sanmiguel, the head are preliminary findings with a plays an important role in the of the CNSR Obesity Research small sample size, but we are seeing activation of hepatic stellate cells Program, is investigating the profound changes in appetite, food and contributes to liver fibrosis connection between the brain and preferences and brain structure susceptibility. Other division faculty the gut microbiome in obesity, in the first months after surgery, members conducting obesity-related particularly after weight loss and then over time the appetite and research through COMET include bariatric surgery. Research involving food cravings tend to return,” Dr. Rabindra Watson, a member identical twins has shown that when Dr. Sanmiguel says. of the division’s interventional the stools from an obese donor endoscopy team, also conducts and a lean donor are transplanted Dr. Sanmiguel’s group is continuing studies with bariatric patients, into germ-free mice, the mice that to examine how the gut microbiome including the impact of endoscopic receive the obese donor’s stool tend contributes to the changes in suturing for patients who may need to subsequently gain more weight. brain structure and function seen a revision after bariatric surgery Moreover, patients who undergo immediately after the surgery that and how reducing the size of the bariatric surgery experience a can promote reduced appetite and pouch created through gastric bypass marked reduction in appetite and increased satiety. “We have found may assist patients in losing weight changes in food preferences that that some of the products of the after they have returned to unhealthy have not been explained, and fecal gut microbiome affect hunger, appetite levels. transplant from post-bariatric satiety levels, and weight loss, and surgery donors results in weight also that certain characteristics of Investigators in the Ingestive loss in animal models. These and the gut microbiome before surgery Behavior and Obesity Program of other findings led Dr. Sanmiguel and can predict who is going to be most the G. Oppenheimer Center for her colleagues to begin to explore successful in losing weight after the Neurobiology of Stress and Resilience role of gut microbial metabolites surgery,” Dr. Sanmiguel says. She is (CNSR) are focusing on identifying in the control of food preference hopeful that her group’s research will the role of brain gut interactions and weight control. “The gut contribute to a better understanding in obesity. Dr. Arpana Gupta is microbiome is certainly not the of which patients are most likely to studying structural and functional only player in the field of obesity, benefit from bariatric surgery— brain changes associated with early but it definitely plays an important and, ultimately, to new treatments adverse life events, socioeconomic role,” Dr. Sanmiguel says. that could achieve the same effect status and obesity. She found on appetite and satiety without that certain brain characteristics In an effort to learn more about that the operation. predispose individuals to obesity, role, Dr. Sanmiguel is collaborating and that traumatic early life events with a group that includes Dr. Erik lead to brain changes that can lead Dutson, COMET’s surgical director, to study appetite and behavioral to dysregulated eating behaviors (“food addiction”), increasing obesity changes in patients following risk. Based on these findings, she bariatric surgery. The ongoing study is now studying the effectiveness has found an association between

Beyond the Scope 7 8 uclahealth.org/gastro UCLA MICROBIOME CENTER

New Center Draws from Campus Strengths to Explore New Frontier in Biomedical Research

Approximately 100 trillion microbes this new frontier in biomedical science, Medicine, CNSI, the Life Sciences reside in the human body, and in recent Drs. Mayer and Jonathan Jacobs have Departments, and the School of years it has become clear that the played key roles in spearheading the Engineering) and the infrastructure microorganisms populating the intestine, establishment of the UCLA Microbiome it has built to support this work, in skin, lungs, urinary tract and many Center, which brings together particular in the areas of neuroscience, other body sites have a major impact investigators with wide-ranging areas gastroenterology, obesity and novel on human health. A growing body of of expertise from across the entire technologies, Dr. Mayer says. “Our evidence suggests that heart disease, UCLA campus, including the California program is unique in the country in the cancer, diabetes, metabolic disease, Nanosystems Institute (CNSI), to learn way that it spans from basic science obesity, inflammatory bowel disease how bacteria and other microbes and animal models to clinical research, (IBD), autoimmune disorders, allergies, affect human health, and to use that looking at the brain-gut microbiome axis as well as neurologic and psychiatric information to explore new therapeutic as it is applied to different diseases in disorders all may be associated in some strategies. The center is directed by a both humans and animals,” he explains. way with microbes gone awry. steering committee composed of Drs. Mayer, Jeffrey Miller (director of CNSI), With the exception of fecal microbial “The microbiome is like a hidden organ, Jonathan Braun (chair of Department transplants — introducing processed larger than any other in the body in of Pathology and Laboratory Medicine), stool from healthy donors into the terms of cell numbers,” says Dr. Emeran Wenyuan Shi (director of Bio-Rad Core GI tracts of patients with recurrent A. Mayer, a professor in the UCLA for Advanced Molecular Research), Clostridium difficile— much of the Vatche and Tamar Manoukian Division Paul Weiss (Department of Chemistry & progress in the emerging field of the of Digestive Diseases and executive Biochemistry), Elaine Hsiao (Department gut-brain microbiome axis has been at director of the G. Oppenheimer of Integrative Biology and Physiology), the research level. Nonetheless, findings Center for Neurobiology of Stress and and Jonathan Jacobs (Vatche and suggest a role for the microbiota Resilience (CNSR). “We can transplant Tamar Manoukian Division of Digestive well beyond what anyone might have entire phenotypes from one mouse to Diseases). Much of the work of the UCLA imagined a decade ago. “There was a lot another — including anxiety, depression Microbiome Center is in digestive disease- of excitement that the Human Genome and obesity- suggesting that these related areas, including functional and Project was going to change medicine microbes produce chemicals that can inflammatory bowel disorders, metabolic fundamentally, and it turned out to be affect the host in complex ways — even syndrome and obesity. just the beginning of a long process,” changing entire behavior patterns. Dr. Mayer says. “But learning about However, we’re still just scratching at The UCLA Microbiome Center is these microbes goes way beyond the the surface, but the field is moving positioned to be a leader in this human genome. Identifying the intricate extremely fast.” growing field through interdisciplinary relationships between the microbiome collaborations it has fostered among and the human host has the potential to To capitalize on UCLA’s campus-wide researchers from all over the UCLA completely transform our understanding strengths in research pertaining to campus (including the School of of health and human disease.”

Beyond the Scope 9 BRAIN GUT MICROBIOME INTERACTIONS

Novel Approaches Toward More Effective Treatments for IBS, Obesity and Chronic Pain

For many years, there has been limited interest within the recognized in the use of integrative medicine approaches to medical field in how the brain and gut interact in health and treat brain-gut disorders. Dr. Tillisch was the first to demonstrate disease. Even patients with common functional GI disorders an effect of gut microbial manipulation with probiotics on such as irritable bowel syndrome (IBS), functional dyspepsia emotional brain responses. Her current NIH-funded and functional heartburn were reluctant to accept such study is looking at the impact of mindfulness- a concept, wrongly assuming their symptoms would be based stress reduction on the brain and explained in psychological terms. The emerging research into the microbiomes of IBS patients, and the gut microbiome has dramatically changed the equation she is working with Drs. Bruce in the last five years, with the study of brain-gut microbiome Naliboff and Mayer in studying (BGM) interactions taking center stage in many fields and the effects of CBT on IBS specialties, including gastroenterology, cardiology, chronic symptoms, the brain and pain and psychiatry, to name only a few. the microbiome. Dr. Jonathan Jacobs, who Investigators at the G. Oppenheimer Center for Neurobiology directs the UCLA of Stress and Resilience (CNSR) have been on the cutting edge Microbiome Center of this research for several decades, being the first to study Core, is collaborating the role of the human brain in patients with IBS and in linking with several alterations in gut microbes to alterations in brain structure investigators in the and function. Under the leadership of Dr. Emeran A. Mayer, CNSR on studies a world-renowned gastroenterologist and neuroscientist with involving the gut 30 years of experience and continuous NIH funding in the microbiome, and study of brain-gut interactions, center investigators are is working with focusing on the role of the mind and of gut microbiota in Dr. Mayer on the modulating brain-gut interactions, including sex differences interactions of the in these interactions; the effects of mindfulness-based brain and gut in stress reduction and cognitive behavioral therapy (CBT) on patients with Crohn’s brain signatures in irritable bowel syndrome (IBS); brain-gut disease — a new area of microbiome interactions in inflammatory and functional IBD research based on the GI disorders; and the role of gut microbes in obesity. recognition that the brain Dr. Lin Chang, one of the co-directors of the CNSR and board is influenced by chronic gut member of the ROME Foundation, and a key opinion leader inflammation, and may play a key on the treatment of IBS, has been studying the epigenetic role in modulating gut permeability, mechanisms underlying the effect of early adverse life events, microbial behavior and the inflammatory psychosocial stress and resilience on IBS symptoms. Her activity in the gut. NIH-funded studies look at the role of micro RNAs and gene Drs. Claudia Sanmiguel and Arpana Gupta are studying the role methylation in the IBS colonic mucosa. of BGM interactions in obesity and food addiction, and evaluate Dr. Kirsten Tillisch is the head of the Integrative Medicine the mechanisms by which bariatric surgery and cognitive Program at the West Los Angeles VA and is nationally behavioral therapy affect weight loss in obese subjects.

10 uclahealth.org/gastro Novel Approaches Toward More Effective Treatments for IBS, Obesity and Chronic Pain

Dr. Jennifer Labus, the director of the CNSR Neuroimaging is that bacteria or other microbes are doing to affect the brain, and Bioinformatics Core, has developed novel analytical and how they communicate with each other.” techniques (“multiomics integration”) to analyze the interactions of gut microbes and their metabolites While at Caltech in 2013, Dr. Hsiao and her colleagues found with the brain. By interacting with all that autism-like behavior could be produced in the offspring of investigators of the CNSR, she plays a mice they treated with a viral mimic during pregnancy. These crucial role in extracting relevant offspring, which were found to have altered gut bacteria, information from extensive sets showed reduced autism-like behaviors when treated with a of brain and gut microbial health-promoting bacterium. Dr. Hsiao’s UCLA lab continues data using machine to follow up on those findings with studies of the impact of learning approaches. microbiome changes on behaviors related to autism and She also pursues other neurological disorders, including depression, epilepsy NIH-funded studies and Parkinson’s disease. Her laboratory recently discovered into the role that bacteria from human-gut microbiota stimulate host of the central biosynthesis of the hormone and neurotransmitter serotonin. nervous system In addition to studying the role of the BGM axis in functional GI and the vaginal disorders, several CNSR investigators are pursuing NIH-funded microbiome in interdisciplinary studies into other chronic pain conditions, vulvodynia. including urological pelvic pain syndromes such as interstitial Dr. Elaine Hsiao, cystitis and chronic prostatitis (Drs. Jason Kutch and Larissa an assistant Rodriguez), and vulvodynia (Dr. Jennifer Labus). professor in Through interdisciplinary collaborations among these the Department researchers and experts from all over the UCLA campus, the of Integrative CNSR has been a leader in the field of mind-body interactions Biology and related to gastroenterology, chronic pain and women’s health. Physiology who holds “Our program is unique in the country in the way that it spans a joint appointment from basic science and animal models to clinical research, in the division and is looking at the brain-gut microbiome axis as it is applied to internationally recognized different diseases in both humans and animals,” Dr. Mayer as an expert in brain-gut explains. Many of the above researchers are in the process microbiome interactions, is using of putting together an interdisciplinary translational program a mouse model to study how microbes project grant that will be submitted to the NIH in late May, in the gut influence behaviors in conditions Dr. Mayer notes. such as Parkinson’s and autism. “We’re seeing that changing the microbiome in the mice can produce substantial effects on their behavior, as well as differences in the structure and activity of the brain cells,” Dr. Hsiao says. “That is inspiring a great deal of effort to better understand what it

Beyond the Scope 11 LIVER DISEASE

Researchers Seek to Better Characterize Hepatotoxicity, Treat Fatty Liver and Improve Quality of Life for Patients

As the first line of defense responsible for clearing chemicals supplements and fat burners,” says Dr. Durazo, who has served ingested in the human body, the liver is being put to the test at a as a principal investigator for the Drug Induced Liver Injury time when the population is increasingly consuming supplements Network, established by the National Institute of Diabetes and for purposes ranging from losing weight and enhancing strength Digestive and Kidney Diseases to collect and analyze cases of to getting an energy boost, or simply improving their health severe liver injury caused by prescription and over-the-counter through “natural” means. Unfortunately, says Dr. Francisco drugs, herbal products and supplements. Durazo, professor of medicine in UCLA’s Vatche and Tamar Manoukain Division of Digestive Diseases and chief of Transplant Drug-induced liver injury is the most common cause of acute Hepatology, this is leading to a growing number of cases in which failure, Dr. Durazo notes. It is estimated that more than half patients are presenting with acute hepatotoxicity. of the U.S. population takes supplements, which has led to increasing concerns about liver injury. Another common cause Dr. Durazo currently has funding from the National Institutes is acetaminophen overdose. While initial attention, particularly of Health (NIH) to study drug-induced liver injury, particularly in Europe, centered on uses of the drug for suicide attempts, the as a result of supplements. “We are seeing a significant focus has now shifted to the problem of unintentional overdose — increase in these injuries, most commonly from workout-related so-called therapeutic misadventures. Antibiotics and anti-seizure

12 uclahealth.org/gastro medications can also cause liver injury. “We are looking to better patients who are experiencing liver disease complications. understand how this occurs and who is at risk,” Dr. Durazo says. That is the focus of Dr. Sammy Saab, a professor in the division. “Each medication has a different pathophysiology and is going Dr. Saab’s group is studying various liver complications, as well to cause a different syndrome; we want to characterize the risk as the impact of hepatitis C therapy and accessibility, in an effort factors, natural history and toxicity of different medications.” to identify the best ways to intervene to improve patients’ quality of life and sense of well-being. Dr. Durazo and colleagues are also participating in a multicenter clinical trial of the drug obeticholic acid for the treatment of “Often, patients don’t associate problems they’re experiencing non-alcoholic fatty liver disease, or non-alcoholic steatohepatitis with the liver, even though it’s affecting their quality of life — for (NASH). “With the obesity epidemic, nearly 30 percent of example, they might describe leg cramps that feel like a knife the population has fatty liver, and some of those patients will ripping through their calves, without recognizing that this could progress to cirrhosis and liver cancer,” Dr. Durazo says. “This be a reflection of excessive diuretics or electrolyte disturbances,” is a major public health problem — we are now doing more Dr. Saab notes. “And doctors don’t always ask questions that transplants from fatty liver than from problems caused by might identify a problem that could be addressed. One of our alcohol — and there is still no effective treatment.” In addition to goals is to empower patients with more knowledge of what the these research projects, Dr. Durazo recently completed a study liver does and what happens when it isn’t working well.” on the natural history of pancreatic cysts in patients undergoing liver transplant, and is currently involved in research exploring Dr. Saab notes that people with liver cirrhosis are at risk for the treatment of hepatocellular carcinoma with radiofrequency complications that can include water retention and confusion, as ablation and thermal injury prevention. well as symptoms of fatigue, itchy skin and leg cramps. His group is studying the frequency with which these symptoms occur and Elsewhere in the division, Dr. Steven-Huy Han, a professor of how they affect patients’ daily activities. medicine and director of the Hepatology Clinical Research Center, is tackling another major public health concern, involving With the high rates of obesity, diabetes, hypertension and the treatment of chronic hepatitis B. The guidelines for who hyperlipidemia, the incidence of fatty liver is expected to should be treated and for how long vary widely not only between continue to rise in the U.S. “Many of us are seeing more and Europe, Asia and the United States, but even across different more patients coming to us with cirrhosis — not just from geographical regions of the United States. Hepatitis B produces alcohol or hepatitis C, but the big gorilla in the room is fatty no symptoms, but if untreated it can cause cirrhosis of the liver, liver,” Dr. Saab says. “A small proportion of people with fatty liver failure, and eventually liver cancer. Dr. Han, who has headed liver will develop cirrhosis, but even a small percentage from multiple clinical studies involving the treatment of chronic this large group of patients will mean many more people will eventually need a liver transplant. The wait for liver hepatitis B as well as hepatitis C, is interested in contributing to more standardized treatment protocols. transplantation is quite long, and so we need to find better ways to assist patients who are experiencing cirrhosis so that Given the trends in liver disease, it is becoming increasingly they can live with it as well as possible.” important to identify ways to improve the quality of life for

Beyond the Scope 13 INTERVENTIONAL ENDOSCOPY

As Lines Between Endoscopy and Surgery Blur, Division’s Team Continues to Advance the Field

Interventional endoscopy has grown off the dysplasia in Barrett’s patients, to obtain enough tissue from more rapidly in recent years, emerging as recently developed new quality metrics accessible areas (such as the pancreas) the preferred procedure for diagnosing for these techniques, called endoscopic to allow for theranostics, or being able to and treating many GI conditions that eradication therapy, with two colleagues. profile tumors to predict which drugs will were once the domain of surgery The American Society of Gastrointestinal be most effective. “Historically we say if given advantages that include fewer Endoscopy and American College of you have cancer of a certain type you get complications, quicker recovery times, Gastroenterology recently endorsed this drug, and some people respond while the ability to combine and tailor these metrics, which can be used others don’t,” Dr. Muthusamy says. “Part procedures to patients’ needs, and to guide and assess endoscopists of moving toward more personalized the fact that the interventions can be performing these procedures. Barrett’s medicine is the need to get enough of the reversible. At UCLA, the four members esophagus is a complication of tumor to actually run these tests, which of the interventional endoscopy team chronic reflux in which the lining of requires more than you would get just for within the Vatche and Tamar Manoukian the esophagus begins to take on the a diagnosis.” His group is now using new Division of Digestive Diseases are appearance and characteristics of the needles to acquire additional tissue for a engaged in studies that are continuing lining of the stomach and small intestine, host of cancers. This increased ability to to blur these boundaries while also putting patients at a significantly higher extract tissue with endoscopic ultrasound improving the diagnostic and therapeutic risk of developing esophageal cancer. is also being applied to obtain liver capability of endoscopy. The ability to perform endoscopic biopsies during endoscopy. eradication techniques that are far less Dr. V. Raman Muthusamy, director invasive than surgery makes treating Another member of the team, of interventional endoscopy for the dysplastic Barrett’s esophagus — and Dr. Rabindra Watson, has been at the division, has extensively studied a thus reducing the risk of progression to forefront of developing endoscopic combination of resection and ablation cancer — a much more appealing option, techniques for patients who gain weight techniques to treat Barrett’s esophagus Dr. Muthusamy notes. after bariatric surgery. A majority of patients, both as a strategy to prevent the more than two million people in the development of cancer and for Dr. Muthusamy is also exploring better the United States who have undergone treating early esophageal cancers ways to getting tissue from endoscopic bariatric weight-loss surgery (most to avoid the need for surgery. Dr. ultrasound — focusing not only on commonly gastric bypass) begin to Muthusamy, who helped to pioneer the how to obtain tissue from areas that regain weight after a period of time, in use of radiofrequency ablation to burn have proved inaccessible, but also how part because their surgically created

14 uclahealth.org/gastro gastric pouch starts to stretch. motility disorders, including achalasia — be problematic with less need to conduct Dr. Watson has refined a procedure to a condition of the esophagus in which costly monitoring of patients whose cysts reduce the volume of the gastric pouch the muscle is chronically contracted, are determined to be benign. through the injection of sclerosing making it difficult to swallow. “This agents that harden/tighten the tissue, is probably the most revolutionary Both Dr. Kim and Dr. Muthusamy are or by re-sewing the pouch to counter endoscopic advance of the last 10-15 developing strategies to ensure that the postsurgical stretching. He has been years, because traditionally the technique duodenoscopes are kept as safe as at the forefront of developing primary has been to open up the chest or go possible in light of superbug outbreaks techniques — including the use of intra- through the abdomen and cut the at hospitals. And Dr. Muthusamy is also gastric balloons or other approaches muscle of the lower esophagus,” says exploring ways to improve the efficiency that mimic surgical procedures — to Dr. Muthusamy. Dr. Sedarat is currently of endoscopic healthcare through better allow an endoscopy procedure for weight the only interventional endoscopist in practice management to decrease delays loss to be used instead of surgery. Los Angeles County offering the procedure. and the costs associated with them.

A third member of the team, Dr. Alireza Dr. Stephen Kim is conducting “As our tools get better and better, Sedarat, is utilizing and developing translational research to advance the endoscopic surgery and laparoscopic new resection techniques. In the past, treatment of pancreatic cysts. He has surgery are melding,” Dr. Muthusamy endoscopists have removed only small been collecting fluid from patients being says. “We’re continually working to lesions, but increasingly they have treated for the cysts in an effort to improve on the things we do, but also adopted approaches to remove larger develop better ways of characterizing to expand into new areas that were cancers or precancerous lesions. After them. By the age of 70, between 10 and typically surgical — in the endoscopic conducting animal studies, Dr. Sedarat 25 percent of patients are found to have eradication therapy that I do for is beginning to perform a technique a pancreatic cyst when they undergo Barrett’s, for example, patients I see in known as endoscopic submucosal radiologic testing. “Most of them don’t the endoscopy unit all would have gone dissection (ESD) in patients, which allows progress to cancer, but we have imperfect to surgery 10 years ago, and now almost for the resection of larger lesions than criteria for determining which ones do none of them do. And as we blend the current endoscopic mucosal resection and which don’t,” Dr. Muthusamy notes. lines between surgery and endoscopy techniques. He is also performing peroral If Dr. Kim is successful, it will potentially with regards to therapy, we are also endoscopic myotomy (POEM) as an pave the way for earlier intervention in working to get better at our diagnostic alternative to surgery for esophageal patients whose cysts are determined to capabilities with endoscopes.”

Beyond the Scope 15 Digestive Disease Week® 2017

SATURDAY, MAY 6 Serotonin Released By FFA2 Activation Fidaxomicin and OP1118 Inhibit C. difficile Stimulates HCO3-secretion, but Induces Toxin A- and B-mediated Inflammatory ASGE Hands-On Workshop: Mucosal Injury in Rat Duodenum Responses via Inhibition of NF-KB Activity Hemorrhoid Therapies Koji Maruta, Yasutada Akiba, Izumi Kaji, Hon Wai Koon, Jiani Wang, X Chen, CP Kelly, BJ Dunkin, N Gupta, A Foxx-Orenstein, Jonathan D. Kaunitz Charalabos Pothoulakis Dennis M. Jensen, SV Kantsevoy, MF McGee, Research Forum Research Forum EM Pauli, WA Qureshi, TJ Savides 8:15 AM 4:00 PM Hands-on Workshop S105bcd - McCormick Place 2677503 S102abc - McCormick Place 2682440 8:00 AM Intestine-specific Dual Oxidase Deficiency Predictors of Interobserver Variability (IOV) South Hall - McCormick Place 2716435 Lacks ATP-P2Y-mediated Luminal H2O2 Among Cytopathologists (CYPS) Evaluating 42 Y/O Media Consultant with Severe IBS Production in Mouse Duodenum and Cecum Pancreatic Endoscopic Ultrasounds-guided Fine Needle Aspiration (EUS-FNA) Cytology Lin Chang Yasutada Akiba, Koji Maruta, Izumi Kaji, Jonathan D. Kaunitz Specimens: A Multicenter Validation Study Postgraduate Course Case-based Sessions R Mounzer, CB Marshall, M Hall, VC Simon, 4:00 PM Research Forum BA Centeno, K Dennis, J Dhillon, F Fan, L Khazai, E450a - McCormick Place 2612209 8:45 AM S105bcd - McCormick Place 2679649 JB Klapman, S Komanduri, X Lin, David Lu, The 2016 Election: What It Means for S Mehrotra, V. Raman Muthusamy, R Nayar, Research Policy? Clostridia from the Gut Microbiome are A Paintal, Jianyu Rao, S Sams, JN Shah, TM Associated with Brain Functional Connectivity Folasade (Fola) P. May Tynan, Rabindra R. Watson, A Rastogi, SB Wani and Evoked Symptoms in IBS Clinical Symposium Topic Forum Jennifer S. Labus, Elaine Hsiao, J Tap, M Derrien, 8:20 AM 10:30 AM Arpana Gupta, B Le Nevé, R Brazeilles, C Grinsvall, S100C - McCormick Place 2596925 E450a - McCormick Place 2674420 L Ohman, H Törnblom, Kirsten Tillisch, M Simren, Standard and Alternative Approaches Emeran A. Mayer A Comparison of Right Colon Adenoma to Malignant Biliary Obstruction Research Forum Detection Rate (RADR) and Proximal Colon ADR V. Raman Muthusamy 2:20 PM (PADR) for CAP-assisted Total Water (CATW) vs CAP-assisted Water Exchanged (CAWE) Methods Clinical Symposium S403a - McCormick Place 2685788 in Screening Colonoscopy 10:15 AM Brain-gut Axis and Bariatric Surgery: Weight S401 - McCormick Place 2610771 JW Leung, A Melnik, J Pearcy, AW Yen, Loss and Changes in Brain Control of Feeding Felix W. Leung Endoscopic Management of Post-bariatric Behaviors are Mediated by Alterations in Amino Topic Forum Surgery Adverse Events Acids Metabolic Pathways 2:30 PM Rabindra R. Watson Arpana Gupta, Jennifer S. Labus, Erik Dutson, E450a - McCormick Place 2670129 Clinical Symposium Kareem Hamadani, Kristen Coveleskie, Jean Adenoma Detection - Where are We Now 2:50 PM Stains, Tiffany Ju, Anna Balioukova, Yijun Chen, and Where are We Going S401 - McCormick Place 2612089 Emeran A. Mayer, Claudia P. Sanmiguel Research Forum Felix W. Leung Neuropeptides and Mucosal Healing 2:37 PM Topic Forum Charalabos Pothoulakis S403a - McCormick Place 2677725 3:15 PM Research Symposium Colonic Mucosal Microbiome is Associated E450a - McCormick Place 2718984 3:00 PM with Mucosal MicroRNA Expression in Irritable Abdominal Compression Administered Early S105a - McCormick Place 2596871 Bowel Syndrome by the Colonoscopist Shortened Insertion Time GLP-2 Acutely Enhances Duodenal Swapna Mahurkar-Joshi, Jennifer S. Labus, of Water Exchange Colonoscopy SGLT1-mediated Glucose Absorption Jonathan Jacobs, Elizabeth J. Videlock, Y Hsieh, CW Tseng, Felix W. Leung via EGF Signaling and Neural Pathways Venu Lagishetty, Dimitrios Iliopoulos, Poster Session Izumi Kaji, Yasutada Akiba, Jonathan D. Kaunitz Emeran A. Mayer, Lin Chang 12:00 PM Research Forum Research Forum South Hall - McCormick Place 2675176 8:00 AM 3:11 PM S403a - McCormick Place 2678736 S403a - McCormick Place 2679405

16 uclahealth.org/gastro Comparison of Transoral Outlet Reduction Treatment with Direct-acting Antivirals Women’s Preferences for IBD Medical (TORE) Alone Versus with Gastroplasty Improves HBA1C in a Cohort of Veterans Therapy During Pregnancy (TORE-G): A Matched Cohort Analysis with Chronic Hepatitis C A Fairchild, T Kushner, FR Johnson, BE Sands, Rabindra R. Watson, Brian L. Huang, Tien S. Dong, Jihane N. Benhammou, U Mahadevan, A Ananthakrishnan, D Goyal, Neela Easwar, SS Irani, MC Larsen Jenna K. Kawamoto, Joseph R. Pisegna, Christina Y. Ha, M Bewtra Poster Session Folasade (Fola) P. May Clinical Symposium 12:00 PM Poster Session 2:00 PM South Hall - McCormick Place 2684749 12:00 PM E345a - McCormick Place 2682266 Do We Properly Diagnose Our Celiac Patients? South Hall - McCormick Place 2670752 Adverse Events Related to Endoscopic Three Year Follow Up in a Celiac Referral Center Eradication Therapy (EET) in Barrett’s Esophagus Aria Zand, Natalie E. Duran, Eric Esrailian, SUNDAY, MAY 7 (BE): Results from a Multicenter Cohort Study Daniel Hommes, Guy A. Weiss JC Obuch, B Cinnor, GL Austin, P Blatchford, Poster Session Substance P-regulated MicroRNA-31-3P Silencing M Boniface, BC Brauer, DS Early, 12:00 PM Enhances Mucosal Repair Following Colitis SA Edmundowicz, HT Hammad, CL Harris, South Hall - McCormick Place 2683562 Kai Fang, Ivy Ka Man Law, Dimitrios Iliopoulos, T Hollander, JB Klapman, VM Kushnir, Charalabos Pothoulakis B McNair, JN Shah, VC Simon, TM Tynan, Flat Spots are Unrecognized as Stigmata V. Raman Muthusamy, S Komanduri, SB Wani for Diagnoses of Definitive Diverticular Distinguished Abstract Plenary Hemorrhage in the Colon 2:20 PM Research Forum S105a - McCormick Place 2668890 9:15 AM Dennis M. Jensen, Mary Ellen Jensen, S501 - McCormick Place 2674320 Thomas O. Kovacs, Kevin A. Ghassemi, Mesenteric Adipose Tissue Derived Stromal Gordon V. Ohning, Marc Kaneshiro, Alireza Cells from Crohn’s Disease Patients Induce CGRP Significantly Regulates Appetite, Sedarat, Gareth Dulai, Gustavo A. Machicado Lactoferrin-dependent Protective Responses Energy Intake and Metabolism Peripherally Poster Session in Colonic Epithelial Cells and Mice with Colitis Daniel Sanford, John P. Vu, Suwan Oh, Leon 12:00 PM Jill M. Hoffman, Aristea Sideri, Jonathan J. Ruiz, Luong, Joseph R. Pisegna, Patrizia M. Germano South Hall - McCormick Place 2671620 JR Turner, Charalabos Pothoulakis, Iordanes Research Forum Karagiannides Lower Sustained Virologic Response in Patients 10:00 AM with Hepatocellular Carcinoma Treated for Distinguished Abstract Plenary S503 - McCormick Place 2686915 Hepatitis C with Direct Acting Antivirals 2:34 PM Brain Morphometry Distinguishes Two Distinct S105a - McCormick Place 2670164 Kelvin T. Nguyen, Peter Konyn, Gina Choi, IBS Subgroups Francisco A. Durazo, Steven-Huy Han, Substance P-induced Colonic Epithelial Cell- Clarence B. Le, Emeran A. Mayer, Kirsten Tillisch, Samantha Ramirez, Sammy Saab, secreted Exosomes Exacerbate Experimental Jennifer S. Labus Mohamed El-Kabany Colitis and Regulate Cell Proliferation and Research Forum Poster Session Migration via Exosomal MIR-21 2:12 PM 12:00 PM Kyriaki Bakirtzi, Dimitrios Iliopoulos, S502 - McCormick Place 2684650 Charalabos Pothoulakis South Hall - McCormick Place 2674822 Crohn’s Disease, Obesity, and High Crohn’s Orally Active Cathelicidin Mimic Veragenin Plenary Session Disease Genetic Risk are Associated with Parallel CSA13 Modulates Clostridium-associated 4:00 PM Changes in the Microbiome of the Cecal and Colitis in Mice via a Modification of Intestinal S12abc - McCormick Place 2679608 Sigmoid Mucosal-luminal Interface Microbiome Irritable Bowel Syndrome Jonathan Jacobs, Maomeng Tong, P Ruegger, Caroline C. Mussatto, Jiani Wang, Lin Chang D Li, T Haritunians, P Fleshner, E Vasiliauskas, Hon Wai Koon Postgraduate Course General Session A Ippoliti, G Melmed, DQ Shih, SR Targan, Poster Session 11:50 AM James Borneman, D McGovern, Jonathan Braun 12:00 PM Arie Crons Theatre - McCormick Place 2608812 Research Forum South Hall - McCormick Place 2682390 Novel Brain Imaging Techniques in IBS 4:42 PM S105bcd - McCormick Place 2685263 Pre-procedure Explanation Provided Adequate Emeran A. Mayer Insight for Patients to Opt for Scheduled Rome Foundation Lectureship Inspection of Endoscope Instrument Channels Unsedated Colonoscopy or On Demand 11:00 AM After Reprocessing Using a Prototype Video Sedation to Obviate Sedation Risks and S100ab - McCormick Place 2597358 Camera: A Pilot Study Post-procedure Burden — Prior Sedation Adarsh M. Thaker, Stephen Kim, Alireza Sedarat, Did Not Preclude Acceptance of These High Upper GI Bleeding Management: Tips from Rabindra R. Watson, V. Raman Muthusamy the Masters Value Options Topic Forum LL Strate, Felix W. Leung Dennis M. Jensen 8:30 AM Poster Session Meet-the-Professor Luncheons E450a - McCormick Place 2672434 12:00 PM 12:30 PM South Hall - McCormick Place 2680085 S502 - McCormick Place 2612104

Beyond the Scope 17 SUNDAY, MAY 7 (continued) Is Hemostasis with Doppler Endoscopic Probe The Impact of Capsule Endoscopy Guidance an Improvement Compared to Visualization on the Ability to Identify A Multilevel Quality Improvement Initiative Visually Guided Treatment of Severe Ulcer Small Bowel Pathologies to Improve Colorectal Cancer Screening in Hemorrhage? Neil B. Marya, Adarsh M. Thaker, a Managed Care Population Dennis M. Jensen, Mary Ellen Jensen, Daniel Eshtiaghpour, Raymond A. Addante, Christine Yu, Aria Zand, Eric Esrailian, Daniela Markovic, Jeffrey Gornbein, Stephen Kim, Alireza Sedarat, Daniel Hommes, Folasade P. May Thomas O. Kovacs, Kevin A. Ghassemi, V. Raman Muthusamy, Rabindra R. Watson Gordon V. Ohning, Marc Kaneshiro, Poster Session Poster Session Alireza Sedarat, Gareth Dulai, 12:00 PM 12:00 PM Gustavo A. Machicado South Hall - McCormick Place 2677698 South Hall - McCormick Place 2680805 Poster Session The Use of Photodynamic Therapy in Characterization and Targeting of the Human 12:00 PM Epigenome in Ulcerative Colitis Pancreatic Cancer: Consensus Statement South Hall - McCormick Place 2671657 from an Expert Panel Marina Koutsioumpa, C Polytarchou, Morphological Brain Alterations and Changes Emmanuelle Faure, Iordanes Karagiannides, KK Wang, Timothy R. Donahue, GB Haber, in Hedonic Ingestive Behaviors Associated with Dimitrios Iliopoulos JM DeWitt, KJ Chang, RJ Shah, Bariatric Surgery V. Raman Muthusamy, A Mahipal, T Mang, Poster Session Arpana Gupta, Emeran A. Mayer, T Hasan, V Grover 12:00 PM Elizabeth Gallagher, Ravi Bhatt, Tiffany Ju, South Hall - McCormick Place 2676236 Poster Session Kristen Coveleskie, Jean Stains, Yijun Chen, 12:00 PM Clinical and Pathologic Evaluation of a New EUS Anna Balioukova, Jennifer S. Labus, Erik Dutson, South Hall - McCormick Place 2682812 Core Biopsy Needle: A Large Multicenter Trial Claudia P. Sanmiguel Time to Diagnostic Colonoscopy and DG Adler, LJ Taylor, V. Raman Muthusamy, Poster Session Colonoscopic Findings after Positive Fit in an G Parasher, N Thosani, AM Chen, 12:00 PM Ethnically Diverse Cohort of U.S. Veterans JM Buscaglia, HR Aslanian, A Siddiqui South Hall - McCormick Place 2679523 Jennifer Phan, Christine Yu, Mark Reid, Dean Poster Session Results of an Ongoing Randomized Controlled Ehrlich, Lisa Lin, Tina R. Storage, Nimah 12:00 PM Trial Comparing the Diagnostic Efficiency Jamaluddin, Doantrang Dinh, Elizabeth Aby, South Hall - McCormick Place 2671465 of Early Deployment of Video Capsule Versus Purnima Bharath, Joseph R. Pisegna, Endoscopic Ultrasound has a Critical Role in the Standard of Care for the Management of Folasade (Fola) P. May Evaluation of Bile Duct Dilation of Unclear Etiology Non-hematemesis Gastrointestinal Bleeding Poster Session Jennifer Phan, Phillip Ge, Ani Kardashian, Neil B. Marya, SA Jawaid, A Foley, K Patel, 12:00 PM Stephen Kim, Alireza Sedarat, Rabindra R. AH Rupawala, S Han, D Kaufman, L Maranda, South Hall - McCormick Place 2674724 Watson, V. Raman Muthusamy J Tennyson, CA Marshall, K Bhattacharya, DR Cave Water Exchange (WE) Significantly Raises Poster Session Poster Session Adenoma Detection Rate (ADR) Compared 12:00 PM 12:00 PM with Water Immersion (WI) and Air Insufflation South Hall - McCormick Place 2677752 South Hall - McCormick Place 2679795 (AI) — Pooled Data from Two Multi-site Factors for Success in Endoscopic Submucosal Shared Gut Microbiome Dysbiosis in Crohn’s Randomized Controlled Trials (RCT) Dissection: A Western Experience Disease and Obesity Felix W. Leung, M Koo, S Cadoni, P Falt, Phillip Ge, WM Abidi, CC Thompson, H Aihara D Li, Jonathan Jacobs, Z Liu, Jonathan Braun, Y Hsieh, A Amato, M Erriu, P Fojtik, P Gallittu, Poster Session SR Targan, D McGovern C Hu, JW Leung, M Liggi, S Paggi, F Radaelli, 12:00 PM Poster Session E Rondonotti, V Smajstrla, CW Tseng, O Urban South Hall - McCormick Place 2686938 12:00 PM Poster Session South Hall - McCormick Place 2685227 12:00 PM Food Addiction and Its Association with South Hall - McCormick Place 2670271 Metabolic Complications Among Liver Suboptimal Interobserver Agreement (IOA) Transplant Recipients Amongst Cytopathologists (CYPS) for Pancreatic Where is the Bleeding Site in Patients with Cameron S. Sikavi, Melissa Jimenez, Endoscopic Ultrasound Fine Needle Aspiration Melena and Severe GI Hemorrhage Youssef P. Challita, Matthew R. Viramontes, (EUS-FNA) Cytology Specimens: A Multicenter Dennis M. Jensen, Mary Ellen Jensen, Ruby Allen, Michelle Mai, Negin Esmailzadeh, Validation Study Thomas O. Kovacs, Kevin A. Ghassemi, Elisa Moreno, Sammy Saab SB Wani, R Mounzer, M Hall, VC Simon, Gordon V. Ohning, Marc Kaneshiro, Poster Session BA Centeno, K Dennis, J Dhillon, F Fan, L Khazai, Alireza Sedarat, Gareth Dulai, 12:00 PM JB Klapman, S Komanduri, X Lin, David Lu, Gustavo A. Machicado South Hall - McCormick Place 2685334 S Mehrotra, V. Raman Muthusamy, R Nayar, Poster Session A Paintal, Jianyu Rao, S Sams, JN Shah, TM Tynan, 12:00 PM GLP-2 Acutely Ameliorates LPS-related Intestinal Rabindra R. Watson, A Rastogi, CB Marshall South Hall - McCormick Place 2671603 Permeability in Rats Poster Session Yasutada Akiba, Izumi Kaji, Koji Maruta, 12:00 PM Jonathan D. Kaunitz South Hall - McCormick Place 2674352 Poster Session 12:00 PM South Hall - McCormick Place 2679728

18 uclahealth.org/gastro MONDAY, MAY 8 Corticotropin-releasing Hormone Receptor 2 Crosstalk Between Insulin/IGF-1 Receptor and (CRHR2) Mediates Enteric Glial Cell Function G Protein-coupled Receptor (GPCR) Signaling Superior Endoscopic and Deep Remission During Colitis Pathways Stimulates YAP Function in Pancreatic Outcomes in Adults with Moderate to Severe Jill M. Hoffman, Jonathan J. Ruiz, Ductal Adenocarcinoma Cancer (PDAC) Cells Crohn’s Disease Managed with Treat to Target Charalabos Pothoulakis Fang Hao, Qinhong Xu, Jan V. Stevens, Approach Versus Clinical Symptoms: Data Research Forum James Sinnett-Smith, Enrique Rozengurt From CALM 4:00 PM Poster Session JF Colombel, R Panaccione, P Bossuyt, M Lukas, S104 - McCormick Place 2684031 12:00 PM FJ Baert, T Vanasek, A Danalioglu, G Novacek, Bitter Taste Receptors, T2R138 and T2R16, South Hall - McCormick Place 2674487 A Armuzzi, X Hebuterne, SP Travis, S Danese, are Induced in the Large Intestine of Male Crosstalk Between Protein Kinase D1 (PKD1) W Reinisch, WJ Sandborn, P Rutgeerts, Daniel and Female Mice on a High Fat Diet in a and P21-activated Kinase (PAK) in Intestinal Hommes, S Schreiber, E Neimark, B Huang, Microbiota-dependent Manner Epithelial Cells: Identification of a Novel Q Zhou, JH Petersson, K Wallace, AM Robinson, Filippo Caremoli, Jennifer Huynh, Phosphorylation Site within the N-terminal RB Thakkar, GR D’Haens Venu Lagishetty, Jonathan Jacobs, Region of PKD1 Distinguished Abstract Plenary Jonathan Braun, Catia Sternini James Sinnett-Smith, Jen-Kuan Chang, 5:16 PM Research Forum Enrique Rozengurt E345a - McCormick Place 2716554 4:45 PM Poster Session H3K4ME3 Affects Glucose Metabolism S104 - McCormick Place 2681069 12:00 PM and Lipid Content in Pancreatic Cancer Cost Comparison Between Deployment of Early South Hall - McCormick Place 2676255 Marina Koutsioumpa, M Hatziapostolou, Capsule Endoscopy Versus Standard of Care Dysregulation of the Long-noncoding RNA, C Polytarchou, Swapna Mahurkar-Joshi, in Patients Presenting with Non-hematemesis GHRLOS, in Irritable Bowel Syndrome Dimitrios Iliopoulos Gastrointestinal Bleeding Elizabeth J. Videlock, Swapna Mahurkar-Joshi, State-of-the-Art Lecture SA Jawaid, Neil B. Marya, M Hicks, K Patel, Dimitrios Iliopoulos, Charalabos Pothoulakis, 8:30 AM CA Marshall, A Foley, L Maranda, K Bhattacharya, Emeran A. Mayer, Lin Chang S101b - McCormick Place 2671552 DR Cave Poster Session IBD Systems Biology & Drug Discovery Topic Forum 12:00 PM Dimitrios Iliopoulos 9:15 AM South Hall - McCormick Place 2676050 Research Symposium E350 - McCormick Place 2684068 Endoscopic Ultrasound Guided Fine Needle Core 3:00 PM Effect of Management Practices on Length of Liver Biopsy Using a Novel 19 Gauge Needle S102abc - McCormick Place 2596924 Stay for Non-hematemesis Gastrointestinal with Modified One Pass Wet Suction Technique Planning for an Academic Career Bleeding Patients Receiving Early Capsule J Nieto, Huda Khaleel, Youssef P. Challita, During Fellowship Endoscopy vs Standard of Care Melissa Jimenez, TH Baron, K Hathaway, Lin Chang SA Jawaid, Neil B. Marya, CA Marshall, A Foley, LR Walter, K Patel, A Lankarani, M Herman, K Bhattacharya, DR Cave D Holloman, Sammy Saab Committee Sponsored Symposium 12:30 PM Topic Forum Poster Session S104 - McCormick Place 2597413 9:22 AM 12:00 PM E350 - McCormick Place 2684130 South Hall - McCormick Place 2675844 Long Non-coding RNA (lncRNA) Profiling Reveals Overexpression of UCA1 and CCAT1 in Human Altered Brain Structure and Functional Expression Profiling of Sigmoid Biopsies in Colonocytes Stimulated by Neurotensin and in Connectivity and its Relation to Pain Perception Irritable Bowel Syndrome vs Healthy Controls Colonic Mucosal Tissues from Ulcerative Colitis in Female Adolescents with Irritable Bowel Elizabeth J. Videlock, Swapna Mahurkar-Joshi, (UC) Patients Syndrome Dimitrios Iliopoulos, Charalabos Pothoulakis, Ivy Ka Man Law, David M. Padua, Ravi Bhatt, Arpana Gupta, Jennifer S. Labus, Emeran A. Mayer, Lin Chang Dimitrios Iliopoulos, Charalabos Pothoulakis Lonnie K. Zeltzer, Jennie Tsao, Kirsten Tillisch Poster Session Research Forum Poster Session 12:00 PM 2:45 PM 12:00 PM South Hall - McCormick Place 2680576 S104 - McCormick Place 2679439 South Hall - McCormick Place 2677034 How are Patient Outcomes Impacted by Value Gene Expression Profiling Identifies Bitter Taste Receptor T2R138 in Mouse Based Health Care Delivery for Inflammatory CDKN2B-AS1 as a Long Non-coding RNA Enteroendocrine Cells is a Sensor for the Bowel Diseases Associated with IBD and Regulated by TGF-BETA Quorum Sensing Molecule, ACYL-homoserine Aria Zand, Elizabeth Aredas, Natalie E. Duran, Carl R. Rankin, Dimitrios Iliopoulos, Lactone Courtney A. DiNicola, Precious Lacey, Charalabos Pothoulakis, David M. Padua Jennifer Huynh, Filippo Caremoli, James Sinnett- Alexandria H. Arenas, Daniel Hommes Research Forum Smith, Steven H. Young, R Latorre, R De Giorgio, Poster Session 3:15 PM RA Liddle, Enrique Rozengurt, Catia Sternini 12:00 PM S104 - McCormick Place 2676764 Poster Session South Hall - McCormick Place 2683704 12:00 PM South Hall - McCormick Place 2676938

Beyond the Scope 19 MONDAY, MAY 8 (continued) Retained Esophageal Contrast on Modified Trauma Severity and Lack of Confiding in Others Barium Swallow Study Predicts Abnormal Increases Risk of Having Irritable Bowel Syndrome Immune Regulatory Effect of Phosphatase High Resolution Esophageal Manometry Tiffany Ju, Bruce D. Naliboff, Wendy Shih, and Tensin Homologue (PTEN) in the Gut is David Lin, Jeremy Wang, Andrew A. Erman, A Presson, Cathy Liu, Arpana Gupta, Associated with Extraintestinal Inflammation Dinesh Chhetri, Jeffrey Conklin Emeran A. Mayer, Lin Chang E Im, Charalabos Pothoulakis, SH Rhee Poster Session Poster Session Poster Session 12:00 PM 12:00 PM 12:00 PM South Hall - McCormick Place 2677560 South Hall - McCormick Place 2676495 South Hall - McCormick Place 2674034 Sex-dependent Alterations of Colonic Epithelial Increased Sleep Disturbances in Irritable Bowel Permeability in Irritable Bowel Syndrome TUESDAY, MAY 9 Syndrome (IBS) Patients is Associated with Muriel H. Larauche, Swapna Mahurkar-Joshi, Greater Symptom Severity and Decreased Mandy Biraud, Tiffany Ju, Nafeesa Islam, Race Predicts SVR 12 Among Patients with Quality of Life Emeran A. Mayer, Lin Chang Hepatitis C Treated with Direct-acting Antivirals in a Large Veterans Affairs Cohort Amir Kalani, Bruce D. Naliboff, Wendy Shih, Poster Session Emeran A. Mayer, Lin Chang 12:00 PM Jihane N. Benhammou, Tien S. Dong, R Dixit, Jenna K. Kawamoto, Vivek Dixit, Folasade (Fola) Poster Session South Hall - McCormick Place 2679714 P. May, Debika Bhattacharya, Joseph R. Pisegna 12:00 PM Statins Inhibit Proliferation of Pancreatic Ductal South Hall - McCormick Place 2677469 Adenocarcinoma Cancer (PDAC) Cells Acting Distinguished Abstract Plenary Synergistically with Metformin and Inhibitors 10:14 AM P21-activated Kinase (PAK)-mediated S502 - McCormick Place 2685295 Phosphorylation of Protein Kinase D1 (PKD1) of MEK and MTOR Triggers Membrane Dissociation of PKD1 in Qinhong Xu, Fang Hao, Yinglan Zhao, Irritable Bowel Syndrome — Looking Through Intestinal Epithelial Cells: Identification of a James Sinnett-Smith, Enrique Rozengurt the Crystal Glass Novel Mechanism in the Regulation of PKD1 Poster Session Lin Chang Localization 12:00 PM Meet-the-Professor Luncheons Jen-Kuan Chang, James Sinnett-Smith, R Jacamo, South Hall - McCormick Place 2674682 12:30 PM Steven H. Young, O Rey, Enrique Rozengurt Statins Potently Inhibit YAP Activity and S405 - McCormick Place 2612378 Poster Session Proliferation of Mouse Pancreatic Cells Isolated Rapid LPS Transport During Long-chain Fatty 12:00 PM from KC and KPC Mice Acid Absorption in Rat Small Intestine South Hall - McCormick Place 2676086 Fang Hao, Jen-Kuan Chang, James Sinnett-Smith, Koji Maruta, Yasutada Akiba, Izumi Kaji, Predictors of Quality of Life in Irritable Bowel Guido Eibl, Hui-Hua Chang, Enrique Rozengurt Jonathan D. Kaunitz Syndrome Compared to Health Controls Poster Session Research Forum Raymond A. Addante, Bruce D. Naliboff, 12:00 PM 3:12 PM Wendy Shih, A Presson, Kirsten Tillisch, South Hall - McCormick Place 2674711 S101a - McCormick Place 2679691 Emeran A. Mayer, Lin Chang Statins Potently Inhibit YAP Function Role of MU and Delta Opioid Receptors and Poster Session and Proliferation of Pancreatic Ductal Their Ligands, Î’-Endorphin and Pre-pro- 12:00 PM Adenocarcinoma Cancer (PDAC) Cells enkephalin, In Stress-induced Visceral Analgesia South Hall - McCormick Place 2682803 Fang Hao, Qinhong Xu, Yinglan Zhao, in Male and Female Mice Progression of Chronic Kidney Disease is James Sinnett-Smith, Steven H. Young, Muriel H. Larauche, Nabila Moussaoui, Mandy Ameliorated by Direct Acting Antivirals in Jan V. Stevens, Enrique Rozengurt Biraud, Won Ki Bae, W Walwyn, Yvette Tache Patients Treated for Chronic Hepatitis C Virus Poster Session Research Forum Infection Resulting in Improved GFR Outcomes 12:00 PM 4:24 PM Elizabeth Aby, Tien S. Dong, South Hall - McCormick Place 2676000 S101b - McCormick Place 2685037 Debika Bhattacharya, Jenna K. Kawamoto, The Trans-golgi Network Protein Aftiphilin Issues in the Endoscopic Management Joseph R. Pisegna, Jihane N. Benhammou is Involved in Maintaining Colonic Epithelial of Lower GI Bleed Poster Session Cell Integrity During Colonic Inflammation Dennis M. Jensen 12:00 PM Ivy Ka Man Law, Charalabos Pothoulakis Topic Forum South Hall - McCormick Place 2676125 Poster Session 11:15 AM Protein Kinase D (PKD) Mediates Yes-associated 12:00 PM S105bcd - McCormick Place 2718985 Protein (YAP) Activation in Response to South Hall - McCormick Place 2679473 A Pilot Study of IGG4 Staining in EoE: G Protein-couples Receptor Activation in An Unreliable Marker of Disease Activity Intestinal Epithelial Cells: Identification of a Novel Crosstalk Between PKD and YAP Amanda Pope, Bita V. Naini, Maria Garcia-Lloret, Kevin A. Ghassemi, Elizabeth A. Marcus, Jia Wang, James Sinnett-Smith, Enrique Rozengurt Martin G. Martin, Laura Wozniak Poster Session Poster Session 12:00 PM 12:00 PM South Hall - McCormick Place 2676175 South Hall - McCormick Place 2675075

20 uclahealth.org/gastro Altered Colonic Motor Response to Stress Diminishing Role of Liver Biopsy for Hepatitis C Insertion Water Exchange (WE) Minimized in Alzheimer Disease Transgenic Mouse is in Liver Transplant Recipients Multitasking-related Distraction from Mucosal Improved by Peripheral TNF-ΑΑ Modulation Elizabeth Aby, Melissa Jimenez, Jonathan Grotts, Inspection During Withdrawal Inspection — Mulugeta Million, Hung Pham, Aleksandra Vatche G. Agopian, Samuel W. French, A Plausible Explanation for Enhanced Adenoma Poteshkina, Peruzo Eslami, Izumi Kaji, Ronald W. Busuttil, Sammy Saab Detection Rate Shuping S. Wu, Muriel H. Larauche Poster Session Y Hsieh, H Yang, CW Tseng, M Koo, Felix W. Leung Poster Session 12:00 PM Poster Session 12:00 PM South Hall - McCormick Place 2671901 12:00 PM South Hall - McCormick Place 2684346 Duodenoscope Reprocessing Practice Patterns South Hall - McCormick Place 2669870 An Investigation of BMI and Sex-related in the U.S. Endoscopy Centers: A Survey Study Relative Preservation of TREG Function in Alterations in Intrinsic Brain Connectivity Adarsh M. Thaker, V. Raman Muthusamy, TL1A-TG Mice Under Germ-free Condition of the Reward and Interoceptive Brain Regions Rabindra R. Watson, Alireza Sedarat, K Kumagai, M Sidhu-Varma, Y Shimodaira, Arpana Gupta, Emeran A. Mayer, ML Kochman, AS Ross, Stephen Kim N Jacob, Y Kanazawa, Jonathan Jacobs, Claudia P. Sanmiguel, Ravi Bhatt, Tiffany Ju, Poster Session Venu Lagishetty, JP Abraham, Y Ye, J Luu, Amanat Bal, Kirsten Tillisch, Bruce D. Naliboff, 12:00 PM RB Sartor, M Fukata, SR Targan, DQ Shih Jennifer S. Labus, Lisa A. Kilpatrick South Hall - McCormick Place 2676548 Poster Session Poster Session Enteric Glial Cells (EGCS) in the Colonic 12:00 PM 12:00 PM Myenteric Plexus are Involved in Abdominal South Hall - McCormick Place 2679983 South Hall - McCormick Place 2676366 Surgery (AS)-induced Inhibition of Colonic Resilience is Associated with Early Life Stress Characteristics and Healthcare Burden of Propulsive Function in Rates and HPA Axis Response in IBS Osteoporotic Fractures in Patients with Cirrhosis Pu-Qing Yuan, Yvette Tache Sarah Park, Bruce D. Naliboff, Wendy Shih, Arpan A. Patel, Jonathan Baghdadi, Poster Session Angela Presson, Tiffany Ju, Lisa A. Kilpatrick, S Silverman, Sammy Saab, S Vinay 12:00 PM Arpana Gupta, Emeran A. Mayer, Lin Chang Poster Session South Hall - McCormick Place 2682651 Poster Session 12:00 PM Fear of the Unknown as an Unique Source 12:00 PM South Hall - McCormick Place 2677420 of Stress for More Severe IBS Patients South Hall - McCormick Place 2675074 Constipation in 6-hydroxydopamine Rat Model JM Lackner, Emeran A. Mayer, AC Braun, Survey of Current Practice Patterns for Per of Parkinson’s Disease and Effect of Ghrelin BM Quigley Oral Endoscopic Myotomy (POEM) Agonist HM01 Poster Session David Lin, Stephen Kim, Rabindra R. Watson, Izumi Kaji, Artem Minalyan, Nabila Moussaoui, 12:00 PM V. Raman Muthusamy, MA Khashab, Yasutada Akiba, Jonathan D. Kaunitz, South Hall - McCormick Place 2671334 GG Ginsberg, Alireza Sedarat Yvette Tache, Lixin Wang Gut Microbiome Dysbiosis in Crohn’s Disease Poster Session Poster Session is Also Associated with Disease Severity 12:00 PM 12:00 PM South Hall - McCormick Place 2679763 D Li, , South Hall - McCormick Place 2682562 Jonathan Jacobs, Jonathan Braun SR Targan, D McGovern Where Fit Falls Short: Why Patients Do Not Dietary Tryptophan Intake and Risk of Incident Poster Session Attend Diagnostic Colonoscopy After Positive Crohn’s Disease and Ulcerative Colitis 12:00 PM Fecal Immunochemical Testing Jenny Sauk, H Khalili, A Ananthakrishnan, South Hall - McCormick Place 2685276 Christine Yu, Jennifer Phan, Mark W. Reid, P Lochhead, J Richter, AT Chan Heightened Awareness of Body Sensations and Dean Ehrlich, Lisa Lin, Tina R. Storage, Poster Session Symptoms Distinguishes Brain Morphology Nimah Jamaluddin, Doantrang Dinh, 12:00 PM in the Somatosensory Cortex Across Elizabeth Aby, Purnima Bharath, South Hall - McCormick Place 2685027 Gastrointestinal Disorders Joseph R. Pisegna, Folasade (Fola) P. May Digital Single-operator Cholangioscopy Beatrix Krause, Nathan Sumarsono, Poster Session and Indeterminate Biliary Strictures: Jennifer S. Labus, Cody Ashe-McNalley, 12:00 PM Improved Visual Optics Enhance the Yield Cathy Liu, Bruce D. Naliboff, Emeran A. Mayer South Hall - McCormick Place 2680719 of Targeted Biopsies Poster Session Mahmoud Omar, Dean Ehrlich, Stephen Kim, 12:00 PM SM Saleh, H Zaghla, EA Rewisha, South Hall - McCormick Place 2684238 Francisco A. Durazo, Saurabh S. Mukewar, Alireza Sedarat, Rabindra R. Watson, Impact of Rifaximin on Health-related Quality V. Raman Muthusamy of Life in Patients with Diarrhea-predominant Irritable Bowel Syndrome Poster Session BD Cash, Z Heimanson, 12:00 PM Lin Chang South Hall - McCormick Place 2672785 Poster Session 12:00 PM South Hall - McCormick Place 2683922

Beyond the Scope 21 non-profit organization u.s. postage PAID Vatche and Tamar Manoukian ucla Division of Digestive Diseases 405 Hilgard Ave BOX 956949, 2114 PVUB Los Angeles, CA 90095-6949

UCLA Gastroenterology and GI Surgery ranked No. 5 in the nation by U.S.News & World Report in its 2016-2017 survey. UCLA Health hospitals in Westwood and Santa Monica ranked No. 5 in the nation.

UCLA VATCHE AND TAMAR UCLA Digestive Diseases UCLA Digestive Diseases UCLA Health – Santa Clarita MANOUKIAN DIVISION OF 100 UCLA Medical Plaza #205 200 UCLA Medical Plaza #365C 25775 McBean Parkway #214 Los Angeles, CA 90095 Los Angeles, CA 90095 Valencia, CA 90277 DIGESTIVE DISEASES 310-208-5400 310-825-1597 661-255-2420 CHIEFS Gary Gitnick, MD, FACG UCLA Digestive Health UCLA Interventional Endoscopy UCLA Health – Santa Monica and Nutrition Clinic 100 UCLA Medical Plaza #205 1223 16th Street #3100 Eric Esrailian, MD, MPH 100 UCLA Medical Plaza #303 Los Angeles, CA 90095 Santa Monica, CA 90404 [email protected] 310-582-6240 Los Angeles, CA 90095 200 UCLA Medical Plaza #365C 310-206-6279 BUSINESS DEVELOPMENT Los Angeles, CA 90095 UCLA Health – Thousand Oaks Trisha James, MBA UCLA Center for Inflammatory 1223 16th Street #3100 100 Moody Court #200 [email protected] Bowel Diseases Santa Monica, CA 90404 Thousand Oaks, CA 91360 805-418-3500 DEVELOPMENT 100 UCLA Medical Plaza #345 310-267-3636 Laurel Zeno Los Angeles, CA 90095 UCLA Health – Toluca Lake* [email protected] 855-IBD-UCLA UCLA Health – Porter Ranch *EIMG Patients Only 855-423-8252 19950 Rinaldi Street #300 4323 West Riverside Drive FINANCE AND OPERATIONS Porter Ranch, CA 91326 Burbank, CA 91050 Tonishia Boyle UCLA Pfleger Liver Institute 818-271-2400 [email protected] 200 UCLA Medical Plaza #214 818-556-2700 Los Angeles, CA 90095 UCLA Health – Redondo Beach CONTRIBUTING WRITER 310-794-7788 514 North Prospect Avenue UCLA Health – Westlake Village Dan Gordon 1250 La Venta Drive #211 Redondo Beach, CA 90277 Westlake Village, CA 91361 310-937-8555 DESIGN 805-494-6920 Oglesby Design

Go to uclahealth.org/gastro to learn more about the UCLA Vatche and Tamar Manoukian Division of Digestive Diseases.

A report of the UCLA Vatche and Tamar Manoukian Division of Digestive Diseases David Geffen School of Medicine at UCLA | Copyright © 2017 UCLA Vatche and Tamar Manoukian Division of Digestive Diseases All rights reserved. ii uclahealth.org/gastro