Finding the cause of IBD - genes, bugs or diet?

Thank you for listening to this podcast, where Frontline Gastroenterology Trainee Editor Dr Philip Smith talks to Dr Charlie Lees, Consultant Gastroenterologist at the Western General Hospital, Edinburgh and honorary senior lecturer at the University of Edinburgh, about Frontline IBD. The podcast is an accompaniment to the Frontline Gastroenterology Twitter Debate (#FGDebate) held on Tuesday 14th October 2014 at 8-9pm GMT, entitled, 'Frontline IBD: Finding the cause of IBD – genes, bugs or diet?'. A summary of this debate can be found at: https://storify.com/FrontGastro_BMJ/frontline-ibd-finding-the-cause-of-ibd-genes-bugs Prior to the debate Dr Charlie Lees said: 'The inflammatory bowel diseases, Crohn’s disease and ulcerative colitis, are common in the Western world affecting about 1 in 200 individuals. In recent years incidence has increased dramatically in developing countries in parallel with the adoption of a Western lifestyle. Whilst the precise aetiology of IBD remains illusive the currently held paradigm is of dysregulated immune responses to commensal gut bacteria in genetically susceptible individuals. Gene discovery in IBD has seen unparalleled success in complex diseases. Nearly 200 disease genes have been identified. These findings have started to yield fruit with important insights into disease biology. However they also demonstrate the underlying complexity of disease pathogenesis. Furthermore, they only appear to explain around one quarter of phenotypic variance – ie why an individual develops disease. Much attention has now start to focus on the role of the gut microbiota in IBD. There is clearly reduced microbial diversity in IBD patients, but it remains unknown which critical aspects of the observed dysbiosis are potentially causal or simply the effect of underlying inflammation. Moreover, the interplay between environmental factors, notably antibiotic exposure and habitual diet, underlying genetic variation and the gut microbiota are only just starting to be explored. In this Frontline Gastroenterology twitter debate we will explore these issues and discuss how present data, planned and future studies can / should address this critical question. How will we find out what causes IBD to develop? Will this knowledge help us prevent the disease from developing in high-risk individuals? Are the environmental triggers for disease onset the same as those for disease flare in patients with established disease? Will these findings bring us closer to a ‘cure’ or at least prolonged remission in those with established disease?. The purpose of the podcast is to 'fill any gaps' the #FGDebate may have left. Dr Charlie Lees has also provided the slides he used in #FGDebate to help those interested understand the issues associated with IBD and IBD research. We hope you enjoy this and it is informative. View the slides: http://goo.gl/ZjMpfU Don't miss the next #FGDebate on Tuesday 11th November 2014 at 8-9pm by Prof Sir Ian Gilmore - "Frontline Hepatology: Alcohol - our favourite drug and everyone's problem".