Target Audience:

This activity has been designed to meet the educational needs of gastroenterologists and other healthcare providers involved in the care of patients with irritable bowel syndrome (IBS).

Learning Objectives:

After completing this program, participants should be better able to

  • Describe the prevalence and symptoms of various causes of persistent diarrhea that may mimic IBS, such as small intestinal bacterial/fungal overgrowth, celiac disease, bile acid malabsorption, congenital sucrase-isomaltase deficiency (CSID), and other carbohydrate malabsorption syndromes.
  • Incorporate current diagnostic strategies to differentiate among the causes of persistent diarrhea seen in clinical practice, particularly among patients with suspected IBS.
  • Summarize the benefits and limitations of current treatment strategies for CSID and other conditions associated with persistent diarrhea.

Provided by

This event is neither sponsored by nor endorsed by ACG.

Supported by an educational grant from QOL Medical, LLC.

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Welcome & Introductions

Brooks D. Cash, MD, FACG

All Cases of Bloating and Gas Are Not IBS: The Role of SIBO/SIFO

Satish S. Rao, MD, PhD, FRCP

Recognizing Carbohydrate Maldigestion and Celiac Disease

Lucinda Harris, MS, MD, FACG

When It's Not IBS: Less Common Causes of Unexplained Diarrhea

Lin Chang, MD

Panel Discussion and Q&A



Dan and Lillie Sterling Professor of Medicine
Chief, Gastroenterology, Hepatology, and Nutrition
UT Health Science Center at Houston
Houston, Texas

Dr. Brooks D. Cash is the chief of the Gastroenterology Division at the UT Health Science Center and the codirector of the Ertan Digestive Disease Center at Memorial Hermann. He holds the rank of professor of medicine at the UT McGovern Medical School and the Uniformed Services University of the Health Sciences in Bethesda, Maryland. Board certified in gastroenterology, he has demonstrated professional excellence that has resulted in his election to fellowships in the American College of Physicians, the American College of Gastroenterology, the American Gastroenterological Association (AGA), and the American Society for Gastrointestinal Endoscopy. Dr. Cash served for 24 years in the US Navy, retiring in 2013 with the rank of captain. While in the navy, he served as chief of gastroenterology, chief of medicine, and deputy commander for medicine at the Bethesda Naval Hospital and the Walter Reed Army Medical Center. His clinical positions included gastroenterology consultant to the US Navy surgeon general, attending physician to Congress, and White House Medical Unit staff. Prior to joining UT in 2018, he was the chief of gastroenterology at the University of South Alabama in Mobile. A recognized international expert in the field of IBS and other functional gastrointestinal disorders, he has chaired numerous professional society committees and meetings.

Dr. Cash has served on the Rome Committee for Functional Gastrointestinal Disorders and has authored over 200 articles and book chapters on a wide variety of gastrointestinal topics, including IBS and chronic constipation, opioid-induced constipation, colorectal cancer screening, CT colonography, gastroesophageal reflux disease, Barrett's esophagus, medical education techniques, and evidence-based medicine. Active in clinical research and education, he is an associate editor for the American Journal of Gastroenterology, an editorial board member and reviewer for multiple internal medicine and gastroenterology medical journals, and a sought-after lecturer at national and international scientific meetings.


Consultant/Speaker: Allergan, Salix Pharmaceuticals, Takeda Pharmaceuticals
Consultant: Arena Pharmaceuticals


Vice Chief, Vatche and Tamar Manoukian
Codirector, G. Oppenheimer Center for Neurobiology of Stress and Resilience
David Geffen School of Medicine at UCLA
Los Angeles, California

Dr. Lin Chang is a professor of medicine and vice chief of the Vatche and Tamar Manoukian Division of Digestive Diseases in the Department of Medicine at the David Geffen School of Medicine at UCLA. She serves as a codirector of the G. Oppenheimer Center for Neurobiology of Stress and Resilience at UCLA. She is also the program director of the UCLA Gastroenterology Fellowship Program. Dr. Chang's clinical expertise is in disorders of gut-brain interactions (also known as functional gastrointestinal disorders). Her research focuses on the pathophysiology, diagnosis, and treatment of these disorders, particularly IBS. She is a fellow of the American College of Gastroenterology and the AGA. She has served as the clinical research councilor of the AGA's Governing Board. She previously served as president of the American Neurogastroenterology and Motility Society (ANMS) and is a member of the Rome Foundation's Board of Directors.


Honorarium/Speaker: Arena Pharmaceuticals, Ironwood Pharmaceuticals, Cosmo, Shire, Takeda Pharmaceuticals
Advisory Board: Arena Pharmaceuticals, Ironwood Pharmaceuticals, Cosmo
Speaker for Nonbranded Interview: Shire, Takeda Pharmaceuticals
Advisor/Stock Options: ModifyHealth
Grant Funding/Research Study: Arena Pharmaceuticals, Vanda, AnX Robotica


J. Harold Harrison, MD, Distinguished University Chair in Gastroenterology
Professor of Medicine
Director, Neurogastroenterology and Motility
Director, Digestive Health Clinical Research Center
Augusta University Medical Center
Medical College of Georgia
Augusta, Georgia

Dr. Satish S. C. Rao is the J. Harold Harrison, MD, Distinguished University Chair in Gastroenterology, founding director of the Digestive Health Center and Digestive Health Clinical Research Center, director of neurogastroenterology and motility, and tenured professor of medicine at Augusta University in Georgia. He has served as the chief of the Division of Gastroenterology and Hepatology, director of the GI Service Line, and program director of the GI Fellowship Program. Previously, he was a professor of medicine and director of neurogastroenterology and motility at the University of Iowa's Carver College of Medicine. Dr. Rao received his MBBS from Osmania Medical College in Hyderabad, India; his PhD from the University of Sheffield, UK; and his Fellowship of the Royal College of Physicians (FRCP) designation in the UK. He completed his internal medicine training at several centers, plus a clinical research fellowship at the University of Liverpool, UK. He is American Board certified in medicine and gastroenterology. He is a former president of the American Neurogastroenterology and Motility Society. His research interests in the field of neurogastroenterology and motility have focused on gaining mechanistic insights, developing novel diagnostic tools, and pioneering innovative treatments for common disorders, including constipation, dyssynergic defecation, fecal incontinence, IBS, food intolerance, gas and bloating, small intestinal bacterial and fungal overgrowth (SIBO/SIFO), and visceral pain. He was credited with discovering dyssynergic defecation, a problem that affects one-third of constipated patients, and its remedy, biofeedback therapy-as well as novel treatments and sensory adaptation training for rectal hypersensitivity. He pioneered several novel tests: translumbosacral anorectal magnetic stimulation for pelvic floor neuropathy, esophageal balloon distension for chest pain, and fructose and fructan breath tests. He developed the first method for examining bidirectional gut and brain interactions in humans. His latest invention, translumbosacral neuromodulation therapy (TNT), is revolutionizing the treatment of fecal incontinence. He has been awarded four patents. Dr. Rao has been a National Institutes of Health-funded principal investigator for 20 years and currently holds $10.6 million in NIH UO-1 grants and $3.8 million in RO-1 grants. Dr. Rao has edited 10 books, including Handbook of GI Motility (2015) and Clinical and Basic Neurogastroenterology and Motility (2020). He has published over 500 peer-reviewed articles with 22,300 citations, and he holds an H index of 87 and an i10 index of 235. An astute clinician, Dr. Rao has been selected as one of the best doctors in America and America's top doctors for over 25 consecutive years. He has mentored over 100 physicians from across the world, many of whom are leaders and professors in their own countries. Thirty of his mentees have received national or international research awards, a testament to his dedication as a distinguished mentor. He has been invited to lecture in 35 countries as a visiting professor. These include invitations to provide live demonstrations of motility and novel TNT procedures and to train gastroenterologists and fellows globally and at multiple institutes in India and across five continents. Dr. Rao has received the three highest meritorious honors from the AGA: the Distinguished Clinician Award, the Masters Award for Outstanding Clinical Research, and the Distinguished Educator Award. He received the American College of Gastroenterology's Auxiliary Research Award, the Senior Clinical Investigator Award from the International Foundation for Functional GI Disorders, the Distinguished Award for Faculty Excellence from the University of Iowa's Board of Regents, the Dr. PN Chuttani Oration (the highest honor of the Indian Society of Gastroenterology), Augusta University's Distinguished Research Award, and the Medical College of Georgia's Distinguished Faculty Award. He was also named an honorary diplomate/fellow of the Mexican Society of Gastroenterology. Dr. Rao is one of a rare breed of academicians: a "triple threat," he has excelled as an internationally renowned researcher, distinguished educator, and outstanding physician.


Honorarium/Advisory Board: Ironwood Pharmaceuticals, Neurogut Inc., Progenity, QuinTron, Takeda Pharmaceuticals, Valeant Pharmaceuticals, Vibrant
Consultant: Ironwood Pharmaceuticals, Progenity, Takeda Pharmaceuticals
Grant Research: Progenity, Valeant Pharmaceuticals, Vibrant
Advisory Board/Consultant/Stock: In Control Medical


Associate Professor of Medicine
Mayo Clinic Alix School of Medicine
Scottsdale, Arizona

Dr. Lucinda A. Harris is currently an associate professor of medicine at the Mayo School of Medicine and a consultant for the Division of Gastroenterology and Hepatology at the Mayo Clinic in Scottsdale. She graduated from the University of Connecticut School Of Medicine. She completed her internal medicine residency at the New York Presbyterian Hospital of Columbia University and her fellowship in gastroenterology and hepatology at the New York Hospital/Weill Medical College of Cornell University. She was on the faculty in the Division of Gastroenterology and Hepatology at the Weill Cornell Medical School before moving to her current position at the Mayo Clinic.

At Mayo she codirected the motility group and has led an IBS patient support group. She is a current member of the Gastroenterology Fellowship Committee and serves as the gastroenterology department's education coordinator, supervising visiting GI fellows and medical students. She has actively mentored medical students, residents, and fellows over the years.

Dr. Harris is currently the president of the Phoenix GI Society. She is also active in professional organizations as a fellow of the American College of Gastroenterology, the AGA, and the American College of Internal Medicine. She is also a member of the American Neurogastroenterology and Motility Society. Her clinical and research interests include IBS, gastroparesis, chronic constipation, pelvic floor disorders, celiac disease, and autonomic disorders. She has written and lectured extensively on these topics.


Honorarium: AbbVie (formerly Allergan), Alnylam, Gemelli, Salix, Takeda Pharmaceuticals
Speaker/Advisory Board: AbbVie (formerly Allergan), Alnylam, Gemelli, Salix, Takeda Pharmaceuticals