Dr. Julian Walters

Biography

Professor Walters's principal interests include the molecular and cellular function of the small intestine, particularly the development and differentiation of mucosal epithelial cells and their effects on nutrient transport. His research also examines how inflammatory diseases of the intestine, such as celiac disease and Crohn's disease, can cause malabsorption and the changes in gene expression during active disease and the repair process. His recent work has resulted in a paradigm shift in the understanding of chronic Bile Acid Diarrhea (BAD), which is also known as Bile Salt Malabsorption and Bile Acid Malabsorption. He discovered that, apart from malabsorption, the underproduction of the ileal hormone FGF19 results in excessive hepatic bile acid synthesis that exceeds the normal capacity for absorption. His review showed that one-third of patients with IBS-D have BAD, which represents around 1% of the adult population. In patients with BAD, the production of FGF19 in the ileum is stimulated by bile acids, and blood levels of the hormone are low. Current drugs known as FXR agonists, specifically obeticholic acid, can stimulate the production of FGF19 and provide symptomatic improvement. Prof. Walters aims to increase awareness of BAD and develop new treatments that are well tolerated.

Research Interests