Travelling the world on diarrhoea

In the nineteen seventies, any young researcher worth his salt, went to America to learn at the feet of the greats. I went to Texas and worked in the laboratory of Professor John Fordtran. John taught me that the most important quality for excellence in medical research was the imagination to ask the right questions and the courage to answer them. Methodology could be acquired.
I was in Dallas for a year and a half. During this time, I studied the intestinal transport of fluid and electrolytes absorption in patients with chronic diarrhoea using intestinal perfusion. Convinced that anal continence was also an important consideration for many patients, John devised some original tests for us to try out. These included infusing saline into the rectum until leakage took place and suspending a container under a small ball inserted into the rectum and pouring lead shot into the container until the ball fell out! This could only happen in Texas.
After leaving Texas, I became interested in the role of intestinal transit and patterns of contractile activity in diarrhoea, developing such concepts such as failure of colonic salvage and diarree motrice.
The Dallas experience also initiated a long and fruitful investigation into the physiology and pathophysiology of the anal sphincter. Someone had to do it!

  1. Read, N.W., Harford, W.V., Schmulen, A.C., Read, M.G., Santa Ana, C., Fordtran, J.S. (1979). A clinical study of patients with fecal incontinence and diarrhea. Gastroenterology 76: 747-756.
  2. Read, N.W., Krejs, G.J., Read, M.G., Santa Ana, C.A., Morawski, S.G. and Fordtran, J.S. (1980) Chronic diarrhea of unknown origin. Gastroenterology 78: 264-271.
  3. Read, N.W., Miles, C.A., Fisher, D., Holgate, A.M., Kime, N.D., Mitchell, M.A., Reeve, A.M., Roche, T.B. and Walker, M. (1980) Transit of a meal through the stomach small intestine, and colon in normal subjects and its role in the pathogenesis of diarrhea. Gastroenterology 79: 1276-1282.
  4. Read, N.W. (1982). Diarrhoea: the failure of colonic salvage. Lancet. Aug 28;2(8296):481-3.
  5. Read, N.W. (1986) Diarrhoea motrice. In: Clinics in Gastroenterology. Vol. 15, 657-686. W.B. Saunders.
  6. Rao, S.S.C., Read, N.W., Holdsworth, C.D. (1987) Is the diarrhoea of ulcerative colitis related to failure of salvage of carbohydrate. Gut 28: 1090-1094.
  7. Rao, S., Read, N.W., Bruce, C., Brown, C., Holdsworth, C.D. (1987) Studies on the mechanism of bowel disturbances in ulcerative colitis. Gastroenterology 93: 1013-1019.