Nick Read » Research

Psychological influences on the gut

admin — Sun, 01 Mar 2009 09:24:52 +0000

The opportunity to retrain as a psychoanalytical psychotherapist sharpened my interest on the influence of the meaning of life experience on gut function and on the role of psychological therapies in treating gut illness. Collaboration with Professor Francis Creed in Manchester led to the award of a large dual centre grant funded by the Medical Research Council. This demonstrated that brief dynamic psychotherapy and SSRI antidepressants could lead to lasting improvements in symptoms of IBS that were unrelated to any alteration in gut physiology.

Read NW (1999). Harnessing the patient’s powers of recovery: The role of the psychotherapies in the irritable bowel syndrome. In Baillieres Best Pract Res Clin Gastroenterol. series. (Ed. Houghton. L .A. and Whorwell P. J.) 13(3):473-87.
Read, N.W, (2000) Bridging the gap between mind and body: do cultural and psychoanalytical concepts of visceral disease have an explanation in contemporary neuroscience? In EA Mayer and CB Saper (Eds) The Biological Basis for Mind Body Interactions. Progress in Brain Research 122, pp 424-443.
Creed F, Guthrie E, Read NW, Thompson D, Ratcliffe J, Fernandez L, Palmer S, Rigby C, Tomenson B. (2000) A randomised trial comparing the cost effectiveness of psychotherapy and antidepressants for severe irritable bowel syndrome. J Psychosom Res 48 (3): 102
Read NW. Panacea or Placebo (2002). What Nutritional Supplements mean to users. In Ransley J, Donnelly J and Read NW. Food and Nutritional Supplements in Health and Disease. Heidelberg. Springer-Verlag.
Read N.W. (2000). Cerebral activation in Irritable Bowel Syndrome. Gastroenterology. 119 (5): 1420-1420.
Hobbis I, Turpin G and Read NW (2002). The Prevalence of Abuse Experiences in Sufferers of Functional Bowel Disease
Creed, F., Ratcliffe, J., Fernandes, L., Palmer, S., Rigby, C., Tomenson, B., Guthrie, E., Read, N., Thompson, D. (2005). Outcome in severe irritable bowel syndrome with and without accompanying depressive, panic and neurasthenic disorders. Br J Psychiatry. 186: 507-515

Diagnostic Criteria for Irritable Bowel Syndrome Irritable Bowel Syndrome is one of the large number of...
Small Intestinal Transit and Motility A collaboration with Dr Immanuel Bergman from the Safety in...
Medical research From 1972 to 2002, I worked as a clinical scientist...

Emotional upset determines the persistence of gastroenteritis after the infection has gone

admin — Sun, 01 Mar 2009 09:22:31 +0000

About 10% of people develop persistent diarrhoea after an attack of gastroenteritis even though there is no evidence of an infective agent. Studies conducted by Dr Kok-Ann Gwee in collaboration with Drs Mike McKendrick and Professor Steve Collins from McMaster University in Ontario revealed that anxiety, depression and life trauma occurring at the time of the original infection predicted persistence of symptoms and inflammation. It was as if the gastroenteritis were recruited to express unresolved emotional issues. Further studies showed that the same principle applied to surgical trauma such as hysterectomy, and to infections in other parts of the body. Symptoms caused by psychological stress were likely to persist as long as the stress persisted.

Gwee, K.A., Graham, J.C., McKendrick, M.W., Collins, S.M., Marshall, J.S., Walters, S.J., Read, N.W. (1996). Psychometric scores and persistence of Irritable Bowel after infectious diarrhoea. The Lancet. Jan 20;347(8995):150-3.
Gwee KA, Leong YL, Graham C, McKendrick M, Collins SM, Walters SH. Underwood JE. Read NW. (1999). The role of psychological and biological factors in post infective gut dysfunction. Gut. 44: 400-406.
Gwee KA. Collins SF and Read NW. (2000) Increased rectal mucosal expression of interleukin lB as a marker of inflammatory pathogenesis in recently acquired post infectious IBS. 2000.
Lewis IM, Read NW, McKendrick MW (2003). Prospective study of factors influencing the persistence of symptoms in hospitalised patients with acute infection. Journal of Psychosomatic Research. 2003; 54 (4): 307-311

IBS, recurrent dyspepsia or gastritis caused by emotional tension? I have been suffering with gastro problems for about 4...
Rectal Sensitivity Irritable Bowel Syndome (IBS) is characterized by increased sensitivity of...
Psychological influences on the gut The opportunity to retrain as a psychoanalytical psychotherapist sharpened my...

Diagnostic Criteria for Irritable Bowel Syndrome

admin — Sun, 01 Mar 2009 09:20:13 +0000

Irritable Bowel Syndrome is one of the large number of unexplained medical illnesses that form the bulk of todays medical practice. These include chronic fatigue syndrome, fibromyalgia syndrome, unexplained backache, functional dyspepsia, depression and many others. I regard each of these illnesses to be the variable expressions of the same state of mind-body dysphoria, what in the past might have been termed neurasthenia, melancholia, hypochondria, irritable weakness, the spleen or hysteria. I have therefore written several critiques of the Rome diagnostic criteria for IBS.

Read, N.W. (1987). Functional gastroenterological disorders. The Name’s the thing. Gut 28: 1-4.
Read, N.W. (1987). In: Irritable Bowel Syndrome. Scand. J. Gastroenterol. Supplement 130, pp.7-13.
Read, N.W. (1990) Functional gastrointestinal disorders: building castles in the air. Gastroenterology International 3 (4): 182-183.
Read NW. Enough is Enough! (A response to the debate ‘Do the Rome Criteria Stand Up’) Falk Symposium 1997. The Irritable Bowel Syndrome (2001). Chapter 90. Sleisenger and Fordtrans’s Gastrointestinal and Liver Disease, edition 7. Eds Mark Feldman, Lawrence Friedman and Marvin Sleisenger. Harcourt Health Sciences.

Managing your Irritable Bowel I have had many years experience of looking after patients...
Psychological influences on the gut The opportunity to retrain as a psychoanalytical psychotherapist sharpened my...
Proforma medico-legal curriculum vitae Medico-legal curriculum vitae Name: Nicholas W. Read Date of Birth:...

Measuring intestinal gas in the bath

admin — Sun, 01 Mar 2009 09:17:37 +0000

Dr Janet Tomlin developed an ingeneous method of collecting flatus in normal volunteers using gas proof bags sealed to the anus. She tested this for leaks in the bath! Her work afforded an impression of the normal variation of flatus production in normal volunteers.

Tomlin, J., Lowis, C., Read, N.W. (1991) Investigation of normal flatus production in healthy volunteers. Gut 32: 665-669.
Read, N.W. (1985) Gastrointestinal Gas. In: Topics in Gastroenterology 12. (Ed. D.P. Jewell and P.R. Gibson), Blackwell Scientific Publications, Oxford (in press) pp. 283-288.

The intestinal regulation of eating behaviour Having shown that intestinal infusion of lipid will delay gastric...
Small Intestinal Transit and Motility A collaboration with Dr Immanuel Bergman from the Safety in...
A method for measuring the activity of the gastropyloroduodenal unit in man Dr John Dent from the University of Adelaide had invented...

A model to study colonic fermentation

admin — Sun, 01 Mar 2009 09:16:24 +0000

Don’t imagine that medical research is a glamorous profession. Dr Christine Edwards spent three years in our department devising a continuous anaerobic culture of human faeces, by which she could study the fermentation of carbohydrate. Her determination earned her a PhD and ultimately a Professorship. Where there’s muck, there’s… a very dedicated scientist!

Edwards, C.A., Duerden, B.I. and Read, N.W. (1985) Metabolism of mixed human colonic bacteria in a continuous culture mimicking human caecal contents. Gastroenterology 88: 1903-1908.
Rao, S.S.C., Edwards, C.A., Austen, C.J., Read, N.W., Holdsworth, C.D. (1988) Impaired colonic fermentation of carbohydrate after ampicillin. Gastroenterology 94: 928-932.

Small Intestinal Transit and Motility A collaboration with Dr Immanuel Bergman from the Safety in...
The intestinal regulation of eating behaviour Having shown that intestinal infusion of lipid will delay gastric...
Faecal impaction in the elderly Dr Leila Abouzekry came from Egypt and was working in...

Fibre and Gastrointestinal Function

admin — Sun, 01 Mar 2009 09:14:44 +0000

The eighties was the decade of dietary fibre, a metaphor that seemed to express society’s need for more moral fibre after the liberal seventies. But was the science there to support it? With tongues firmly lodged in our cheeks we investigated the mode of action of various types of fibre on gut function, even showing that small pieces of plastic were just as good as coarse wheat bran in accelerating transit and softening the stool. We were perhaps the first voice of criticism to arrest the progress of The Bran Wagon.

Cann, P.A., Read, N.W., Holdsworth, C.D. (1984). What is the benefit of coarse wheat bran in patients with the irritable bowel syndrome. Gut 25: 168-173.
Read, N.W. (1987) The Bran Wagon. Lancet i: April.
Edwards, C.A., Johnson, I.T. and Read, N.W. (1988) Do viscous polysaccharides slow absorption by inhibiting diffusion or convection? Eur. J. Clin. Nutr. 42: 307-312.
Tomlin, J. and Read, N.W. (1988). Laxative properties of indigestible plastic particles. Brit. Med. Journal 297: 1175-1176.
Read, N.W. (1988). The power of plastic bran. The Independent. Tuesday, 8th November, 1988.
Read, N.W. (1990). Pharmaceutical Aspects of Dietary Fibre. Dietary Fibre: Chemical and Biological Aspects. Cambridge: Royal Society of Chemistry 83: 340-349.

Anorectal Function The anus is much cleverer than we like to think....
The Intestinal Regulation of Gastric Emptying A series of studies demonstrated how that the slowing of...
Measuring intestinal gas in the bath Dr Janet Tomlin developed an ingeneous method of collecting flatus...

Food and mood

admin — Sun, 01 Mar 2009 09:12:06 +0000

We had been investigating the effects of intestinal infusions of lipid on small bowel transit times in rats when we observed that animals that received the lipid tended to fall asleep. We wondered whether this might explain why people tend to feel drowsy after a rich meal and irritable after changing to a low fat diet. This led to a series of experiments in human volunteers by Anita Wells showing that dietary or intestinal infusion of fat reduces alertness, enhances mood and impairs concentration, while carbohydrate does the reverse. Fat also reduced heart rate, altered EEG activity and suppressed pain. These effects are probably either related to release of gut hormones particularly CCK or enhancement of activity in the sensory (afferent) component of the vagus nerve.

Wells, A.S., Read, N.W., Craig, A. Influences of dietary and intraduodenal lipids on alertness, mood and sustained concentration. British Journal of Nutrition 1995; 74: 115-123.
Wells, A.S., Read, N.W. Influences of fat, energy and time of day on mood and performance. Physiology & Behaviour 1996; 59: 1069-1076.
Wells AS, Read, NW, Uvnas Moberg K, Asler P. Influences of fat and carbohydrate on postprandial sleepiness, mood and humour. Physiology and Behaviour l997; 6l (5): 679-686.
Wells AS, Read NW, Laugharne J, Athluwalia NS. Alterations to mood after changing to a low fat diet. B.J. Nutr. l998; 79: 23-30.
Wells AS, Read, NW, Idzikowski C. Jones J. Effect of meal on objective and subjective measures of daytime sleepiness. Am. J. Applied Physiology. 1998; 84 (2); 507-515
Wells AS, Read NW, MacDonald I. (l997) The effect of carbohydrate and lipid on resting energy expenditure, heart rate, sleepiness and mood. Physiology and Behaviour 1998; 63 (4): 621-628.
Zmarzty SA, Wells AS, Read NW. The influence of food on pain perception in healthy human volunteers. Physiology and Behaviour 1997; 62 (l):185-191.
Zmarzty SA, Read NW. (1999) An examination of isoenergetic intragastric infusions of pure macronutrients on cold pain perception in healthy human volunteers. Physiology and Behaviour. 1999; 65(4):643-648.

The intestinal regulation of eating behaviour Having shown that intestinal infusion of lipid will delay gastric...
The Intestinal Regulation of Gastric Emptying A series of studies demonstrated how that the slowing of...
Sensitivity to fat in dyspepsia This work unlined the importance of fat in generating dyspeptic...

The intestinal regulation of eating behaviour

admin — Sun, 01 Mar 2009 09:09:08 +0000

Having shown that intestinal infusion of lipid will delay gastric emptying, probably by the release of CCK, we were interested to find out whether it would inhibit eating behaviour. The discovery that it did and was more potent than isoenergetic quantities of carbohydrate initiated a new area of research. Further studies revealed that the intestinal mechanisms regulating eating behaviour by lipid could be blunted by high fat diets, suggesting that physiological toleration of fat could contribute to obesity. Psychological needs could, however, override physiological control.

Welch, I.McL., Saunders, K. and Read, N.W. The effect of ileal and intravenous infusions of fat emulsions on feeding and satiety in human volunteers. Gastroenterology.1985; 89: 1293-1297.
Welch, McL.I., Sepple, C., Read, N.W. Comparisons of the effects on satiety and eating behaviour of infusion of lipid into the different regions of the small intestine. Gut. 1988; 29: 306-311.
Sepple, C.P., Read, N.W. Gastrointestinal correlates of the development of hunger in man. Appetite 1989; 13: 183-191.
French, S.J., Murray, B., Rumsey, R.D.E., Sepple, C.P., Read, N.W. Preliminary studies on the gastrointestinal responses to fatty meals in obese people. Int. J. Obesity 1993; 17: 295-300.
Read, N.W., French, S.F., Cunningham, K. The role of the gut in regulating food intake in man. Nutrition Reviews 1994; 52(1): 1-10.
French, S.J., Bergin, A., Sepple, C.P., Read, N.W., Rovati, L. The effects of loxiglumide on food intake in normal weight volunteers. Int. J. Obesity 1994; 18: 738-741.
French S.J., Murray B, Rumsey, R.D.E., Fadzlin, R., Sepple, C.P., Read NW. Adaptation to high fat diets: effects on food intake and plasma cholecystokinin. Brit. J. Nutr. 1995; 73: 179-189.
Cecil JE, Castiglione K, French SJ, Francis J, Read NW. Effects of intragastric infusions of fat and carbohydrate on appetite ratings and food intake from a test meal. Appetite. 1998; 30: 65-77.
Cecil JE, Francis J, Read NW. Relative contributions of intestinal, gastric, orosensory and informational influences to changes in appetite induced by the same liquid meal. Appetite. l998; 3l (3): 377-390.

The Intestinal Regulation of Gastric Emptying A series of studies demonstrated how that the slowing of...
Food and mood We had been investigating the effects of intestinal infusions of...
Small Intestinal Transit and Motility A collaboration with Dr Immanuel Bergman from the Safety in...

Sensitivity to fat in dyspepsia

admin — Sun, 01 Mar 2009 09:06:23 +0000

This work unlined the importance of fat in generating dyspeptic symptoms by demonstrating how duodenal infusions of fat could sensitise the stomach to distension and to motion sickness. These effects could be treated by drugs that acted on cholecystokinin, opiate and serotonin receptors.

Khan, M.I., Read, N.W., Grundy, D. (1993) The effect of varying the rate and pattern of gastric distension upon its sensory perception and motor activity. Am. J. Physiology. 264: G824 –G827.
Barbera, R., Feinle, C., Read, N.W. (1995) Abnormal sensitivity to duodenal lipid infusion in patients with functional dyspepsia. Europ.J.Gastro. Hep. 7 (11):1051-7.
Feinle, C., Grundy, D., Read, N.W. (1995) Fat increases vection induced nausea independent of any changes in gastric emptying. Physiol Behav. 58(6):1159-65.
Barbera, R., Feinle, C., Read, N.W. (1995) Nutrient Specific Modulation of Gastric Mechanosensitivity in patients with functional dyspepsia. American Journal of Physiology. Digestive Diseases & Sciences. 40: 1636-1076.
Feinle, C., D’Amato, M., Read, N.W. (1996) Cholecystokinin-A receptors modulate gastric sensory & motor responses to gastric distention & duodenal lipids. Gastroenterology. 110: 1379-1385.
Feinle C, Read NW. (1996) Ondansetron reduces nausea induced by gastro duodenal stimulation without changing gastric motility. Am. J. Physiol. 271: G59l – 597
Read N.W., Freitag B, Abitbol JL. (l997) Efficacy and safety of the peripheral kappa agonist, fedotozine, versus placebo in the treatment of functional dyspepsia. Gut 4l: 664 – 668
Read N.W. (1999). Functional Dyspepsia: a case of indecision. Gastroenterology (editorial). 116 (3):515 – 520.

Rectal Sensitivity Irritable Bowel Syndome (IBS) is characterized by increased sensitivity of...
Disturbed gastroduodenal motility in duodenal ulcer patients A series of studies conducted by Mr David Kerrigan and...
Anorectal Function The anus is much cleverer than we like to think....

Disturbed gastroduodenal motility in duodenal ulcer patients

admin — Sun, 01 Mar 2009 09:03:31 +0000

A series of studies conducted by Mr David Kerrigan and using the Dent sleeve demonstrated that acid can get trapped in the duodenal bulb in patients predisposed to duodenal ulceration. This can be prevented by drugs that induce gastroduodenal peristalsis.

Houghton, L.A., Kerrigan, D., Read, N.W. (1990) Effect of intraduodenal infusion of acid on the antro-pyloroduodenal motor unit in human volunteers. J. GI Motility 2 (3): 202-208.
Kerrigan, D.D., Read, N.W., Taylor, M.E., Houghton, L.A., Johnson, A.G. (1989) Duodenal bulb acidity and the natural history of duodenal ulceration. Lancet. (8th July). 2(8654):61-3.
Kerrigan, D.D., Houghton, L.A., Read, N.W., Johnson, A.G., Taylor, M.E. (1991) Disturbed gastroduodenal motility in patients with active and healed duodenal ulceration. Gastroenterology 100 (4): 892-900.
Kerrigan, D.D., Taylor, M.E., Read, N.W., Johnson, A.G. (1993) Acid motility and ulcers: a comparison of cisapride with placebo in the prevention of duodenal ulcer relapse. Gut 1993; 34: 1042-1046.

The Intestinal Regulation of Gastric Emptying A series of studies demonstrated how that the slowing of...
Sensitivity to fat in dyspepsia This work unlined the importance of fat in generating dyspeptic...
Rectal Sensitivity Irritable Bowel Syndome (IBS) is characterized by increased sensitivity of...