Gut instinct

Professor Nick Talley has made great inroads into the understanding of common but often mystifying gastrointestinal ailments.

Professor Nick Talley looking off into the distance 

For the one in three Australians who suffer from them, chronic stomach and bowel disorders are a source of great pain and frustration. For Professor Nick Talley, they are a scientific conundrum that he has devoted a large part of his esteemed medical career to researching and treating.

The University's Pro Vice-Chancellor of the Faculty of Health is a neurogastroenterologist, a specialist in unexplained gut disorders affecting nerves and muscles such as irritable bowel syndrome, functional dyspepsia (a form of severe indigestion) and slow stomach emptying (also called gastroparesis). These conditions, called functional gastrointestinal disorders, together affect millions of people but little is understood of their causes.

"There are many different disorders where the gut fails to work properly. At their most severe they seriously affect a patient's health and quality of life," Talley says.

"In the past these conditions were poorly diagnosed, poorly recognised and therefore poorly managed. Over the past 25 years I have worked very hard, with collaborators all over the world, to help classify these diseases more effectively so that we can better manage them.

"What that work has done has confirmed that these are real disorders, that they can be identified biologically – and that is a major advance. We have proven they are not just conditions that are imagined or purely psychologically driven."

A former Professor of Medicine and medical department Chair at the prestigious Mayo Clinic in the United States, Talley came to the University of Newcastle last year with impeccable credentials as a researcher, teacher, administrator and clinician.

Talley is one of the most highly cited researchers in his field and, working with his teams of collaborators in Australia and internationally, has been credited with significant advances in our understanding of the underlying causes of functional gastrointestinal diseases.

His self-confessed "career of reinvention" has encompassed two periods at Mayo, both in research and administration, interspersed with a nine-year period as Foundation Professor of Medicine at the University of Sydney's Nepean-based medical school.

He holds adjunct research appointments with Mayo, the University of North Carolina and Sweden's Karolinska Institute. He is an author of several major medical textbooks and has published more than 700 articles in peer-reviewed journals.

Talley says his team's work in verifying the presence of eosinophils (inflammatory white blood cells) in the small intestine in functional dyspepsia is a critical breakthrough because it offers new treatment options that could ultimately lead to a cure.

"One of the things we've been able to ascertain is that there is inflammation in the gut that appears to be an important driver, a fact that is now becoming well accepted but certainly was not when we started this work," he says.

Talley has maintained his commitment to clinical work throughout his academic career and is a Visiting Medical Officer at Newcastle's John Hunter Hospital.

He is an advocate for introducing all students to research early, starting from undergraduate level, because he believes it enhances their proficiency regardless of which career path they choose. In his new role, he is keen to promote research training for practitioners, too, so they have the opportunity to directly translate research into practice.

"Research builds new knowledge that when well done is robust and can make a real difference in patient lives," he says. "Apart from that, research is fun. It is also fascinating and challenging and, when tied in with clinical practice, it becomes highly relevant to what you are doing every day."

To that end, Talley has practised what he preaches. In 2001, when he was offered the chance to return to Mayo to research genetic aspects of functional gastrointestinal disorders, he enrolled in a Masters degree course in genetic epidemiology through Newcastle's to upgrade his skills.

As to why he chose Newcastle and a Chair in Health for the latest phase of his career reinvention, Talley is unequivocal.

"I see enormous potential here," he says "and I want to contribute.

"Newcastle has a tremendous cadre of researchers and educationalists, and many health research programs that are world-standard. The national and international rankings of the Faculty of Health are excellent, but I think we can do even better.

"It is a great place to be for my career, but it is also a nice place to live for my family and I, so that is a perfect combination."