Associate Professor Robert Fraser MBBS, PhD, FRACP

Current Appointments | Biography | Staff & Students | Publications

Current Appointments

Biography

Robert Fraser was appointed as Director of the Investigation and Procedures Unit, Repatriation General Hospital, and Associate Professor of Medicine at both the University of Adelaide and Flinders University in 2002. He leads a unique group that includes gastroenterologists, intensive care specialists, and basic scientists, in studies which are addressing the broad hypothesis that many of the problems associated with the delivery of adequate nutrition to patients with critical illness relate to disordered gastrointestinal function. This important area of research has hitherto received inappropriately little attention, as abnormal gut function occurs frequently in these patients, and both prevents delivery of effective feeding at a time when they are especially vulnerable to malnutrition, and predisposes to complications such as pneumonia, sepsis, and gastrointestinal haemorrhage. A/Prof Fraser’s group, funded by successive NHMRC Project Grants, has pioneered the application of sophisticated physiological measurement techniques in the ICU setting, including gastrointestinal manometry, intraluminal impedance to evaluate luminal flow, scintigraphy, and stable isotope breath tests. This has resulted in the most comprehensive information regarding gut function in these patients, and enabled evaluation of the effectiveness of interventions to improve nutrition in this group. A/Prof Fraser has been a chief investigator on 6 previous and one current NHMRC grant, and is a co-author of 88 peer-reviewed papers and 6 book chapters He has been an invited speaker at a number of national and international meetings, and has supervised several higher degree students; his current PhD students include gastroenterology, and intensive care consultants..

Staff

Ms L Bryant
Ms C Burgstad

Higher Degree Students

Dr Q Nguyen
Dr M Chapman
Dr A Deane

Current Funded Research

2007-11 NHMRC CCRE Grant 453557: Centre of Clinical Research Excellence in nutritional physiology, interventions and outcomes. M Horowitz, P Clifton, G Wittert, I Chapman, R Fraser, C Rayner, C Feinle-Bisset, K Jones. ($2,000,000)

2005-7 National Health and Medical Research Council Project Grant. Fraser R, Holloway R, Young R, Jones K. Oesophageal, gastric and small intestinal motility in critical illness ($489,000)

2007 Australian and New Zealand College of Anaesthetists. Chapman M, Deane A, Fraser R, Jones K, Holloway R, Horowitz M. Effects of glucagon- like peptide-1 on glucose concentrations and small intestinal transit in critically ill patients.($39,961)

2007 Special Purposes Fund, Hanson Centre Nguyen N, Chapman M, Bryant L, Holloway R, Butler R, Davidson G, Fraser RJ. Novel technique to determine small intestinal mucosal integrity in critically ill patients ($19,000)

Recent Publications 

Original papers

Chapman M, Fraser R, Buist M, De Nicolo D. Effects of erythromycin on gastric emptying in ICU. Crit Care Med (2000) 28; 2234-2237.

Yeoh EK, Botten, R Russo, A, McGowan R, Fraser R, Sun, WM, Roos D, Penniment M, Borg M. Chronic effects of therapeutic irradiation for localised prostatic carcinoma on anorectal function. Int J Radiation Oncol Biol Phys (2000) 47; 915-924.

Fraser R, Frisby C, Blackshaw LA, Howarth G, Schirmer M, Yeoh E. Lack of effect of IGF-I on intestinal dysmotility following abdominal radiation in the rat. J Gastroenterol Hepatol. (2000) 15; 1132-1137.

Tournadre J-P, Barclay M, Fraser R, Dent J, Young R, Berce M, Jury P, Fergusson L, Burnett J. Small Intestinal motor patterns in critically ill patients following major abdominal surgery. Am J Gastroenterol (2001) 96; 2418-2427.

Ritz M, Fraser R, Edwards N, Di Matteo ACD, Chapman M, Butler R, Cmielewski P, Tournadre J-P, Davidson G, Dent J. Delayed gastric emptying in ventilated critically ill patients: measurements by 13C-octanoic acid breath test. Crit Care Med (2001) 29; 1744-1749.

Andrews, JM, Doran SM, Di Matteo DC, Leong L, Macintosh C, Chiu C-J, Read NW, Fraser R. Effect of lacto-ovo vegetarian diet on fasting small intestinal motility. Scand J Gastroenterology (2001) 36;1037-1041.

Russell AW, Horowitz M, Ritz M, Fraser R, Chapman IM. Effect of hyperglycaemia on appetite in type I diabetes mellitus. Diabetes Medicine (2001) 18; 718-725.

von Richter O, Greiner B, Fromm MF, Fraser R, Omari T, Barclay ML, Dent J, Somogyi AA, Eichelbaum M. Determination of in vivo absorption, metabolism and transport of drugs by the human intestinal wall and liver with a novel perfusion technique. Clin Pharmacol Ther (2001) 70; 217-227.

de Beaux I, Chapman M, Fraser R, Finnis M, De Keulenaer B, Liberalli D. Enteral nutrition in the critically ill: A prospective survey in an Australian intensive care unit. Anaesth Int Care. (2001) 29; 619-622

Viani F, Verdú EF, Idström JP, Cederberg C, Fraser R, Fried M, Blum AL, Armstrong D. The effect of omeprazole on regional and temporal variations in intragastric acidity. Digestion. (2002) 65; 2-10.

Vozzo R, Su Y-C, Fraser R, Wittert GA, Horowitz M, Chapman IM. Antropyloroduodenal and feeding responses to pulsatile and non-pulsatile intradudoenal lipid infusion. Neurogastroenterol Motil. (2002) 14; 25-34.

Vozzo R, Wittert G, Cocchiaro C, Tan WC, Mudge J, Fraser R, Chapman I. Similar effects of foods high in protein, carbohydrate and fat on subsequent spontaneous food intake in healthy individuals. Appetite (2003) 40; 101-7.

Yeoh EK, Fraser R, McGowan R, Botten R, Roos D, Penniment M, Borg M, Palumbo K. Evidence for efficacy without increased toxicity of hypofractionated radiation therapy for prostatic carcinoma: early results of phase III randomised trial. Int J Radiation Oncol Biol Phys. (2003) 55; 943-55.

Worthley D, Rayner C, Devitt P, Fraser R. Splenic artery collaterals as cause of upper gastrointestinal haemorrhage. (2003) J Gastroenterol Hepatol.18; 604-5.

Chapman M, Fraser R, De Beaux I, Creed S, Finnis M, Butler R, Cmielewski P, Zacharskis B, Davidson G. Cefazolin does not increase gastric emptying in the critical ill. Intensive Care Med (2003) 29:1169-1172.

Russo A, Botten R, Kong MF, Chapman I, Fraser R, Horowitz M, Sun WM. Effects of acute hyperglycemia on anorectal motor and sensory function in diabetes mellitus. (2004) Diabetes Medicine 21; 176-82

Ritz MA, Fraser R, Di Matteo AC, Greville H, Butler R, Cmielewski P, Davidson G. Evaluation of 13C-Triolein Breath Test For Fat Malabsorption In Adult Patients With Cystic Fibrosis. (2004) J Gastroenterol Hepatol. 19:448-53.

Yeoh EE, Holloway RH, Fraser RJ, Botten RJ, Di Matteo AC, Moore JW, Schoeman MN, Bartholomeusz. FDL Anorectal dysfunction increases with time following radiation therapy for carcinoma of the prostate. (2004) Am J Gastroenterol. 99;361-9.

Bryant LK, Fraser RJ, Vozzo R, Zacharakis B, Mathews GM, Butler R. Stimulation of small intestinal burst activity in the postprandial state differentially affects lipid and glucose absorption in healthy adult humans. (2004) Am J Physiol. 287;G1028-34.

Nind G, Chen W-H, Protheroe R, Iwakiri K, Fraser R, Young R, Chapman M, Nguyen N, Sifrim D, Rigda R, Holloway RH. Mechanisms of gastro-oesophageal reflux in critically ill mechanically ventilated patients. Gastroenterology (2005) 128:600-606.

Fraser RJ, Vozzo R, Di Matteo AC, Boeckxstaens G, Adachi K, Dent J, Tournadre JP. Endogenous nitric oxide modulates small intestinal nutrient transit and activity in healthy adult humans. Scand J Gastroenterol (2005) 40:1290-1295

Young R, Chapman MJ, Fraser R, Vozzo R, Chorley DP, Creed S. A novel technique for post pyloric feeding tube placement in critically ill patients: a pilot study. Anaesthesia Intensive Care (2005) 33: 229-234.

Ritz M, Chapman MJ, Fraser RJ, Finnis ME, Butler RN, Cmielewski P, Davidson GP, Rea D. Erythromycin dose of 70 mg  accelerates gastric emptying as effectively as 200 mg in the critically ill. Intensive Care Med (2005). 31: 949-954.

Chapman M, Fraser R, Vozzo R, Bryant L, Tam W, Nguyen N, Zacharakis B, Butler R, Davidson G, Horowitz M.. Antropyloroduodenal motor responses to gastric and duodenal nutrient in critically ill patients. Gut (2005) 54:1384-1390.

Bull J, Dunn SV, Gasener LA, Fraser RJ. Upper gastrointestinal endoscopy training : A retrospective audit of the first 210 examinations performed by an Advanced Practice Nurse at a metropolitan hospital in South Australia. J GENCA (2006) 16: 5-10.

Fraser R, Ritz M, Di Matteo AC, Vozzo R, Kwiatek M, Foreman R, Stanley B, Walsh J, Burnett J, Jury P, Dent J. Distal small bowel motility and lipid absorption in patients following aortic aneurysm repair. World J Gastroenterol (2006) 12: 582-587.

Bampton PA, Schloite A, Bull J, Fraser RJ, Padbury RT, Watson D. Improving surveillance for Barrett’s oesophagus. Br Med J (2006) 332;1320-1323.

Nguyen N, Chapman M, Fraser RJ, Ritz M, Butler R, Davidson G, Zacharakis B, Holloway RH. L. Longstanding Type II Diabetes Mellitus is not a Risk Factor for Slow Gastric Emptying in Critically Ill Patients. Intensive Care Med (2006)  32:1365-70.

Nguyen, NQ, Fraser RJ, Chapman M, Bryant L, Holloway RH. Vozzo R, Feinle-Bisset C. Proximal gastric response to small intestinal nutrients is abnormal in mechanically ventilated critically ill patients World J Gastroenterol (2006) 12:4383-8.

Nguyen NQ, Fraser RJ, Chapman M, Bryant L, Holloway RH, Vozzo R, Wishart J, Feinle-Bisset C, Horowitz M. Feed Intolerance of Critical Illness is Associated with Increased Basal and Nutrient-Stimulated Plasma Cholecystokinin Concentrations. Crit Care Med (2007) 35:82-88.

Roberts-Thomson KC, Iyngkaran G, Fraser RJ. Intra-articular glucocorticoid injection: an unusual cause of transient hypophosphataemia. Rheumatol Int 27(1):95-6 (2006).

Yeoh EE, Holloway RH, Fraser RJ, Botten RJ, Di Matteo AC, Butters J, Weerasinghe S, Abeysinghe P. Hypofractionated versus conventionally fractionated radiation therapy for prostate carcinoma: Updated results of a Phase III randomized trial. Int J Radiat Oncol Biol Phys. 66:1072-83 (2006).

Nguyen NG, Fraser RJ, Chapman M, Bryant LK, Wishart J, Holloway RH, Horowitz M. Fasting and nutrient-stimulated plasma peptide-YY levels are elevated in critical illness and associated with feed intolerance: a randomised controlled trial. Crit Care. (2006) 10:R179.

Nguyen NQ, Chapman MJ, Fraser RJ, Bryant LK, Holloway RH. Erythromycin is more effective than metoclopramide in the treatment of feed intolerance in critical illness. Crit Care Med (2007) 35:483-489.

Nguyen NQ, Mangoni AA, Fraser RJ, Chapman M, Bryant L, Burgstad C, Holloway RH. Prokinetic therapy with erythromycin has no significant impact on blood pressure and heart rate in critically ill patients. Br J Clin Pharmacol (2007) 63:498-500.

Nguyen NQ, Fraser RJ, Chapman M, Bryant L, Holloway RH, Feinle-Bisset C. Proximal gastric motility in type 2 diabetic patients with critical illness. World J Gastroenterol (2007) 13: 270-275

Nguyen NQ, Ng M, Chapman M, Fraser RJ, Holloway RH. The Impact of Admission Diagnosis on Gastric Emptying in Critically Ill Patients. Critical Care ( 2007) 11:R16.

Nguyen NQ, Fraser RJ, Bryant L, Holloway RH, Functional Association between Proximal and Distal Gastric Motility during Fasting and Duodenal Nutrient Stimulation in Humans. Neurogastroenterology Motility Accepted for publication (Jan 2007).

Reviews

Ritz M, Fraser R, Tam W, Dent J. Impacts and patterns of disturbed gastrointestinal function in critically ill patients. Am J Gastroenterol (2000) 95; 3044-3052.

Fraser R. Drug therapy of Irritable Bowel Syndrome. Australian Prescriber (2001) 24: 68-71.

Worthley D, Fraser R. Management of acute bleeding in the upper gastrointestinal tract. Australian Prescriber (2005).28; 62-66.

Baker G, Fraser RJ, Young G. Subtypes of Dyspepsia. World J Gastroenterol (2006) 12:2667-2671.

Helliwell V, Fraser RJ, Hubble S. Failure to regain weight after critical illness: a short review. Critical Care Management (2006) 4; 18-21.

Chapman M, Nguyen NQ, Fraser RJ. Gastrointestinal motility and prokinetics in the critically ill. Current Opinion Critical Care (2007) 13:187-194.

Book Chapters

Fraser RJ. Gastric emptying disorders in the elderly. In “Practical Handbook of Geriatric Prescribing”. Editors Jackson S, Jansen P, Mangoni A. Wiley (2007) in press.

Worthley DL, Young GP, Fraser RJ. Lower Gastrointestinal Disorders. In “Practical Handbook of Geriatric Prescribing”. Editors Jackson S, Jansen P, Mangoni A. Wiley (2007) in press