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Is There a Link Between GI Problems and High-Functioning Autism?

“Is there a link between GI problems and high-functioning autism? Our son has frequent constipation, and we’re wondering if this has something to do with the disorder.”

Gastrointestinal (GI) disorders do occur in some children with High-Functioning Autism (HFA) and Asperger’s (e.g., chronic constipation, diarrhea, irritable and inflammatory bowel conditions). However, the link between GI issues and autism is up for debate.

One study from the Mayo Clinic found no apparent overall link between the two, although the researchers did find that some individual GI problems are more common in kids on the autism spectrum as compared to their “typical” (i.e., non-autistic) peers.

The Centers for Disease Control and Prevention (CDC) reports that kids on the autism spectrum are 3.5 times more likely to experience chronic diarrhea or constipation than their typical peers. Some researchers propose that toxins produced by abnormal gut bacteria may trigger or worsen the symptoms associated with the disorder.

Furthermore, researchers report that the GI activity of some young people on the spectrum differs from that of typical children in two major ways: 1) their intestines are home to abnormal amounts of certain digestive bacteria, and 2) their intestinal cells show abnormalities in how they break down and transport carbohydrates. In addition, it has been suggested that some of these children have abnormal levels of certain bacteria. Bacteria play an important role in normal digestion, and abnormal levels have been associated with intestinal inflammation and digestive problems.

==> Preventing Meltdowns and Tantrums in Asperger's and HFA Children

We also know that alterations in how intestinal cells break down carbohydrates can affect the amount and type of nutrients that these cells offer to intestinal bacteria. Such alterations may negatively impact the makeup of the intestine’s normal community of digestive bacteria. These findings may explain why some parents of kids on the autism spectrum report that special diets and probiotics improve both their child’s digestion and his or her behavior.

Treating GI Disorders in Kids on the Autism Spectrum—

1. Gastroesophageal reflux disease (GERD): Behavioral modifications include avoiding food near bedtime, eating smaller meals, avoiding foods that tend to trigger symptoms, and elevating the head during sleep. Also, medications can be implemented (e.g., antacids, Pepcid, Zantac, Nexium, Priolosec).

2. Chronic diarrhea: Treatment will depend on the cause. For example, if diarrhea is due to food allergies, lactose intolerance or celiac disease, it’s usually treated with dietary restrictions. Also, medications may be warranted in certain circumstances.

3. Chronic constipation: This condition is often addressed using behavioral management, which includes dietary changes (e.g., increasing fiber, eliminating constipating foods), and management of toileting behaviors (e.g., teaching a child to sit on the toilet after meals). In addition, supplements can be used to alleviate constipation (e.g., soluble fiber, laxatives such as mineral oil, magnesium hydroxide or sorbitol).

4. Casein- and gluten-free diets: Many moms and dads of kids on the spectrum report that behavior improves when their youngster eats a diet free of the proteins gluten (found mostly in wheat, barley and rye) and casein (found in dairy products).

5. Probiotics: In addition to eliminating casein and gluten from their child’s diet, many parents have reported that probiotics (i.e., the "good" bacteria) help lessen gastrointestinal distress.

How Parents Can Help—

You may want to consider consulting with a dietary counselor (e.g., a nutritionist or dietician). If so, bring the counselor a 3 - 5 day “dietary history” by writing down what was eaten and how much. The counselor will review the history to determine whether there is a risk for nutritional deficiency. He or she can then work with you to add foods or supplements that address potential gaps in nutrition.

==> Preventing Meltdowns and Tantrums in Asperger's and HFA Children

In addition to providing a history of what was eaten and how much, create a list of the specific symptoms and behaviors that you would like to work on (e.g., your child’s tantrums, meltdowns, shutdowns, inability to sit quietly during class, problems sleeping at night, etc.).

Recruit the assistance of teachers, babysitters, and others outside the family to help you accurately monitor targeted symptoms and behaviors – and verify your awareness of changes. If a consensus is reached that improvements are indeed occurring, then continuing the dietary changes will be worth the cost and effort.

Note that improvements may be due to the removal of just one of the aforementioned proteins (i.e., gluten or casein) from the diet. Some parents report improvement with a gluten-free diet alone, while others report improvements with just a casein-free diet. In addition, improvement may be due to dietary changes other than the removal of casein or gluten (e.g., the new diet replaces processed foods high in sugar and fat with healthier foods like fruits and vegetables).

Also note that a strict casein-gluten free diet requires hard work and can be costly (e.g., parents will be faced with the task of sending or bringing special meals and treats whenever their child eats away from home, it may be difficult to eat from the menus in a restaurant or school cafeteria, birthday parties may present a challenge, etc.).

==> More information on diet and children with ASD can be found here...

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