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Gut woes may accompany repetitive behaviors in autism

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Laura Geggel
24 January 2014

Although children with autism frequently complain of gastrointestinal (GI) problems, the link between gut health and autism is not entirely clear. Researchers have now begun to trace a connection between the two.

Children with autism who have constipation are often also plagued by compulsive or repetitive behaviors, a core feature of autism, finds a study published 29 November in the Journal of Autism and Developmental Disorders.

The researchers initially noticed that many of the children with autism who have GI problems are also prone to compulsive behaviors. To investigate a possible link, they mined data from the Autism Treatment Network, a collaboration among 17 medical centers in the U.S. and Canada run by the research and advocacy group Autism Speaks.

Using parent surveys collected by clinicians in the network, the researchers divided 5,076 children with autism, aged 2 to 17 years, into five groups.

One group included 806 children who experience multiple symptoms of bowel distress such as diarrhea and constipation, or show other signs such as the underwear staining that can result from severe constipation. The 2,957 children who do not have any GI symptoms served as the control group. The remainder fell into categories of individuals with a single digestive complaint.

The researchers' hunch proved right. Children who have more than one GI symptom are more likely than the controls to show compulsive or repetitive behavior, have a diagnosis of obsessive-compulsive disorder (OCD) or engage in ritualistic behaviors such as flipping on a light switch a specific number of times. These children also tend to have a family history of anxiety or OCD, and are likely to have been prescribed an antipsychotic drug.

Further analysis showed that children with constipation alone have nearly double the odds of being diagnosed with OCD. The researchers did not find a link between any of the other symptoms in isolation, such as diarrhea, to compulsive or repetitive behaviors, suggesting that constipation is the primary driver of the connection to behavior.  

It's possible that constipation might somehow trigger these compulsive behaviors or, conversely, that attempts to toilet-train a child with repetitive behaviors might result in the child becoming constipated.

The researchers also found that girls are more likely to have constipation than are boys, and that parents of white children report more GI symptoms in their children than do parents of nonwhite children. Nonverbal children are also more likely to have GI troubles than those who can speak. These results reinforce those of a 2012 study.

It's possible that children who cannot speak have trouble indicating when they need to relieve themselves, triggering some of these symptoms.

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Name: ASD Mom
25 January 2014 - 2:13AM

Strep titers can be remarkably high among these kids. Many on the East Coast are plagued with Lyme disease. These conditions, although initially treated, may re-appear. The Strep and Lyme cause chronic inflammation in the brain and body, harming the immune system. 80% of the immune system is in the gut, hence the propensity for GI problems. Pediatric Autoimmune Neuropsychiatric Disorder is also common in this population. Untreated PANDAS also causes unrelenting OCD. Sue Swedo at the NIH has done pioneering research on the subject.

Compulsive OCD is usually not behavioral among this population. Test T cell count and infection titers before prescribing Risperdal or anti-psychotics, which will be ineffective. Also test for anti-NMDA antibodies which cause regression and OCD. If caught early it can be successfully treated. If caught to late damage to brain and body hard to reverse.

Name: j.francis
28 January 2014 - 4:27PM

my adult son has shown improvement in sociability since taking Probiotics for the past year

Name: Roxirachel
29 January 2014 - 10:10AM

Our daughter has the gut issues, but not so much OCD. Thankfully, we have a non verbal system that can tell us when she is uncomfortable with her tummy. This report gives good information to those who have no idea about gut issues & autism.

Name: Tiffany Cruz
29 January 2014 - 10:47PM

My 7yr old son, Gabe, is autistic and non verbal and has severe GI issues, mostly constipation. Gabe is on no physic meds and has showed no signs of OCD. Gabe does get frustrated really easy when he is constipated. I guess that's his way of letting me know hes having trouble going potty.

Name: Stella Metsovas B.S.
30 January 2014 - 9:52PM

Compiling gut microbiome data from autistic children is key to understand disturbances caused by pathogens. If you'd like to learn more about Pediatric Autoimmune Neuropsychiatric Disorders (PANDAS), head over to the National Institute of Mental Health for quality information.

Yours in Health,
Stella Metsovas B.S.

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