4 Aug 2009

The Autism Gut Question

One of the most prevalent unsubstantiated claims about autism (after the "lack of empathy" myth) is the idea that autistic children have more gut problems than non-autistic children. This notion was fed by the now debunked 1998 article by Andrew Wakefield who claimed to have discovered a new disorder he called autistic enterocolitis, a condition not recognised by scientists.

I have read countless times, parental tales of woe about their autistic children's constipation. yeasty poos, diarrhoea, and all sorts of bowel problems. No doubt, many of these are real, but reporting is rather self selecting. Most parents whose autistic children have no gut issues don't make as much noise. Moreover, constipation etc is common in all children.

In the past week, 2 scientific studies have been published that cast doubt on the validity of the autism gut connection. These are ably discussed on LB/RB.

The first study compared the stool patterns of autistic children and non-autistic children and concluded,
"During the first 42 months of life, ASD children had a stool pattern that was very similar to that of other children, apart from a slight increase in stool frequency at 30 and 42 months. There were no symptoms to support the hypothesis that ASD children had enterocolitis."


Jax said...

Paul Shattock! There's a name from the past. Assume he is the one who started up Communities for Autistic People in the northeast, which was the first place I worked after university. Well, first full time job that is.

And oddly, got back in touch with a woman who worked there with me just a week ago. Synchronicity.

Sharon McDaid said...

Yeah it must be. He's connected to the university of Sunderland. I've heard that he's a lovely man and I did try to go hear him talk in Belfast last year but it was cancelled. But this notion of his that milk and wheat proteins mimic opiates in autistic people is just bizarre and had never been backed up. That kind of talk-without-evidence is all to common in autism and really damaging IMO.

Jax said...

You might want to take a look at his wikipedia page then, if the theories are controversial, it certainly isn't reflected on there.

I don't think I ever met him, by the time I worked there, his son, Jamie iirc, had moved to a different residential placement. Mind they have a lot of units, and I worked in Seaham rather than in Sunderland.

Lisamaree said...

I'm old enough to remember seretonin and how intravenous transfusions were supposed to cure our sick kids.

I think we need to take a frank approach to this issue.

Part I Kids are curious they like to pick things up and put them in their mouths. Do that enough and you are going to get some bacteria and as a result the splats. Take away the typically developing kid's ability to limit this through social disapproval, and you have a lot of tasting and mouthing, fiddling and mouthing and - more splats. (I wonder if our kid's immune systems are stronger as a result though?*)

Part II
Kids with a limited diet and poor body tone, may suffer from constipation too. The pain of constipation or "impacted bowels" as some parents describe it can be self perpetuating as the kids are fearful of going to the loo and hold on.
Getting fruit and fibre into their diet is difficult as they often have heightened taste and texture sensitivity which makes such foods repellent. It isn't just fussiness, I met enough Aspies in the wine industry to know that many people with autism have a very sensitive palate. (in the wine industry this is a skill!)
So you have plain diet - lots of simple starches and the gut gets glued up.

Add to that the fact that some of our kids have hypotonia and going to the loo can become an issue for them - especially coupled with the extra pressure of a toilet training program implemented to schedule.

Getting a bit of fibre or fruit juice into the diet (sneaking in some soft wholemeal bread as we did) and ensuring they make time to go daily (a stack of reading material in the loo helps, followed by a fun bubbly bath) and you can find things a lot "easier".

This is just logic speaking, but it makes a bit more sense than the whole "leaky gut" or "food becoming morphine" theories that you hear flouted by Dr-Curebies. Not sure if I will get a publishing deal out of "don't eat stuff off the ground but do eat more fruit and fibre" though.


*ps. we had a kid with pica in Boo's first school. we called him "the bush tucker kid" as he ate branches, leaves, dirt and sand. He bit a teacher once and it took months to find an antibiotic to treat her as the kid carried a bacteria in his mouth - that he was immune to. (commonly found in potting mix)