Autism spectrum disorder from the gastro intestinal side. (developed by Veronique Bure)

It seems that gastro-intestinal symptoms are found in up to 75% of children under the Pervasive Developmental Disorders (PDD) spectrum. Also 47% of children with ASD that have been tested suffer from an increase of permeability of the intestine⁽¹⁾. This allows particles (such as peptides) bigger than usual and in greater number to travel in the blood stream. It could cause toxic absorption, allergies, and general discomfort causing sleep disorder. The affects it could have on the brain cells have not been evaluated yet. ( A study is  in progress on brain tissue). In general population, it is well known that stress increases intestinal permeability and modifies the amount of chemicals circulating in the bloodstream.

- If not addressed, recurrent abdominal pains can result in self injurious behavior or aggression.

 -  Symptoms might include poor appetite or/and very selective tastes,

 This can be the consequence of bad stomach clearing due to poor motor skills, and low muscles tone. Insufficient clearing of the stomach can cause abdominal pains. Before the age of five the display of discomfort related to GI problem is not behavior related such as attention seeking, or task avoiding and has to be investigated. (if those occur without being linked to precise environmental antecedents).

- Pains can be related to constipation or diarrhea. Constipation is a very common symptom in children with PDD due to difficulties in processing sensory information, and a tendency to refrain defecation.

-  Low muscle tone can be responsible for motility disorder and GI reflux which causes damage to the GI track and pain, responsible for sleep disorders. It needs to be treated effectively. Avoid chocolate.

- Food allergy is found in 36% of children in the ASD as compare to 8% in the general pediatric population. The red flags are:  vomiting, constipation, diarrhea, rashes, pain and sleep disorder. The IGE test used to determine the presence of allergy can be normal even if  there is allergy. Only positive results can be trusted. This is especially true for peanut allergy which accounts for 25% of all allergies.

- Prevalence of allergy is 4 times higher in children born through C section. This birth modality prevents the child from being exposed to the mother bacterial flora in the birth canal.

- 50% of children experiencing GI problems lack lactase enzyme. (Enzyme necessary to digest dairy products)

- Strategies: identify possible food allergy. (Keep in mind that allergic reaction can occur up to four days after ingestion). Retrieval of this item from diet for a month .If the response is not clear, rechallenge  by reintroducing the food. Rebalance gut flora.

- Perform a screening to rule out Celiac disease before starting a specific diet.

- Regulate stools before starting any toilet training. 

(1) Thimothy Buie MD, Massachusetts General Hospital for Children. Boston.

 Eight international conference on  Autism ,Relating and  Communication