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Age of Autism Science Summary: Anxiety, Sensory Over-Responsivity, and Gastrointestinal Problems in Children with Autism Spectrum Disorders.

Science post imageJ Abnorm Child Psychol. 2012 Aug 1. [Epub ahead of print]

Anxiety, Sensory Over-Responsivity, and Gastrointestinal Problems in Children with Autism Spectrum Disorders.

Mazurek MO, Vasa RA, Kalb LG, Kanne SM, Rosenberg D, Keefer A, Murray DS, Freedman B, Lowery LA.

Department of Health Psychology and Thompson Center for Autism and Neurodevelopmental Disorders, University of Missouri - Columbia, 205 Portland Street, Columbia, MO, 65211, USA, mazurekm@missouri.edu.

Abstract

Children with autism spectrum disorders (ASD) experience high rates of anxiety, sensory processing problems, and gastrointestinal (GI) problems; however, the associations among these symptoms in children with ASD have not been previously examined. The current study examined bivariate and multivariate relations among anxiety, sensory over-responsivity, and chronic GI problems in a sample of 2,973 children with ASD enrolled in the Autism Treatment Network (ages 2-17 years, 81.6 % male). Twenty-four percent of the sample experienced at least one type of chronic GI problem (constipation, abdominal pain, bloating, diarrhea, and/or nausea lasting three or more months). Children with each type of GI problem had significantly higher rates of both anxiety and sensory over-responsivity. Sensory over-responsivity and anxiety were highly associated, and each provided unique contributions to the prediction of chronic GI problems in logistic regression analyses. The results indicate that anxiety, sensory over-responsivity and GI problems are possibly interrelated phenomenon for children with ASD, and may have common underlying mechanisms.

Comments

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Jodi

This is interesting. My daughter doesn't have autism but she does have high anxiety and Tourette syndrome, ADHD and OCD disorders. She was born with colic and it seems to have never went away. She is now 11, and has constipation, diarrhea, bloating gas, stomach pain all the time! Sometimes she throws up for no reason. It is hard when your child is always in pain.

Jenny Allan

@Cherry Sperlin Misra
I'm a bit of an expert on Clostridium difficile, after contracting this in hospital after a bowel operation. I had a condition called pseudomembranous colitis, caused by the C diff toxins attacking the bowel. This causes bleeding and eventual bowel 'necrosis'. This can be fatal and in advanced cases total colon removal is the only option. The body attempts to get rid of the toxins by inducing diarrhoea. I will never forget it!!

The condition is caused by an overgrowth of C diff bacteria after the patient has received broad spectrum antibiotics, which kill off ALL the bowel bacteria. C diff spores are like anthrax -resistant to heat and hospital disinfectants. These spores are ubiquitous on hospital surfaces and only a few need to be injested to cause this dangerous illness in vulnerable patients. I was put, post operative, into a ward between two other patients with severe diarrhoea. I had NO chance of avoiding it!!

Thankfully, a little Chinese first year doctor told us about probiotics. I am sure they saved my life (and the rest of my colon) by putting back friendly bacteria into my colon. I have been campaigning for an NHS 'clean up' of superbugs ever since. In this I have come up against a huge number of vested interests. These include business interests which manufacture disinfectants and 'deep cleaning' equipment for hospitals and a Cambridge company which spent millions on developing-yes you've guessed it- a C diff vaccine. The company have sold on the rights to a European pharmaceutical company to manufacture the vaccine, but no sign of it yet. Certain antibiotics are implicated in C diff development as are some acid reducing medications-both profitable- and Big Pharma wants the profits to continue!!

All these vested interests don't want C diff to be eradicated in hospitals by the simplest means i.e. medical staff washing their hands and probiotic therapy. The latter gets vilified by the medico-pharma shills every bit as much as the special diets for autistic children. These days I spend my time advising persons who are going into hospital on how to avoid picking up hospital superbugs.

In many ways I am now similar to my grandson in that I have pain, discomfort and food intolerances. I think research into probiotics for autism is long overdue and NO child should receive any vaccine containing live viruses for at least 3 months after antibiotic therapy. Balanced gut bacteria also prevent virus damage.

Cherry Sperlin Misra

Jenny Allan, Could you please tellus about your experience with gut problems. It sounds very interesting. At the same time isnt it ironic that autistic parents have to practically do their own research to help their childrens gut issues. Where is "Modern Medicine"?

Martha Moyer

I just hope none of your children end up like my 38 year old son with paralyzed bowels. We tried everything possible to solve the problem but could not do a thing to solve it. We had sophisticated potty trainings; every bowel drug available; we tried practicing sitting on toilet so he would experience success but they were huge BMs. I know they hurt him. Three bowel impactions resulted finally in paralyzed bowels. Don't see much research going on. We use a special cleanout device to clean out the upper and lower bowel..three times a week. Martha TEXAS

Jenny Allan

Sarah raises some interesting questions regarding gut flora imbalances and autism spectrum disorders. It is well known that newborn babies have Clostridium difficile bacteria in their guts, but this does not seem to harm their developing bowels. C diff overgrowths are normally associated with broad spectrum antibiotic prescribing, which 'knocks out' friendly as well as unfriendly bowel bacteria. Vancomycin is a 'last ditch' treatment. As a C diff survivor myself, after a bowel operation, I am aware of the effects that bowel toxins have on the brain!!

My autistic grandson had just completed a course of antibiotics for a respiratory infection when he was administered the MMR vaccine. The importance of a balanced gut flora is only now being recognised within medical circles. More of this research please.

Sarah

I've heard Vanomycin used to treat the GI in children with regressive autism. Has any one heard of fecal transplants? It may sound gross but according to patients with clostridia difficile overgrowth and Crohns it's a very effective treatment. Symptoms disappear within a day according to some reports.

I wonder if it would help our kids?

Some interesting links:

Bacteriotherapy and Autism- Autism One radio

http://www.voiceamerica.com/episode/56218/fecal-bacteriotherapy-with-dr-thomas-borody

Dr. Emma Allen-Vercoe interviewed about autism microbiome and possible use of fecal transplant for children with autism here:

http://cogentbenger.com/autism/interviews/emma-allen-vercoe-interview/

some other sources:

Your Inner Ecosystem- how microbes are important to our health- Scientific Amercian

http://www.scientificamerican.com/article.cfm?id=ultimate-social-network-bacteria-protects-health

On Point with Tom Ashbrook, NPR - "Your inner Ecosystem" radio broadcast

http://onpoint.wbur.org/2012/06/20/bacteria-2


GASTROINTESTINAL BALANCE AND THE COMPLEXIY OF NEUROTRANSMITTER FORMATION OF THE GASTROINTESTINAL
BY AMY YASKO, PHD, AMD, FAAIM, AND NANCY MULLAN, MD

http://www.scribd.com/doc/98433639/Gastrointestinal-Balance-and-Neurotransmitter-Formation

Short-term benefit from oral vancomycin treatment of regressive-onset autism.Sandler RH, Finegold SM, Bolte ER, Buchanan CP, Maxwell AP, Väisänen ML, Nelson MN, Wexler HM.


http://www.ncbi.nlm.nih.gov/pubmed/10921511

Benedetta

Hi Sarah;
Natasha very right!
If you mess up the metabolism, the endocrine system - it makes the environment right for certian types of bacteria overgrowth.
Dr. Wakefield even talked about clostridia -- he said that - GI Docs have noticed that if they shorten the gut because of injury - they get overgrowth of certian type of bacteria.
Diabetics with all their sloppy digestion of carbs get yeast overgrowth.

The cause of overgrowth of the wrong bacteria is further on up the pipes.

Sarah

Thanks Natasa, it makes total sense that our kids caught in a vicous cycle of gut microbiota imbalance leading to chronic inflammation. It will take proper GI treatment to break the cycle. I defintely notice an improvement in my sons behavior when he takes probiotics. I wonder to what extent antibiotics are the culprit.

When he was about 18 months, my son had a horrible reaction to an antibiotic. He developed severe gastroentoritis. I had to take him the ER. His aftercare was not great and being a new mom I didn't understand the long term seriousness of gut problems or how to treat. I think his guts been a mess ever since.

Natasa

Hi Sara, see my previous post. Autonomic Nervous System controls most of gut immune response. When it is malfunctioning there will be bacterial overgrowth. Bacterial toxins will then further impair functioning of ANS, creating a vicious loop that needs to be cut somehow.

Have a look at this French TV report 'Treating Autism with Antibiotics' http://www.autismtreatmenttrust.org/?p=1898

Natasa

Yes, most likely all signs of dysautonomia - malfunction of the Autonomic Nervous System, with mainly symptathetic activation over parasympathetic ('fight or flight' symp mode over 'rest and digest' parasympathetic one).

This is an understudied area but central to autism imo. I very much hope things will change sometime in the near future, with more research and treatement trials.

http://uwire.com/2011/10/11/u-missouri-researcher-finds-autism-hope-in-pill/

Sarah

Studies on gut mircrobiota have found children with autism have high levels of Clostridia and even Sutterella bacteria in their gut. According to a study done by a team from Columbia University, Sutterella was not found in GI of typical children who served as controls. Could these bacteria be causing severe chronic inflammation in the GI and brain. If the bad gut microbiota is properly treated perhaps our kids would function better. Perhaps the fact that Sutterella was only found in children with autism is very significant. We need more studies that look at treatment for gut imbalance and behavioral improvement.

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