Overview of GI in ASD Blog Series
Cell-El Ltd. studies stem cell therapy as a possible treatment for immune dysfunction. During the past decade, ASD associated immune dysfunction has been observed in numerous studies. We have also been observing this dysfunction in our diagnostic study of children with ASD as compared with typically developed children. Our working theory is that immune dysfunction is possibly a root cause of ASD behavioral issues. By affecting change at the source at a young age the treatments will hopefully improve the child’s future function and quality of life. Cell-El’s goal is to enable treatments for young children based on our biological diagnostic tool.
This is the second of two Cell-El blog posts by Dr. Arthur Krigsman MD, Board certified pediatric gastroenterologist specializing in the evaluation and treatment of children with autism and related disorders. This post has been reprinted as well as edited with permission from Dr Krigsman. Originally published in Pediatric Gastroenterology Resources of New York & Texas
Disclaimer: The views, practices and opinions expressed by the individuals in these posts do not necessarily reflect the official policy or position of Cell-El Ltd
Part 2: Symptoms and Treatment of GI Disease in kids with ASD
Gastrointestinal disorders and associated symptoms are commonly reported in children with ASD
Some children do not present with obvious symptoms until they are older. Because of deficits in both verbal and non-verbal modes of communication and the frequently observed muting of normal responses to painful stimuli, gastrointestinal disease in many autistic children is overlooked or even dismissed.
GI Symptoms in Autistic Children Include:
- Abdominal pain
- Abdominal distention
- Abnormal posturing
- Constipation (defined as either infrequent stools or overly hard stools)
- Diarrhea (described as either unformed stools or excessively frequent stools)
- Failure to thrive
- Weight loss
- Feeding problems
- Malodorous stool
- Undigested food in stool
- Straining to pass stool that is not overly hard
- Gastroesophageal Reflux
Patients with ASDs and gastrointestinal disorders also often exhibit problem behaviors such as self-injury and aggression, food refusal, disturbed sleeping patterns, and irritability. Often, behavioral problems are the ONLY manifestation of an underlying gastrointestinal disorder.
Additionally, patients who fail to make expected cognitive and behavioral progress from recognized therapeutic interventions (e.g. ABA, speech therapy, etc.) may have an underlying gastrointestinal disease that is preventing them from benefiting from these therapies.
Treatment of GI Disease in kids with ASD
Identification and treatment of gastrointestinal disease in children with ASD is for the purpose of alleviating the symptoms of gastrointestinal disease, just as in children without ASD. Pain, diarrhea, constipation, growth failure etc. need to be treated in children with ASD just as in any other child.
Proper gastrointestinal evaluation, diagnosis, and treatment in this group of children is often hampered by a historic bias favoring psychiatric explanations for ASD behaviors, an over-reliance by health care personnel on psychotropic medications and other related challenges. Individual patient Intolerance to many commonly used medications and added ingredients (e.g. dyes, preservatives, etc.), feeding difficulties, and the overall poor cooperation of many ASD children impose further difficulties in attempting to treat these children.
Many of the gastrointestinal diagnoses in these children are curable, as they are in neurotypical children. While other diagnoses, such as IBD’s (inflammatory bowel disease), are not curable, IBD’s are treatable and most patients respond to some combination of anti-inflammatory medication, antimicrobials, probiotics, digestive enzymes and dietary restriction. These responses are measurable and quantifiable improvement in the presenting gastrointestinal symptoms can be observed..
The first step in treatment is an accurate diagnosis
Proper diagnosis and treatment of gastrointestinal disease in autistic children may result not only in improvement of their gastrointestinal symptoms but also in improvement of behavioral and cognitive symptoms following gastrointestinal symptom resolution. It is thought that the presence of chronic GI symptoms, whatever their source, makes the child less available to the benefits of proven behavioral and functional therapies and that treating them removes this barrier.
Aside from being intuitive, this conclusion has also been widely disseminated as a consensus opinion in a recent publication in Pediatrics, the flagship journal of the American Academy of Pediatrics.
Treating the gastrointestinal symptoms of children with ASD may not treat autism as such, but relieving these children of chronic physical pain can make them more available for the therapies that are of demonstrated benefit and allow them to better participate in an academic setting.
A few links for further reading
- Gastrointestinal Pathology in Autism: Description and Treatment, A. Krigsman/Medical Veritas 4 (2007) 1522–1530 doi: 10.1588/medver.2007.04.00167 1522
- A molecular biomarker for prediction of clinical outcome in children with ASD, constipation, and intestinal inflammation (Scientific Reports, April 2019)
- Gastrointestinal disease in children with autism spectrum disorders: Etiology or consequence? World J Psychiatr 2021; 11(9): 605-618 [PMID: 34631464 DOI: 10.5498/wjp.v11.i9.605]
Help Us Help You
You too can join our team and help us in making a difference in the lives of children with ASD and their families! For the Cell-El study, we are recruiting infants aged 10-18 months not diagnosed with ASD but with a sibling diagnosed with ASD and their mothers. Parents please help spread the word to others and thus enable this important tool to be integrated into Autism treatment as quickly as possible. Additionally, if your child is diagnosed with ASD and between the ages of 2-12 years old and you are planning to take them privately to a clinic offering Stem Cell treatment for ASD, please contact Leah at email@example.com or fill out the form to find out about eligibility to participate in our diagnostic study.