Medication absorption for children with autism

Research indicates that medication absorption in children with autism should be examined more closely due to the connection between autism and gastrointestinal issues.

Recent research has revealed that many children and adults with autism experience gastrointestinal symptoms and that such symptoms can impact the absorption and availability of medications.

Because approximately 35% of people with autism take at least one psychotropic medication to help control their symptoms, the authors of a Journal of Clinical Pharmacology commentary are calling for a formal evaluation of the potential relationship between gastrointestinal symptoms and the effectiveness of autism medications. Alternative modes of drug administration may be needed to provide more effective therapy for patients.

"Admittedly, there are a number of variables that can influence medication response but given how common gastrointestinal issues are for those with autism, it seems the relationship should be examined more closely," said senior author Dr. Maria Valdovinos.

Read more here

Autism and risk of GI issues

This article discusses why children with autism may be at an increased risk of having gastrointestinal issues.

Children with an autism spectrum disorder (ASD) are more likely to deal with gastrointestinal issues, than non-ASD children, according to recent findings published in the journalPediatrics.

Despite lack of attention to the linked health issues, researchers are now more closely examining this possible connection. Findings revealed that children with an ASD were four times more likely to experience general GI complaints and up to three times more likely to experience constipation or diarrhea than their non-ASD counterparts, according to Medical Xpress. In fact, these children complained about abdominal pain twice as often as other peers not dealing with the cognitive health issue.

For the study, researchers at the Marcus Autism Center, Children's Healthcare of Atlanta and Emory University School of Medicine, conducted an analysis to determine the link.

"One was to survey what we know about these issues-and we don't know much," said co-study author William Sharp, director of the Pediatric Feeding Disorders Program at Marcus Autism and assistant professor of pediatrics at the School of Medicine, in a news release. "There have been only fifteen studies published in the past 32 years that have really good experimental controls. "We also hope this study prompts the medical community to increase its focus on the prevalence, cause, and remediation of these issues."

Researchers noted that in the past 32 years, only 15 studies have been published with good experimental control groups to examine any connections between these health issues. 

However, while this new research confirms a connection to these two health issues based on the anecdotal experience of pediatricians and parents, it does not show a casual relationship.

Furthermore, researchers reiterate the need for more research strictly focusing on GI symptoms experienced in ASD populations.

"Clearly, consideration should be given to the high rate of feeding problems and related behavioral issues such as toileting concerns documented in this population," Sharp added.

At this time, researchers do not have enough evidence to suggest a unique GI pathology in children with an ASD. 

Read more here

The CHD8 mutation was found to be a genetic link to Autism

A study found that the CHD8 mutation is a genetic link to autism.

In a collaboration involving 13 institutions around the world, researchers have broken new ground in understanding what causes autism. The results are being published in Cell magazine July 3, 2014: "Disruptive CHD8 Mutations Define a Subtype of Autism in Early Development."

"We finally got a clear cut case of an autism specific gene," said Raphael Bernier, the lead author, and UW associate professor in the Department of Psychiatry and Behavioral Sciences and the clinical director of the Autism Center at Seattle Children's.

Bernier said people with a mutation in the CHD8 gene have a very "strong likelihood" that they will have autism marked by gastrointestinal disorders, a larger head and wide set eyes.

In their study of 6,176 children with autism spectrum disorder, researchers found 15 had a CHD8 mutation and all these cases had similar characteristics in appearance and issues with sleep disturbance and gastrointestinal problems.

Bernier and his team interviewed all 15 cases with CHD8 mutations.

To confirm the findings, researchers worked with scientists at Duke University who do zebra fish modeling. The researchers disrupted the CHD8 gene in the fish and the fish developed large heads and wide set eyes. They then fed the fish fluorescent pellets and found that the fish had problems discarding food waste and were constipated.

Bernier said this is the first time researchers have shown a definitive cause of autism to a genetic mutation. Previously identified genetic events like Fragile X, which account for a greater number of autism cases, are associated with other impairments, such as intellectual disability, more than autism. Although less than half a percent of all kids will have this kind of autism related to the CHD8 mutation, Bernier said there are lots of implications from this study.

"This will be a game changer in the way scientists are researching autism," he said.

The results could lead the way to a "genetics-first approach" that could uncover hundreds more genetic mutations and lead to genetic testing. Genetic testing could be offered to families as a way of guiding them on what to expect and how to care for their child. Currently, autism is diagnosed based on behavior, said Bernier.

In the short term, Bernier said, clinicians can pay attention to the small population with this CHD8 mutation and provide targeted treatment.

Researchers say autism has currently been linked to different types of genetic events. The most commonly researched genetic events associated with autism are chromosomal re-arrangements, called "copy number variations," in which a chunk of chromosome is copied or deleted. But no one rearrangement affects more than 1 percent of all autism cases. While these copy number events are associated with autism, they do not have a definitive link, or as they say among researchers, a "strong penetrance."

Then there are genetic mutations in which a gene has been disrupted and is not creating the kind of protein it should create. The CHD8 gene mutation is the first gene mutation to show a very strong penetrance linked to a certain subtype of autism.

Read more here

Autism in adults leads to many health problems

This article discusses how autism in adults can result in many other health problems.

Autism apparently isn't a stand-alone disorder, with new research revealing that adults with autism often face a host of mental and physical illnesses.

Kaiser Permanente researchers found that nearly all medical conditions are significantly more common in adults with autism spectrum disorders than those without, ranging from depression to gastrointestinal problems to obesity. Notably, however, adults with autism are much less likely to smoke or use alcohol than other adults, and cancer rates are similar.

"Some of these conditions we've seen in children with autism, so we expected higher rates of anxiety and depression, and some of the medical disorders, such as gastrointestinal disturbances, in adults," said study author Lisa Croen, director of the Kaiser Permanente Autism Research Program in Oakland, Calif.

"That's been reported for a long time in children, so we're not surprised to see those continue to be elevated," she added. "But we were surprised by the magnitude of what we found."

The study is scheduled to be presented Thursday at the International Meeting for Autism Research in Atlanta. Research presented at scientific conferences typically has not been peer-reviewed or published and results are considered preliminary.

Diagnosed in about 1 in 68 American children, autism spectrum disorder is the fastest-growing serious developmental disability in the United States, according to the advocacy and research organization Autism Speaks.

The disorder can be mild or severe, but symptoms typically include social and communication difficulties and repetitive behaviors.

Croen and her colleagues examined medical records from 2008 to 2012, and compared the prevalence of psychiatric, behavioral and medical diagnoses among 2,100 adults with an autism spectrum disorder to 21,000 adults without the disorder.

Adults diagnosed with an autism spectrum disorder had markedly higher rates of mental health problems than the other adults:

• Depression (38 percent versus 17 percent)
• Anxiety (39 percent versus 18 percent)
• Bipolar disorder (30 percent versus 9 percent)
• Suicide attempts (1.6 percent versus 0.3 percent)

People with autism spectrum disorders were also more likely than adults without the disorder to have physical ailments, such as:

• Diabetes (6 percent versus 4 percent)
• Gastrointestinal disorders (47 percent versus 38 percent)
• Epilepsy (12 percent versus 1 percent)
• Sleep disorders (19 percent versus 10 percent)
• High cholesterol (26 percent versus 18 percent)
• High blood pressure (27 percent versus 19 percent)
• Obesity (27 percent versus 16 percent)

"What the data show is really an extension of what we've learned already of children and adolescents with autism," said Dr. Paul Wang, senior vice president and head of medical research for Autism Speaks, who wasn't involved in the study. "It's not just a brain disorder -- it's really a disorder that affects the whole body. And this shows that these problems don't go away."

Croen said that many possible reasons exist for the wide gap in mental and physical ailments suffered by adults with autism, including a potential genetic basis. But the "core impairments" of those with autism -- such as communication problems and heightened sensitivity to touch -- can also make it difficult for them to be properly examined by clinicians, she said.

"People with autism often have very selective eating and their nutrition suffers," Croen added. "Their social impairments can lead to isolation, which leads to a lack of exercise. So some lifestyle factors can create more unhealthy lifestyles."

Social isolation may also explain why adults with autism are less likely to drink alcohol or smoke, noted Croen, also a senior research scientist at Kaiser Permanente Northern California Division of Research.

"Smoking and drinking are more social behaviors, especially in young people," she said. "Or, that's how it gets started. These young people with autism are out of the mainstream."

Croen and Wang agreed that autism researchers should extend their focus beyond the brain to multiple bodily systems as well as examine the transition from pediatric to adult health care.

"I hope these findings raise awareness among the medical community and others that adults with autism have a really high burden of medical and psychiatric conditions, much more than people think," Croen said. "There's a real need for doctors to be educated about autism and the characteristics of these adults so they can provide adequate and effective care."

Read more here

Study claims children with autism have more GI symptoms

For many the link is obvious.

 But the question about the common genetic link between the gut's nervous system and the central nervous system. Energy production, Cell structural proteins, cell-cell signaling could be affected centrally AND peripherally. - JR

A study shows that children with autism have a higher prevalence of GI symptoms than children without autism.

A new study conducted by researchers at Marcus Autism Center, Children's Healthcare of Atlanta and Emory University School of Medicine indicates that children with autism spectrum disorder (ASD) are more than four times more likely to experience general gastrointestinal (GI) complaints compared with peers, are more than three times as prone to experience constipation and diarrhea than peers, and complain twice as much about abdominal pain compared to peers.

The results are reported in the April 28, 2014, online early edition of the journal Pediatrics.

While parents frequently express concern regarding GI symptoms among children with ASD in pediatric settings, this study is the first meta-analysis of all published, peer-reviewed research relating to this topic.

"Our findings corroborate a history of anecdotal reports and case studies suggesting increased risk of GI concerns in autism," says co-author William Sharp, PhD, director of the Pediatric Feeding Disorders Program at Marcus Autism Center and assistant professor of pediatrics at Emory University School of Medicine. "This analysis reinforces the need for greater clinical and research scrutiny in this area to guide best standards of care and to address important questions regarding the detection and treatment of GI symptoms among children with autism."

The process of detecting and studying possible GI concerns in children with ASD is complicated by the unique combination of behavioral, neurological and medical issues associated with the condition. Most notably, limitations in verbal communication in patients with ASD make it difficult for them to communicate information about GI symptoms, making it more challenging for physicians to detect possible underlying GI issues. In such cases, parents and medical professionals must rely on non-verbal signs that fall outside of the routine GI diagnostic evaluation.

"In many cases, the only indication of a possible GI problem in autism may be the emergence or escalation of problem behaviors, such as self-injury, aggression, or irritability, that cannot be otherwise explained," says co-author Barbara McElhanon, MD, pediatric gastroenterologist at Children's Healthcare of Atlanta and assistant professor of pediatrics at Emory University School of Medicine. "Relying on these atypical signs to detect possible GI concerns can be difficult for practitioners because repetitive and stereotyped patterns of behavior occur so frequently in ASD and no guidelines exist to help parents and clinicians navigate the diagnostic process."

For this reason, McElhanon and her colleagues emphasize the need to develop a standardized screening instrument as well as clinical guidelines for conducting GI examinations among children with ASD, particularly non-verbal children. More detailed, standardized screening procedures would enhance detection, while also increasing awareness in the ASD community regarding what to look for among children suspected of possible GI disorders.

"The important point from this research is that children with autism -- who have difficulties in communicating their symptoms -- need special attention from physicians to determine whether or not a child is experiencing GI distress" says Sharp. "Unfortunately for parents, the unfounded assertion that vaccinations somehow caused an inflammatory GI disease which then caused autism has significantly hindered progress in this field for years. Many studies have now shown no evidence of an association with vaccines, and vaccines are important for child health. That controversy diverted attention from the GI needs of children with ASD, and we hope that our work helps spur renewed investment for addressing these needs."

In addition to more standardized assessment, the authors recommend studying GI symptoms in ASD with consideration to the high rates of feeding problems and related dietary issues, such as food selectivity, in this population. "If food intake becomes highly restricted, a child is likely to experience issues like GI distress and constipation or diarrhea; but for children with autism, they often can't communicate those issues in the same way," says McElhanon. "More research is needed to understand the best means of identifying and treating these special health needs of children with ASD."

Read more here

One stop shop for a scholarly review of state-of-the-art research on autism in children

This article reviews the recent research that has been done on autism in 6 main areas.

Recent years have seen exciting progress in key areas of research on autism spectrum disorders (ASD): from possible genetic causes, to effective treatments for common symptoms and clinical problems, to promoting success for young people with ASD entering college. Updates on these and other advances in ASD research are presented in the March special issue of Harvard Review of Psychiatry.

"Autism is one of the most challenging disorders to treat and the public health concerns associated with the disorder are numerous due to its burden on the individual, on the family and on society," write guest editors Drs Jean A. Frazier of University of Massachusetts Medical School and Christopher J. McDougle of Harvard Medical School. The special issue provides a timely update on research into the causes, important clinical issues, and evidence-based treatments for ASD.

Updates on ASD Research in Six Key Areas

Leading experts provide state-of-the-art reviews on six topics: the genetics of ASD; the use of psychoactive drugs; symptoms of special clinical problems, including obesity, gastrointestinal problems, and sensory issues; and transitioning to college.

Genetics. Over the last few years, there have been "unprecedented advances" in understanding the genetic causes of ASD. Hundreds of genes conferring varying degrees of ASD risk have been identified to date. Many of these genes also appear to be risk factors for related neurodevelopmental disorders and psychiatric problems. While many unanswered questions remain, it may soon be possible to make specific genetic diagnoses in children with ASD.

Psychoactive medications. Despite limited evidence, psychotropic drugs are widely used to manage behavior problems and mental health disorders in children with ASD. For medication classes -- including antidepressants and stimulants -- effectiveness may differ for youth versus adults with ASD. New treatments affecting specific neurotransmitters and the hormone oxytocin are under development, and may help in targeting the "core symptoms" of ASD.

Obesity. Obesity is a common problem with a major impact on the health of children with ASD. Some ASD-related genes may also promote obesity; the same is true for antipsychotic drugs used to help manage behavior problems. Other contributing factors may include sleep disorders and barriers to getting enough exercise. Childhood obesity and related health issues may be a "significant threat" to the health and quality of life of children with ASD.

Gastrointestinal issues. Children with ASD also have high rates of gastrointestinal symptoms and disorders. Some genes linked to ASD may also play a role in gastrointestinal disturbances, with a possible link to immune system dysfunction. There's also emerging evidence of a potential "gut-brain" connection, with gastrointestinal dysfunction contributing to the development or severity of ASD symptoms.

Sensory symptoms. Children with ASD have various abnormalities of sensory function, including both over- and under-responsivity as well as "sensory seeking behavior." Although the neurobiology of these sensory symptoms remains unclear, some researchers suggest they are related to known abnormalities of brain structure and function. Recent studies show that sensory symptoms are related to other ASD-related symptoms and behaviors; more research is needed to demonstrate the effectiveness of "sensory integration therapy" and other occupational therapy approaches.

Preparing for college. The final article highlights the need for new approaches to meeting the needs of "high-functioning" ASD patients entering college. Students "on the spectrum" transitioning to college are at risk of both academic and social problems, and may benefit from accommodation and supports. Based on a growing body of research, a set of recommendations for developing more effective transition plans for children with ASD are proposed.

Along with the editors of Harvard Review of Psychiatry, Drs Frazier and McDougal hope their special issue will provide a useful update for clinicians caring for the growing numbers of individuals and families living with ASD. They conclude, "Clearly, more research is needed on every level for the field to help support and treat individuals on the spectrum so that they can optimize their developmental trajectory and as adults become integral members of our work force."

The journal can be found online at:http://journals.lww.com/hrpjournal/Pages/default.aspx

Read more here

http://journals.lww.com/hrpjournal/pages/currenttoc.aspx

New and odd ideas for treating autism symptoms.

Fasten your seatbelt - new and unusual autism treatments (???): hot baths and worm eggs, were presented at a recent meeting  to help with autism symptoms. 

I was asked what I thought of these treatments... My impression, from a medical  standpoint is..."YIKES", "OMG" and "You are kidding, right?". 

It goes without saying, but Ill say it....I DO NOT recommend these therapies.   1) There does not seem to be biologic plausibility. 2) This is not nearly convincing data. 3) There may be dangers in these treatments (the picture of the child sitting alone in the bath is intended to be alarming).  

http://www.autism-watch.org/ is still a good site. 

Hardly a nihilist on therapeutics, I look forward to more data on effective treatments.    - JR

A new study shows that two unusual treatment approaches may have beneficial effects on the symptoms of autism in children and adults with the disorder. Using a hot bath to raise body temperature and thereby mimic the effects of infection, or using worm eggs to stimulate the production of immunoregulatory factors in the gut to diminish inflammatory signals, both attenuated symptoms of autism. These findings support the idea that disruption of systems in the body that control inflammation may contribute to the disorder. The study was presented at the American College of Neuropsychopharmacology (ACNP) Annual Meeting.

Approximately 1 in 88 children are afflicted with autism spectrum disorder (ASD). A prevailing hypothesis of ASD is that a hyperactive immune system, resulting in elevated levels of inflammation, may contribute to the disorder. Consistent with this possibility, it is known that approximately one third of those with ASD show a clinical improvement in symptoms in response to a fever.

In a new study led by Eric Hollander MD, a professor at Albert Einstein College of Medicine in New York, the effects of two novel treatment approaches that modify aspects of inflammation were tested on ASD symptoms.

First, as fever may trigger the release of protective anti-inflammatory signals in the body, the effects of raising body temperature to mimic fever on ASD symptoms were assessed. It was found that children with ASD and a history of positive behavioral response to fever had improved social behaviors when bathed each day in a hot tub at 102oF compared with water at 98 oF.

Second, using a more unusual approach, adults with ASD were treated for 12 weeks with Trichuris suis ova (TSO), which are the eggs of the worm helminth trichura (whip worm). This worm is safe in humans as it does not multiply in the host, is not transmittable by contact, and is cleared spontaneously. However, the worms can inhibit immune-mediated responses and diminish inflammation.

The subjects for this study were 10 high functioning ASD patients who were able to give informed consent and who had a history of allergies or a family history of immune-inflammatory illness. Patients were treated for 12 weeks with the worm eggs (2500 eggs every two weeks) but were also subjected to a 12 week placebo phase in a randomized order. It was found that adults with ASD had improvement in repetitive and ritualistic behaviors in response to treatment with the worm eggs.

This is not the first time that worm eggs have been used successfully to treat diseases, particularly immune-related diseases, in humans such as Crohn's Disease. As noted by Dr. Hollander, "TSO has been shown to improve various immune inflammatory illness by shifting the ratio of T regulator/T helper cells and their respective cytokines.."

The findings support the idea that inflammation may contribute to the symptoms of autism, at least in some individuals, and highlight novel treatment approaches. However, as noted by Dr. Hollander, the small sample size and unusual treatment approach means that caution should be exercised when interpreting the studies:

"Future studies in autism spectrum disorders are needed to replicate and expand these findings, and to study younger subjects with more severe irritability."

Nevertheless, the findings raise the intriguing possibility that approaches designed to module immune responses in ASD patients may be future treatment approaches for the disorder.

Read more here

Study: Gut Bacteria Levels Lower in Children with Autism

A study claims that children with autism have lower levels of bacteria in the gut which makes them more susceptible to harmful bacteria.

A link may exist between autism and bacteria in a child's digestive tract, a small new study suggests.

Researchers analyzed gut bacteria in fecal samples from 20 children with autism and 20 children without the disorder. The children with autism had significantly fewer types of gut bacteria, which potentially could make them more vulnerable to harmful bacteria.

The study also found that children with autism had significantly lower amounts of three types of important gut bacteria.

Autism, a neurodevelopmental disorder that can range from mild to severe, affects social and communication skills.

The new study appears July 3 in the journal PLoS One.

"One of the reasons we started addressing this topic is the fact that autistic children have a lot of [gastrointestinal] problems that can last into adulthood," study leader Rosa Krajmalnik-Brown, a researcher at Arizona State University's Biodesign Institute, said in a university news release. "Studies have shown that when we manage these problems, their behavior improves dramatically."

This type of research could lead to new ways to treat autism-associated gastrointestinal problems, and improve diagnosis, prevention and treatment of autism, the study authors said.

Previous research has shown that gut bacteria plays a role in a wide range of important functions, including digestion, controlling body weight, immune response regulation and the production of neurotransmitters that affect the brain and behavior.

Although this study showed a potential link between gut bacteria and autism, it did not prove a cause-and-effect relationship.

Read more here

Vaccine to Help Control Autism Symptoms

This article discusses a new vaccine that was developed to help control the symptoms of autism.

A first-ever vaccine created by University of Guelph researchers for gut bacteria common in autistic children may also help control some autism symptoms.

The groundbreaking study by Brittany Pequegnat and Guelph chemistry professor Mario Monteiro appears this month in the journalVaccine.

They developed a carbohydrate-based vaccine against the gut bugClostridium bolteae.

C. bolteae is known to play a role in gastrointestinal disorders, and it often shows up in higher numbers in the GI tracts of autistic children than in those of healthy kids.

More than 90 per cent of children with autism spectrum disorders suffer from chronic, severe gastrointestinal symptoms. Of those, about 75 per cent suffer from diarrhea, according to current literature.

"Little is known about the factors that predispose autistic children toC. bolteae," said Monteiro. Although most infections are handled by some antibiotics, he said, a vaccine would improve current treatment.

"This is the first vaccine designed to control constipation and diarrhea caused by C. bolteae and perhaps control autism-related symptoms associated with this microbe," he said.

Autism cases have increased almost sixfold over the past 20 years, and scientists don't know why. Although many experts point to environmental factors, others have focused on the human gut.

Some researchers believe toxins and/or metabolites produced by gut bacteria, including C. bolteae, may be associated with symptoms and severity of autism, especially regressive autism.

Pequegnat, a master's student, and Monteiro used bacteria grown by Mike Toh, a Guelph PhD student in the lab of microbiology professor Emma Allen-Vercoe.

The new anti- C. bolteae vaccine targets the specific complex polysaccharides, or carbohydrates, on the surface of the bug.

The vaccine effectively raised C. bolteae-specific antibodies in rabbits. Doctors could also use the vaccine-induced antibodies to quickly detect the bug in a clinical setting, said Monteiro.

The vaccine might take more than 10 years to work through preclinical and human trials, and it may take even longer before a drug is ready for market, Monteiro said.

"But this is a significant first step in the design of a multivalent vaccine against several autism-related gut bacteria," he said.

Monteiro has studied sugar-based vaccines for two other gastric pathogens: Campylobacter jejuni, which causes travellers' diarrhea; and Clostridium difficile, which causes antibiotic-associated diarrhea.

The research was supported by the Natural Sciences and Engineering Research Council.

Read more here

Study Shows Children With Autism Experience Interrelated Health Issues

Children who have autism are more likely to also have anxiety, gastrointestinal issues, and sensory problems, all of which can effect their daily lives.

One in 88 children has been diagnosed with an autism spectrum disorder (ASD) in the United States, according to the Centers for Disease Control and Prevention. A new study by a University of Missouri researcher found that many children with ASD also experience anxiety, chronic gastrointestinal (GI) problems and atypical sensory responses, which are heightened reactions to light, sound or particular textures. These problems appear to be highly related and can have significant effects on children's daily lives, including their functioning at home and in school.

Micah Mazurek, an assistant professor of health psychology and a clinical child psychologist, found in her study of 2,973 children and adolescents with ASD that nearly one-fourth also had chronic GI problems, such as constipation, abdominal pain, bloating, diarrhea or nausea. The results also showed that children with chronic GI problems were more likely to experience anxiety and sensory problems.

"These problems can have a very real impact on daily life. Children with anxiety may be distressed or reluctant to engage in new activities, and those with sensory problems may have trouble paying attention or participating in over-stimulating enviornments," Mazurek said. "These children may also suffer uncomfortable GI problems that they may not be able to communicate about to adults."

Clinicians should be aware that anxiety, GI problems and sensory sensitivity often co-occur in individuals with ASD. Effectively managing these concurrent issues may improve children's quality of life and their responses to treatment, Mazurek said.

"Parents need to be aware that these problems may underlie some of their children's difficulties, so if they notice any symptoms, they should talk to their doctors or therapists about treatment options," Mazurek said. "Practitioners who work with children with ASD need to be mindful that there is a pretty high rate of these problems, so if children are treated for one issue, it may helpful to screen for these additional symptoms."

This is the first study to examine the relationships among anxiety, GI problems and sensory over-responsivity in a large, nationally representative sample of children and adolescents with ASD. Participants in the study were enrolled in the Autism Treatment Network, a network of 17 autism centers throughout North America that are focused on best practices for medical treatment of children with ASD.

Read more here

Study Produces New Findings on Autism and GI Dysfunction

Pat Levitt, director of the Zilkha Neurogenetic Institute at the Keck School, served as principal investigator of the study, which was published on Jan. 9 on the website of Autism Research.

“This research shows that physicians should take parents seriously when they report GI problems,” said Levitt, who was joined in the study by first author Philip Gorrindo, a Ph.D. student in neuroscience at the Vanderbilt University Medical Center. “Doctors should be especially diligent inchecking children who have major language problems and who have not been identified previously with GID because there’s a higher likelihood that they could have GI problems, and these children may be less able to report their physical distress.”

The findings showed that parents and physician specialists are equally accurate in identifying GID in children with autism spectrum disorder (ASD). The behavior and communication problems in these children are more severe than in children with ASD only, and diet and medication do not appear to play a role in the gastrointestinal condition of ASD-GID children.

The study examined more than 120 children, mostly boys, both with and without ASD, whose average age was 11, at Vanderbilt in Nashville, Tenn. The most frequently reported GI problem was severe constipation, often accompanied by severe abdominal pain, and was common in both those with and without autism.

While earlier studies of the relationship between ASD and GID solely examined medical charts or previous parental reports, Levitt said this research was the first time that children with ASD have been recruited for a study in which a pediatric gastroenterologist actively was involved in diagnosing their medical condition.

All parents were asked to fill out a questionnaire to determine the accuracy of their reports of GI problems in their children, which was compared to diagnosis by a pediatric gastroenterologist. The study found that parents were 92 percent accurate in reporting such problems.

“This shows that when a pediatrician sees a mom with a child who says he has major gut problems, it’s an indication that the doctor should send the child to a specialist - a pediatric GI doctor,” Levitt said. “It dispels the myth that parents are over-reporting these types of problems.”

In addition, parents were asked to keep a seven-day diet diary for their children. The results found no difference in the kinds of food that any of the children with GID were eating. Researchers also looked at the behavioral medications taken by children with ASD and found no differences in medication use with or without GID.

The study also looked at the relationship between the severity of autism and GI symptoms. It found that six times as many children with GID had more severe language impairment than those without GID. Investigators also used a Social Responsiveness Scale (SRS), which indicated more social impairment among those with GI symptoms.

“Overall, the research is about changing the way we deal with the potential for medical problems in children with autism, a behaviorally diagnosed disorder,” Levitt said. “We think that improving a child’s GI function will have effects that reach far beyond their GI problems. It may make them more amenable to interventions focused on their autism because they’re not preoccupied with physical distress.”

Read more: http://www.healthcanal.com/genetics-birth-defects/26350-Study-Produces-New-Findings-Autism-and-Dysfunction.html

Study links autism, intestinal bacteria levels

Editors note: I am interested in systemic comorbidities in autism. For many years, parents have reported GI symptoms in children with autism. Perhaps we are getting some reputable data on this topic? But for those living with autism I ask you to proceed with caution! There is a difference between association and causation. For instance, do children with Down syndrome get more ear infections? Yes. Does that mean that ear infections cause Down Syndrome? Obviously not. JR

Study links autism, intestinal bacteria levels

Researchers at Columbia may be making strides toward understanding the neurological disorder of autism–starting with, of all places, the intestine, according to a recent study.

Dr. Brent Williams, an associate research scientist from the Mailman School of Public Health, headed the study, which examined gastrointestinal disturbances in children with autism. Researchers discovered that children diagnosed with autism that suffer from gastrointestinal disturbances have heightened levels of Sutterella, a type of intestinal bacteria.

After examining intestinal biopsies from his patients, Williams found that Sutterella bacteria existed in more than half of the children who had been diagnosed with autism. In comparison, Sutterella was not found in any normally developing children that also had gastrointestinal, or GI, disturbances.

“There have been reports relating to the prevalence of GI disturbances in children with autism, and those reports have been somewhat inconsistent,” Williams said. “One of the questions that is important to look at is whether the molecular underpinnings of the GI symptoms differ between children with autism and typically developing children.”

Although the correlation between autism and gastrointestinal dysfunction has been explored before, “the link between gastrointestinal and central nervous system dysfunction remains unclear,” according to Mady Hornig, researcher and associate professor of epidemiology.

“Gastrointestinal complaints are a prominent cause of concern and distress among children with autism and their caregivers,” Hornig explained. “Our approach allows us to rigorously investigate whether specific clinical and molecular patterns in the gastrointestinal tract are associated with neuropsychiatric disease.”

Williams and Hornig both said that they plan to work on future studies that delve more deeply into the relationship between GI disturbances and autism.

“We are exploring larger prospective studies where we could control for many factors that could be playing a role in the specific changes,” Williams said. “There is much work to be done toward understanding the role Sutterella plays in autism.”

Hornig added that to test the strength of the correlation, she hopes to expand the research to sample from a larger pool of patients.

“If we saw a close correlation, we would have a better time in accessing a larger population because not everyone will have serious GI disorders to bring to colonoscopy,” she said. “We could study larger populations in a more rapid fashion.”

Read more: http://www.columbiaspectator.com/2012/01/24/study-links-autism-intestinal-bacteria-levels