Digestive problems and altered microbiome in autism

Digestive, microbiome and inflammation in autism

Digestive problems impact the majority of people diagnosed with autism. Changes in gut flora alter the ecosystem in the gut which is called the microbiome.  Digestive disorders and altered microbial balance subsequently lead to inflammation that contributes to developmental delays and behavioural concerns in autism.

“Surveys published in the gastroenterology literature have stated that gastrointestinal problems, such as chronic constipation or diarrhea, occur in 46% to 85% of children with ASDs.”

Journal of Pediatrics – Scott M. Myers, MD

How do digestive problems impact children with autism?

Children diagnosed with autism almost always have digestive problems.  The most common are constipation, diarrhea and pain.  In addition to absorbing nutrients, the digestive tract plays a critical role in producing brain chemicals that govern development.  In fact, the gut makes over 90% of the body’s serotonin which is a key regulator of language, appetite, sleep and mood.

So, why do neurotypical kids who have constipation not have autism too?  Children diagnosed with autism have methylation impairments which consequently results in decreased levels of glutathione being produced. 

Glutathione is the body’s master antioxidant which is responsible for removing heavy metals, chemicals and the breakdown products of microbes. For examples of glutathione helps remove toxins made by both yeast and clostridia.  Methylation impairment combined with low glutathione and digestive problems lead to retained toxins.

Autism has been linked to elevated levels of lead, mercury, pesticides and plastics but every child who experiences increased exposure doesn’t end up with autism.  It is the additional unique physiological differences that set the stage for the “perfect storm”.  Genetic predisposition, impaired methylation and gut issues all combine and as a result contribute to the inflammatory cascade that seen in autism.

Above all, assess gut function:

Assessing gut function and motility needs to be the first step in biomedical treatment.  Many children experience over digestive symptoms like frequent loose stool or going days without bowel movements.  Some children and adults diagnosed with autism experience a silent form of constipation that is due to fecal loading.  Mitochondrial weakness negatively impacts every cell, tissue and organ in the body and as a result, slows the motility of the digestive tract. It is Important to note that mitochondrial dysfunction occurs in most cases of autism. 

Mitochondria are the powerhouses of our cells producing a molecule called ATP.  Less ATP leads to impaired organ function.

This is what happens for many people with autism.  Weak tissues in the gut lead to stretching of the bowel and loss of tone.  The bowel stops being able to remove stool effectively unless is completely full.  The best way to identify if this is happening is to ask your doctor to requisition a bowel x-ray.  Lots of kids poop every day but they are removing stool that has been in there for days.  The longer stool sits in the intestine and as a result toxins in the gut are re-absorbed into the body.  Fecal loading also contributes to overgrowth of yeast and clostridia which, in turn, further contribute to autism symptoms.

What role does the microbiome play in development:

The Human Genome Project funded by the National Institutes of Health has identified that the microbes that live in the gut govern brain function.  Our intestine is home to trillions and trillions of microbes including thousands of different types.  Members of the gut community include bacteria, yeast and viruses.  In autism, the balance of these microbes is altered resulting in an altered microbiome.  Research in this area is transforming our understanding of the medical aspects of autism and subsequently the medical interventions that can improve quality of life and development.

Research shows that children with autism have elevated levels of inflammation and immune dysregulation. The digestive tract is the heart of the innate immune system and therefore plays a crucial role in regulating inflammation.  It contains both immune cells and beneficial bacteria and other microbes that support our body’s metabolism.  The innate immune system is a barrier defence against microbes.  This barrier system also plays a key role in regulating inflammation.

Harmful or opportunistic microbes change the microbiome and therefore change the way the body and brain is function.

In autism, research on inflammation and immune changes lead to medical treatment options that can restore balance in the microbiome which improves the function of every cell as a result. Most importantly, medical treatment improves quality of life and enhances development.

Causes and symptoms of digestive dysfunction include:

  • Food allergies and sensitivities
  • Enzyme deficiency or dysfunction
  • Chronic constipation and/or diarrhea
  • Mucous, blood or undigested food in stool
  • Pain, cramping or discomfort
  • Bloating
  • Leaky gut
  • Issues with absorption / Nutrient deficiencies
  • Bacterial overgrowth in the small intestine (SIBO)
  • Elevated histamine levels
  • Methylation impairment / SNPs

Addressing digestive problems is the key to successful biomedical treatment:

So, what is healthy digestion?

Your child should be having 2-3 bowel movements daily.  The bowel movements should be formed, easy to pass and uniform in colour.  There should be no undigested food (except corn!), mucous or blood in the stool.  Although bowel movements usually have an unpleasant odour, sometimes the odour is unhealthy.  The smell of the stool can be very helpful in identifying the root cause of digestive symptoms. For example, yeasty, foul, sweet, like a harbour, and bready smells can all indicate yeast overgrowth

Signs of inflammation outside the digestive tract include:

What contributes digestive problems and altered microbiome in autism?

  • Above all, complex carbohydrates and dairy products
  • Food allergies and sensitivities and early introduction of allergens
  • C-Section and IV antibiotics – prevent natural colonization of good bacteria
  • Toxins like heavy metals and environmental toxins
  • Harmful or opportunistic microbes including yeast and clostridia
  • GMO – Genetically modified foods disrupt innate immune in the gut
  • Antibiotics – kill good bacteria alters the balance in the microbiome
  • Elevated histamine