Gastrointestinal Factors in Autistic Disorder: A Critical Review

Department of Pediatrics, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana, United States
Journal of Autism and Developmental Disorders (Impact Factor: 3.34). 01/2006; 35(6):713-27. DOI: 10.1007/s10803-005-0019-4
Source: PubMed


Interest in the gastrointestinal (GI) factors of autistic disorder (autism) has developed from descriptions of symptoms such as constipation and diarrhea in autistic children and advanced towards more detailed studies of GI histopathology and treatment modalities. This review attempts to critically and comprehensively analyze the literature as it applies to all aspects of GI factors in autism, including discussion of symptoms, pathology, nutrition, and treatment. While much literature is available on this topic, a dearth of rigorous study was found to validate GI factors specific to children with autism.

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    • "It is sometimes possible to identify physiological weaknesses that are the direct or indirect cause of certain behavioural and eating problems. These include impaired sensory-motor processing (Brisson, Warreyn, Serres, Foussier, & Adrien, 2011; Matson, Matson, & Beighley, 2011; Ming, Brimacombe, & Wagner, 2007; Overland, 2011; Provost, Lopez, & Heimerl, 2007), cognitive and emotional dysfunction (Nadon, 2011) and gastrointestinal disorders (Erickson et al., 2005; Goodwin, Cowen, & Goodwin, 1971; Souza et al., 2012; Wang, Tancredi, & Thomas, 2011). It is important that such conditions are not ignored because an exclusively behavioural approach to treatment in these cases can underrate the impact of organic problems on children's feeding habits (Hsu & Ho, 2009; Twachtman-Reilly, Amaral, & Zebrowski, 2008). "
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    ABSTRACT: We aimed to compare body mass index( BMI) and healthy eating index( HEI) in children with autism spectrum disorder( ASD, n = 105) and typically developing (TD, n = 495) children.They were aged 6–9years,lived in Valencia (Spain) and came from similar cultural and socio-economic backgrounds.In this case–control study,the weight,height and BMI were measured for both groups.Three-day food records were used to assess dietary intake.Although the differences between children with ASD and TD children in raw BMI (p = 0.44),BMI z-score (p = 0.37),HEI(p = 0.43)and total energy intake (p = 0.86) were not significant,children with ASD and the boys subgroup were shorter (p = 0.01),but not the girls subgroup,compared to TD children of the same gender.Using the controls values as a reference,the BMI distribution in children with ASD be came distorted,with values below the 5th percentile (11%vs.4%, p = 0.03) and above the 95th percentile (8%vs.5%, p = 0.04).The gender-and age-adjusted odds ratios for being underweight in the groups of all children and boys with ASD were 3.03 and 2.39,respectively,vs.TD children.Our data suggest that routine monitoring of children with ASD should include anthropometric measurements and assessment of their dietary habits
    Research in Autism Spectrum Disorders 10/2014; 9(2015)26–33. DOI:10.1016/j.rasd.2014.09.013 · 2.96 Impact Factor
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    • "Monosymptomatic enuresis nocturnal was diagnosed in the early years of the patient's life and was unsuccessfully treated in childhood with high doses of oxybutynin (5 mg/day). The patient did not have any bowel or other gastrointestinal problems typical of autism (Erickson et al. 2005; Levy et al. 2009). "

    Journal of Child and Adolescent Psychopharmacology 10/2014; DOI:10.1089/cap.2014.0023 · 2.93 Impact Factor
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    • "The proposition is that, as a result of gastrointestinal inflammation, also causing gastrointestinal symptoms (GIS), the normal barrier to peptide absorption from the gut is compromised. Increased rates (22–70%) of GIS have been reported in autism spectrum disorder (ASD) [Chandler et al., 2013; Erickson et al., 2005; Gorrindo et al., 2012; Horvath & Perman, 2002; Smith, Farnworth, Wright, & Allgar, 2009; Valicenti- McDermott et al., 2006; Wang, Tancredi, & Thomas, 2011], a variability that may depend on the sample (clinical or population-derived); the type, definition, and number of symptoms; the method of investigation employed; and whether symptoms are current or lifetime. The GIS most commonly reported in ASD are diarrhea "
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    ABSTRACT: To test whether gut permeability is increased in autism spectrum disorders (ASD) by evaluating gut permeability in a population-derived cohort of children with ASD compared with age- and intelligence quotient-matched controls without ASD but with special educational needs (SEN). One hundred thirty-three children aged 10-14 years, 103 with ASD and 30 with SEN, were given an oral test dose of mannitol and lactulose and urine collected for 6 hr. Gut permeability was assessed by measuring the urine lactulose/mannitol (L/M) recovery ratio by electrospray mass spectrometry-mass spectrometry. The ASD group was subcategorized for comparison into those without (n = 83) and with (n = 20) regression. There was no significant difference in L/M recovery ratio (mean (95% confidence interval)) between the groups with ASD: 0.015 (0.013-0.018), and SEN: 0.014 (0.009-0.019), nor in lactulose, mannitol, or creatinine recovery. No significant differences were observed in any parameter for the regressed versus non-regressed ASD groups. Results were consistent with previously published normal ranges. Eleven children (9/103 = 8.7% ASD and 2/30 = 6.7% SEN) had L/M recovery ratio > 0.03 (the accepted normal range cut-off), of whom two (one ASD and one SEN) had more definitely pathological L/M recovery ratios > 0.04. There is no statistically significant group difference in small intestine permeability in a population cohort-derived group of children with ASD compared with a control group with SEN. Of the two children (one ASD and one SEN) with an L/M recovery ratio of > 0.04, one had undiagnosed asymptomatic celiac disease (ASD) and the other (SEN) past extensive surgery for gastroschisis. Autism Res 2013, ●●: ●●-●●. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.
    Autism Research 06/2014; 7(3). DOI:10.1002/aur.1350 · 4.33 Impact Factor
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