Posted on 27 January 2010 by admin
Let’s talk a little bit about the differences between gluten sensitivity and Celiac disease. Now for most of the kids on the Autism spectrum we talk about the gluten and casein free diet as a primary diet to help reduce some of the inflammatory proteins that are found in gluten. Gluten is found in wheat and casein is found in dairy. But we know that these foods also have a drug like effect on many kids because they have something called peptides. Peptides are small amino acid chains that can influence brain chemistry adversely.
So gluten sensitivity is actually having an intolerance in the body to the gluten protein found in the wheat. Celiac disease is a form of gluten sensitivity except that with Celiac disease it is actually a genetic disorder where you truly lack the ability to breakdown the specific proteins found in wheat, one of them being gluten, another one is something called gliadin. Gliadin is actually a subfraction of gluten and it is an inflammatory protein in individuals with Celiac disease where they lack the specific enzymes that allow them to process that protein in the digestive tract. Then it creates an autoimmune reaction, auto meaning self, immune reaction in the gut and that leads to an inflammatory type process and essentially over time it starts to wear away at the surface lining of the gut. What I often tell people is you can have a gluten sensitivity and not Celiac disease but if you have Celiac disease, you have gluten sensitivity. Everyone with Celiac disease has a gluten sensitivity but not everybody who has a gluten sensitivity has Celiac disease.
Testing for it can be somewhat complicated. You can do an IgG food sensitivity profile and look for reactions to gluten, to look for reactions to gliadin and even to look for reactions to the entire wheat complex if you will. That only identifies a sensitivity reaction. The Celiac disease tests are more in-depth. You can do IgA as well as IgG reactions to gliadin. You can do an IgA reaction which is an immune test for something called transglutaminase. There is also something called reticulin antibodies. Many times to get a confirmatory diagnosis, some gastrointestinal doctors will also put a scope down into the intestinal system and take biopsy samples of different parts of the intestinal tract to see if there are cellular changes specific to Celiac disease. So it is a little bit more in-depth getting a diagnosis of Celiac disease as opposed to getting a diagnosis of gluten intolerance. The treatment for it is essentially the same and that is the avoidance of gluten proteins. I just wanted to make you aware that there is a distinction between gluten sensitivity and Celiac disease. With kids on the spectrum it is one of those things that we make a common recommendation for because we know it helps so many of them, not only from a digestive standpoint but from a cognitive standpoint.
Posted on 19 January 2010 by admin
Let me talk a little bit about regression particularly now that the holidays are over with, regression after the holidays. I have seen a few kids in my practice where regression is really hitting them pretty hard and obviously it is very disturbing for their family. Kids who were doing pretty well, language, eye contact, socialization and things seemed to be on the mend, improving and now all of a sudden we have a child who has regressed, they’ve lost eye contact, they’ve lost language, they are doing more self stimulatory behaviors, their sensory seeking has increased, what could be going on?
Well a couple of things particularly after the holidays, first thing I’ll always want to find out about is dietary infractions that may contribute to regression. Have there been any infractions with the diet whether it is gluten that they were not eating that they got over the holidays or dairy that they were not eating that they got over the holidays. Is that a possible trigger for regression? If not, another avenue is sugar, kids just naturally being exposed to more sugar and artificial ingredients through the holidays whether it is being at a friend’s house, parties at school, wherever it may be, that can also contribute to regression. Sometimes just a change in diet can bring on some of these regressive behaviors. Usually, particularly too if your child has any sort of yeast sensitivity, increasing sugars in their diet sometimes bring a worsening in yeast and obviously that can lead to eye contact problems and self stimulatory behaviors and sensory issues associated with regression.
Sometimes just the change in routine, as school is getting out, we’re now on to the holidays, there is a lot of excitement, people are traveling, sometimes that change can disrupt the normal routine for a child and that can cause regression with some kids. Also, transitioning back into school, if your child is of school age where they have been off for a couple of weeks over the holidays, now they are being transitioned back into school and that can contribute to regression. Or their therapies are starting up again so things are a little bit altered that way, maybe they are feeling overwhelmed and that is causing regression. There can be a combination of these things happening to cause regression. But sometimes you just simply have to look back and find out what changed in their environment, what changed in their routine and what may be changed in their diet that may have contributed to some of the regressive patterns that you are currently seeing with your child.
Posted on 18 January 2010 by admin
It comes up quite a bit in my practice and that is a child who either been on an antibiotic or they’ve recently been given an antifungal medication, instead of improving with their overall behavior, they regress. And if we are talking about yeast specifically with respects to treatment for yeast from the antifungal medication whether it is Nystatin, Diflucan, Nizoral, or some of the more antifungal herbs, things like oregano oil, grapefruit seed extract, etc. and the child is worsening instead of improving. But they are worsening in a pattern of becoming irritable and aggressive, self injurious, they are more withdrawn. Usually what you are dealing with is some underlying type of bacterial problem.
Now there is a common bacteria that is present with many kids on the spectrum called clostridia. There is a wide variety of clostridia bacteria. One particular form of clostridia called clostridia dificil can actually cause a form of inflammatory bowel disease, that is not specifically what we are talking about when we talk about these behavioral changes. That particular bacteria may lead to certain toxins that could contribute to that but what we are talking about is the family of clostridia, not just one specific type of clostridia.
There is a test called an Organic Acid Test from Great Plains Lab, they also have something called a Microbial Organic Acid Test and it looks at the markers specific to yeast and specific to clostridia bacteria. The clostridia marker is specifically something called HPHPA and it is a metabolic toxin of clostridia. It is that metabolic toxin that seems to interfere with different brain chemicals that can to contribute to some of the behavioral problems we see with kids on the spectrum.
Now why it is tied back to antifungal use is that yeast and bacteria, particularly yeast and clostridia bacteria, are living in somewhat competition in the digestive tract. When you lower one, the other one if it is not being treated at the same time, can sometimes get worse. So if you have a yeast overgrowth and you are just treating the yeast and you also have an overgrowth of clostridia bacteria, many times that clostridia bacteria can increase because it is no longer being inhibited or it is no longer in competition with yeast. If you had a regression in your child where you’ve recently given an antifungal medication or if you’ve given an antibiotic, antibiotics can also deplete the normal bacteria in the digestive tract and that sometimes can spur on this opportunistic bacterial called clostridia to get worse. Those two situations can be very common.
Posted on 07 January 2010 by admin
I want to touch a little more on the concept of leaky gut. The previous videos I had done I talked about leaky gut as being a breakdown of the space that occurs between the cells of the digestive tract, what are called these tight junctions. They start to open up and you start to get food proteins and other metabolic toxins from yeast and bacteria or anything we absorb from our food or water that we take into our digestive tract and now gain entry into the bloodstream with a leaky gut.
There is no one particular treatment for leaky gut. There are various supplements that have been shown to help with leaky gut and the integrity and health of the digestive system. Probiotics like acidophilus and bifidobacter and saccharomyces boulardii which is a type of yeast that helps to fight other types of yeast in the digestive system, help with leaky gut.
Dietary control from the gluten free, casein free diet, to the specific carbohydrate diet, to the low oxalate diet, for kids on the spectrum can help decrease inflammation in the digestive tract which aids in treating leaky gut. Any time that you decrease inflammation in the digestive tract you create an opportunity for the gut lining to heal and to regenerate. We know certainly with anyone has Celiac’s disease, which is a genetic intolerance to gluten, that can cause a blunting of the digestive surface and over time can lead to a leaky gut situation. So in those cases you need to remove gluten to allow for that inflammatory process to diminish and for the mucosal barrier, which is the lining of the gut and the mucosal barrier is the mucous that gets produced, to regenerate.
Glutamine is a particular amino acid product that has been shown to be helpful as a nutritive amino acid for the digestive tract and in treating leaky gut. Cayenne is an herb that also has been shown to increase blood flow to the digestive system, it helps stimulate secretory IgA production and so too that can also be a useful remedy for leaky gut. It is being shown that turmeric or the active ingredient in turmeric called curcumin can be helpful for inflammation, not only digestive inflammation but systemic inflammation throughout the body which can also be helpful in treating leaky gut.
So there are a number of things that can be done to help leaky gut. There is not just one treatment that does the same thing for everybody. So if there is a leaky gut situation happening, dietary control, supplement control, controlling yeast and bacteria, make sure you decrease inflammation in general can be helpful for leaky gut.
Posted on 06 January 2010 by admin
I have talked before about leaky gut and what that means. But, I want to discuss some of the things that can cause leaky gut and how leaky gut is diagnosed. Things that can lead to leaky gut include something like a traumatic injury so you can have a chemical insult or chemical injury in the digestive tract that could disrupt this leaky gut. You can have what are called oxalates, oxalates are compounds found in food. And absorption of too many oxalates into the body can create chemical imbalances that disrupt the leaky gut function. And of course anything that can lead to inflammation from infections to food sensitivities to auto immune disorders like ulcerative colitis or Crohn’s disease can lead to areas in the digestive tract that start to become stressed, worn down, inflamed and that can lead to a leaky gut phenomenon.
There are certain tests that can be done that sort of show the significance of leaky gut. It isn’t always an easy thing to ascertain 100% from a diagnostic standpoint. There are some tests that sort of indicate that there is a likelihood of a leaky gut situation happening with the absorption of certain chemicals that can be measured in the urine. But I just wanted to make you aware that leaky gut is a true phenomenon. Leaky gut is not an all or none situation. Leaky gut can happen with kids on the spectrum it can happen with other disorders whether it is Autism or Autism spectrum disorders or other neurological diseases or chronic fatigue or fibromyalgia. Leaky gut is something we commonly talk about with respects to digestive problems. Leaky gut is a real thing that can be caused by underlying infection and inflammation of the digestive tract. In part 3 I will cover a few of the common supplements used to treat leaky gut.
Posted on 05 January 2010 by admin
Let’s talk a little bit about leaky gut. Now leaky gut has been around for a long time within the complementary medical system. It is not well recognized in traditional medicine. Leaky gut is actually a phenomenon of essentially the epithelial lining of the digestive tract, what is called the mucosal layer, breaking down and essentially you get holes, these microscopic holes that can develop in the lining. These holes, or leaky gut, allow for food proteins or other infectious toxins that come from bacteria and yeast to filter through the mucosal lining, into the lymphatic system, into the bloodstream to a significant degree that can essentially stimulate inflammation, cause an overactive immune system and create other problems.
Leaky gut is controversial because there are many scientists and physicians that look at leaky gut and say “well that’s impossible, how could you develop holes in the gut“ and they are correct, you are not really developing holes per se. What is happening is the cells that line the digestive tract are grouped very tightly together. You normally have things that can be absorbed across the cell surface, through the cell and then excreted out the other side. That is how many nutrients and whatnot get into our body.
But between the cells sometimes things can get by as well. There is something called tight junction and the tight junction is chemicals that help attach the one cell to the next. You can almost think of it like Velcro. You have one cell is being velcroed to another. If that Velcro structure starts to breakdown then those tight junctions start to breakdown and you start to create microscopic gaps in between cells which is leaky gut. And you can now get food protein or other toxins that can flow across the mucosal lining unabated and into the blood stream and essentially that is what we are talking about with respect to leaky gut.
Posted on 04 January 2010 by admin
Food sensitivity is a big problem for kids on the Autism spectrum. Now we see this problem in children of different ages, different types, different ethnicity so it is not specific to one group of kids. And we certainly see this in the adult population as well. People generally have an intolerance to certain foods. Many times it may be wheat, it may be dairy, it may be soy or other things can show up on the list. Now testing for it can be a little bit challenging.
Now not one test will always tell you all you need to know as far as food reactions. You can do an IgE test which is a true food allergy test and you may be able to isolate some specific allergies to foods but that doesn’t really tell you what other types of immune reactions may be happening to foods because the body also produces chemicals called IgG and this gives an indication of hypersensitivity to foods but its really unrelated to the IgE reactions. These IgE reactions tend to be more immediate these are the things that cause hives, itching, runny eyes, runny nose and in real severe cases anaphylactic reactions such as somebody reacting to peanuts for example and having a life threatening reaction. The IgG reactions are more delayed and can occur hours to over a few days after where you may get bloating gas or fatigue and sometimes those can be difficult to figure out.
There are other tests that look at just immune reactions in general. Things to give you an idea of what other types of foods and other types of chemicals may be reacting that’s apart from the IgG or even the IgE reactions. And with these kinds of tests you can actually evaluate for other types of chemicals, things called phenols, or salicylates, artificial flavors, or artificial colors, as opposed to some of the other tests which only look at certain proteins found in foods. These other types of immunological tests can look at a more wide range of not only food groups but chemicals within foods as well.
Recent studies have actually shown that kids on the spectrum are four times more likely to have food allergic reactions in the digestive tract than neurotypical kids of the same age. So it goes to show you that In an Autistic child their tendency to have bowel problems related to food sensitivities is quite high. As you move forward in your education you realize that inflammation in the digestive tract can also mean inflammation to the rest of the body and the area we are most concerned about it neurological inflammation with respects to kids on the spectrum. So foods play a big role so being able to understand the differences in some of the testing that is available is very important to help differentiate what kids of foods your child needs to avoid.
Posted on 03 January 2010 by admin
I have talked a lot about constipation. Constipation is a big problem in our society, not only in kids but in adults. Ideally we should be having a bowel movement for every meal that we eat in a day. Now that seems like a lot so what I try to shoot for with my patients is at least, minimally to have two bowel movements a day. If we can get one bowel movement in a day with most people we are doing pretty good. Now with kids on the spectrum it does get a bit challenging.
I have talked before in previous videos about some issues related to constipation with kids on the spectrum. Lets talk real quickly about the child who has a difficult time passing stool but has the urge to go. If they have the urge to go but they just have a difficulty time passing it, there could be problem with the stool being too hard. So one thing you may do is just increase the fluid intake of your child. That will help to get more fluid in the digestive tract, help soften the stool and sometimes that can help. Fiber supplements whether it is Tru Fiber or other types of fiber supplements that are gluten free, they can help to add bulk to the poop and that can also then help with the ease of passing. In those cases if you are going to use fiber supplements you certainly are going to want to increase their fluid intake.
One herbal remedy that can be helpful is something called Slippery Elm. Slippery elm is an herb and it does essentially what its name implies. It makes things slippery so basically it helps to make the poop slippery. What it does is it helps to increase the mucous production inside the digestive tract and makes the lining of the gut more slippery but it also makes the fecal matter more slippery so it is easier to pass. Slippery elm is generally available at most health food stores. You can either get slippery elm as a bulk powder or in capsules that can be opened up with juice or mixed with food if your child has a difficult time with taste. Slippery elm is a very safe herb to take, I have taken it myself, I have many, many patients take it, adults, teenagers, children and it can be very effective. There is no specific dose for slippery elm based on weight or age.
So in most cases with a slippery elm capsule start with one capsule, maybe two, it might take 3. Sometimes I have had some kids who are 4, 5, 6, 7, 8 years old who need sometimes to take anywhere between 3 and 6 slippery elm capsules a day to make their poop just slippery enough so it is easier to pass. So if there is an issue with your child as far as constipation goes where they have the urgency to go but are having a really difficult time really moving their stool, make sure they are keeping their fluids up but slippery elm could be an option as well to help things move a little easier.