Gastrointestinal Abnormalities
How might gastrointestinal issues affect my child?
Associated Signs & Symptoms* often reported by Parents & Carers:-
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* This list is not exhaustive, one or more signs may indicate a potential gastro-intestinal problem
The Issues Identified
Science, Studies, Papers & Presentations
Malabsorption
Maldigestion
Microbial Overgrowth
Abnormal Intestinal Permeability (Leaky Gut)
Autistic Enterocolitis - Lymphoid Nodular Hyperplasia (FREE Videos)
Differences between the gut microflora of children with autistic spectrum disorders and that of healthy children.
Parracho HM, Bingham MO, Gibson GR, McCartney AL.
J Med Microbiol. 2005 Oct;54(Pt 10):987-91.
Food Microbial Sciences Unit, School of Food Biosciences, The University of Reading, Whiteknights, PO Box 226, Reading RG6 6AP, UK.
Children with autistic spectrum disorders (ASDs) tend to suffer from severe gastrointestinal problems. Such symptoms may be due to a disruption of the indigenous gut flora promoting the overgrowth of potentially pathogenic micro-organisms. The faecal flora of patients with ASDs was studied and compared with those of two control groups (healthy siblings and unrelated healthy children). Faecal bacterial populations were assessed through the use of a culture-independent technique, fluorescence in situ hybridization, using oligonucleotide probes targeting predominant components of the gut flora. The faecal flora of ASD patients contained a higher incidence of the Clostridium histolyticum group (Clostridium clusters I and II) of bacteria than that of healthy children. However, the non-autistic sibling group had an intermediate level of the C. histolyticum group, which was not significantly different from either of the other subject groups. Members of the C. histolyticum group are recognized toxin-producers and may contribute towards gut dysfunction, with their metabolic products also exerting systemic effects. Strategies to reduce
clostridial population levels harboured by ASD patients or to improve their gut microflora profile through dietary modulation may help to alleviate gut disorders common in such patients.
PMID: 16157555 [PubMed - indexed for MEDLINE]
Finegold SM et al. Gastrointestinal microflora studies in late-onset autism. Clin Infect Dis 2002 35(Suppl 1):S6-S16 PMID 12173102
'Some cases of late-onset (regressive) autism may involve abnormal flora because oral vancomycin, which is poorly absorbed, may lead to significant improvement in these children. Fecal flora of children with regressive autism was compared with that of control children, and clostridial counts were higher. The number of clostridial species found in the stools of children with autism was greater than in the stools of control children. Children with autism had 9 species of Clostridium not found in controls, whereas controls yielded only 3 species not found in children with autism. In all, there were 25 different clostridial species found. In gastric and duodenal specimens, the most striking finding was total absence of non-spore-forming anaerobes and microaerophilic bacteria from control children and significant numbers of such bacteria from children with autism. These studies demonstrate significant alterations in the upper and lower intestinal flora of children with late-onset autism and may provide insights into the nature of this disorder.'
The Vaccine-Autism Connection - Part II (MMR)
BERNARD RIMLAND, Ph.D., Director April, 2004
Partial list of scientific studies linking the MMR vaccine and autism:
Read and download an Adobe Acrobat (pdf) file
Past publications specific to Childhood Developmental Disorders (CDD) by Thoughtful House Director of Research, Dr. Andrew J. Wakefield:
CDD and Gastrointestinal Disease
(links to Thoughtful House website)
- Wakefield AJ, Anthony A, Murch SH, Thomson M, Montgomery SM, Davies S, Walker-Smith JA. Enterocolitis in children with developmental disorder. American Journal of Gastroenterology 2000;95:2285-2295 Read more
- Furlano RI, Anthony A, Day R, Brown A, McGavery L, Thomson MA, Davies SE, Berelowitz M, Forbes A, Wakefield AJ, Walker-Smith JA, Murch SH. Colonic CD8 and gamma delta T-cell infiltration with epithelial damage in children with autism. Journal of Pediatrics 2001;138:366-72.
Read more - Wakefield AJ. The New Autism (Invited Article) Clinical Child Psychology & Psychiatry 2002;7:518-528
Read more - Wakefield AJ., Puleston J. Montgomery SM., Anthony A., O?Leary J.J., Murch SH Entero-colonic encephalopathy, autism and opioid receptor ligands. Alimentary Pharmacology & Therapeutics. 2002;16:663-674
Read more - Torrente F., Machado N., Perez-Machado M., Furlano R., Thomson M., Davies S., Wakefield AJ, Walker-Smith JA, Murch SH. Enteropathy with T cell infiltration and epithelial IgG deposition in autism. Molecular Psychiatry. 2002;7:375-382
Read more - Anthony A, Ashwood P., Wakefield AJ. The significance of ileo-colonic lymphoid nodular hyperplasia in children with autistic spectrum disorder. European Journal of Gastroenterology and Hepatology 2005: 17
Read more - Ashwood P, Anthony A, Pellicer AA, Torrente F, Wakefield AJ. Intestinal lymphocyte populations in children with regressive autism: Evidence for extensive mucosal immunopathology. Journal of Clinical Immunology, 2003;23:504-517.
Read more - Ashwood P, Anthony A, Torrente F, Wakefield AJ., Spontaneous mucosal lymphocyte cytokine profiles in children with regressive autism and gastrointestinal symptoms: Mucosal immune activation and reduced counter regulatory interleukin-10. Journal of Clinical Immunology. 2004:24:664-673
Read more - The Gut-Brain Axis in Childhood Developmental Disorders: Viruses and Vaccines. Wakefield AJ., Collins I., Ashwood P. Invited chapter in Infectious Disease and Neuropsychiatric Disorders Chapter 21, pp 198-206. Ed. S.H. Fatemi
- Wakefield AJ. The Gut-Brain Axis in Childhood developmental Disorders. Journal of Pediatric Gastroenterology and Nutrition. 2002;34:S14-S17
Read more - Wakefield AJ, Murch SH, Anthony A, Linnell J, Casson DM, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Harvey P, Valentine A, Davies SE, Walker-Smith JA: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998 Feb 28;351(9103): 637-41
Read more
Etiology of CDD
- Wakefield AJ and Montgomery SM. Autism, viral infection and measles mumps rubella vaccination. Israeli Medical Association Journal 1999;1:183-187
Read more - Montgomery SM, Morris DL, Pounder RE, Wakefield AJ. Paramyxovirus infections in childhood and subsequent inflammatory bowel disease. Gastroenterology 1999;116:796-803
Read more - Kawashima H., Takayuki M., Kashiwagi Y., Takekuma K., Hoshika A., Wakefield AJ. Detection and sequencing of measles virus from peripheral blood mononuclear cells from patients with inflammatory bowel disease and autism. Digestive Diseases and Sciences. 2000;45:723-729
Read more - Wakefield AJ and Montgomery SM. Measles, mumps, rubella vaccine: through a glass, darkly. Adverse Drug Reactions & Toxicological Reviews 2000;19:265-283
Read more - Uhlmann V., Martin C, Shiels, Wakefield AJ, O.Leary JJ. Possible viral pathogenesis of a novel paediatric inflammatory bowel disease. Molecular Pathology 2002;55:84-90
Read more - Bradstreet JJ., El Dahr J., Anthony A., Kartzinel J., Wakefield AJ, Detection of Measles Virus Genomic RNA in Cerebrospinal Fluid of Children with Regressive Autism: a Report of Three Cases Journal of American Physicians and Surgeons. 2004.9:39-45
Read more - Wakefield AJ. Enterocolitis, autism and measles virus. Molecular Psychiatry. 2002;7:S44-46
Read more - O'Leary JJ, Uhlmann V, Wakefield AJ. Measles virus and autism. Lancet. 2000;356:772 (letter)
Read more - Wakefield AJ. MMR vaccination and autism. Lancet. 1999;354:949-50 (letter)
Read more - Stott C., Blaxill M., Wakefield AJ. MMR and Autism in Perspective: the Denmark Story. Journal of American Physicians and Surgeons 2004;9:89-91
Read more - Wakefield AJ. Entero-colitis, Autism and Measles Virus. Consensus in Child Neurology. 2002;6:74-77
Other Studies
Ashwood P et al. Intestinal lymphocyte populations in children with regressive autism: evidence for extensive mucosal immunopathology. J Clin Immunol. 2003 Nov;23(6):504-17. PMID: 15031638
Torrente F et al. Small intestinal enteropathy with epithelial IgG and complement deposition in children with regressive autism. Mol Psychiatry. 2002;7(4):375-82, 334. PMID: 11986981
Furlano RI et al. Colonic CD8 and gamma delta T-cell infiltration with epithelial damage in children with autism. J Pediatr. 2001 Mar;138(3):366-72. PMID: 11241044
O'Leary JJ et al. Measles virus and autism. Lancet. 2000 Aug 26;356(9231):772. PMID: 11085720
Quigley EM, Hurley D. Autism and the gastrointestinal tract. Am J Gastroenterol. 2000 Sep;95(9):2154-6. PMID: 11007210
Kawashima H et al. Detection and sequencing of measles virus from peripheral mononuclear cells from patients with inflammatory bowel disease and autism. Dig Dis Sci. 2000 Apr;45(4):723-9. PMID 10759242
Vijendra K. Singh, Ph.D. Autism, Vaccines, and Immune Reactions. IOM presentation, Feb 9, 2004.
Audio only: http://www.iom.edu/view.asp?id=19132
Singh VK, Jensen RL. Elevated levels of measles antibodies in children with autism. Pediatr Neurol. 2003 Apr;28(4):292-4. PMID: 12849883
Singh VK et al. Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism. J Biomed Sci. 2002 Jul-Aug;9(4):359-64. PMID 12145534
© copyright 2005 Autism Research Institute
March 2006 - Preliminary Results
Persistent Ileal Measles Virus In A Large Cohort Of Regressive Autistic Children With Ileocolitis And Lymphonodular Hyperplasia: Revisitation Of An Earlier Study
S. Walker, K. Hepner, J. Segal, A.
Background: Autistic enterocolitis, consisting of a non-specific ileocolitis coupled with ileocolonic lymphonodular hyperplasia (LNH), was first introduced as a new, potentially virus-induced disease entity eight years ago in a group of ASD children with developmental regression.
Objectives: The primary objective of this study was to examine ileal biopsy tissue in a large cohort of pediatric patients who carry a diagnosis of regressive autism and whose chronic gastrointestinal symptoms warranted diagnostic endoscopic evaluation, for evidence of measles virus RNA.
Methods: Patients who had been diagnosed with autism and who were referred to a pediatric gastroenterologist for evaluation of chronic GI symptoms were eligible to participate in this IRB approved study.
For each patient, medical histories, vaccination records, histopathology reports, and ileocolonoscopic biopsy tissue were available for evaluation. Terminal ileum (TI) biopsy tissue was assayed by RT-PCR for the presence of measles virus RNA and PCR-positive samples were sequenced.
Results: Medical and clinical data have been collected for 275 patients who fit the study inclusion criteria. PCR analysis on TI biopsy tissue from an initial 82 patients showed that 70 (85%) were positive for the F gene amplicon. Fourteen have been verified by DNA sequence and an additional 56 amplicons are being sequenced now. Work is ongoing to assay the remaining specimens (~200) and to identify and assay relevant control tissue samples.
Conclusions: Preliminary results from this large cohort of pediatric autistic patients with chronic GI symptoms confirm earlier findings of measles virus RNA in the terminal ileum and support an association between measles virus and ileocolitis /LNH.
Sponsors: ARI; NAA; individual donations