Celiac Disease, autism & Developmental disorders - is there a link?
Like ‘Chinese whispers’, for several years there has been the belief that putting autistic children on a gluten free diet will in time reduce the symptoms of their autism. Many mothers in forum groups still stand by this assertion. The latest tests indicate that there is no specific link between celiac disease and autism, however there are cautions to ruling out potential benefits of going gluten free for children with developmental disorders.
It appears that the basis of this story traces back to a 1998 medical paper that suggested that autistic children often suffered from a problem called "leaky gut" / "autistic entercolitis". The idea was that opiates found in gluten and casein (dairy) were released when gluten food was improperly digested. This happened when the GI tract was damaged by such things as celiac disease. The opiates then supposedly were released into the bloodstream causing or increasing obvious autistic like symptoms. This paper is now widely discredited and retracted.
The current concern is that the ‘bounce back effect’ from such a retraction is the discrediting of celiac disease in healthy and autistic children. For those unaware of ‘Developmental disorders’ in children they cover five main categories. These are:
Attention deficit hyperactivity disorder (ADHD)
Attention deficit disorder (ADD)
Non-verbal learning disorder (NLD)
Pervasive development disorder (PDD)
COELIAC DISEASE SYMPTOMS IN CHILDREN
Some of the symptoms of celiac disease and/ or milk intolerance on the Gastro Intestinal (GI) tract in children are:
• Bloating/swollen tummy
• Breaking wind frequently
• Craving/ dislike for certain foods
• Dark shadows under the eyes
• Eating non-food items e.g. earth, paper, sand, soap
• Excessive sweating, especially at night
• Giggling/ screaming for no apparent reason
• Gut disorders in the family
• Inability to control body temperature
• Pale skin/pasty face
It appears that the most rigorous research into the possible links between celiac disease (or other GI disorders) and autism (or other related Developmental disorders) are coming from American PEDIATRICS department studies.
One definition of Autism is that that it is “a pervasive developmental disorder (PDD) that is generally manifested in the first 3 years of life and characterized by dysfunction in social interaction and communication” AND although not included in the diagnostic criteria, there have been many reports describing gastrointestinal symptoms in 9% to 84% of children with autism.
However the very latest papers released in January 2010 suggest that “care providers should be aware that problem behavior in patients with ASD's may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders.” (Ref 2)
Another study confirms that a “Significant differences between autism case and control subjects were identified in the cumulative incidence of constipation (33.9% vs 17.6%) and feeding issues/ food selectivity (24.5% vs 16.1). BUT No significant associations were found between autism case status and overall incidence of gastrointestinal symptoms or any other gastrointestinal symptom category.” ( Ref 3) Which leads to the conclusion that “as constipation and feeding issues/food selectivity often have a behavioral etiology, data suggest that a neuro behavioral rather than a primary organic gastrointestinal etiology ” is the cause – that is, the autism was not specifically affected by gluten.
The American Association of Pediatrics reports clarify that children with autism and other Developmental disorders often do have untreated gastrointestinal issues. However they stress that there is no higher rate of GI disorders in children with autism than any other children.
Further to this they add the caution that a central difficulty in recognizing and characterizing gastro intestinal dysfunction with ASDs is the communication difficulties experienced by many affected individuals. That is, GP’s and parents often fail to recognize the symptoms of GI because they are handling some greater behavioral disorders and hence GI disorders, including celiac disease, can easily go undiagnosed for even longer than the regular population (which can take ten years).
One can draw the conclusion from this latest research that just as easy as it is for celiac disease to go undiagnosed in healthy children and adults, gluten intolerance would very easily be ignored in symptoms of a child with strong behavioral disorders such as autism.
If you are at all concerned with whether someone you know with autism or a related disorder may have a GI such as celiac disease, it is best discussing this with your doctor. However do remember, that for a full confirmation of the disease a biopsy will usually need to be taken which requires that the person is still ingesting gluten at the time.
REF 1 http://www.wheat-free.org/wheat-gluten-allergy-autism-adhd.html
Ref 2 http://pediatrics.aappublications.org/cgi/content/extract/124/2/796
REF 3 http://pediatrics.aappublications.org/cgi/content/abstract/124/2/680
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