About Gut issues with Autistic children

I have been really slow in updating this blog but for all those who bother to read it, I promise that there is plenty to share and happening. Will be more regular going forward.


I thought I should share some experience about a very common problem encountered bya utistic children- issues with gut - translating to indigestion, gas, constipation and other bowel related issues.  Warning - this post will use the words poop more that once!

Often parents get really frustrated with challenges related to toilet training and later on, regularity of bowel movement for their special needs child. Interestingly , the propensity of autistic children to follow a set routine when practiced sufficiently and under an ABA mechanism may be helpful to initiate toilet training. It will take time and the earlier started the better. Maybe not all children will be able to master it but as with everything else in this area, the effort is the main thing.

There is an important study from Columbia University that points to sustained gut issues in infants as one of the indicators of autism. It is important to note that the study does not attribute this as a cause of autism but as a possible indicator. The reason is being attributed to lack of synapse between the brain and the gut – and obviously a lot of research needs to be done on this as well. 

http://www.mailman.columbia.edu/news/autistic-children-more-likely-have-gi-issues-early-life



Let me share the example of progressive experience on this with Adi. From the age of 3, Adi was toilet seat trained.  This was a great exercise devised by his grandma following the same practices as followed for most children – making him sit after a meal or at particular times of the day ! Around the age of 4,  his home therapist instituted a program which very  quickly moved him from a child potty seat to the bathroom seat - I will share those details if anyone is interested to know about it. His diet  was normal for kids his age.


As he grew older, we noticed constipation issues setting in. Irregular bowel  movements - sometimes after a couple of days. Reluctance to sit and push while pooping. And sometimes an obvious sign that he was "holding back" - as if the sensation of flexing his sphincter muscles was a pleasurable sensation. Later on we learned that this is not uncommon in special needs children.


For those with autistic children, this may be a known and frustrating issue. A nice article on this –

http://www.learn2do.net/blog/bowel-problems-autism.

We went through several hoops for diagnosing what the issue is. First, Adi was an early user of Risperdal - it had a possible side effect of constipation. Doctor advised fiber in his diet and a course of MiraLax when the situation was bad enough - obvious discomfort and no movement for a few days. This went on for a while - the benefit being that he developed a taste for Indian vegetables like okra, opo squash, calabaza and other high fiber foods.

 We switched over from Risperdal after a few years owing to its side effect on heart, but the irregularity continued. At the same time, possibly as a side effect of medication, he started gaining weight. Significantly. Within the age of 11, he has crossed 100 pounds and was in obse range. Again, a round of medication changes happened to take care of the weight gain side effect. We started increasing the amount of exercise that he got during the week- and his adaptive PE in school also helped with its emphasis on running. Tried to make him jump more on the trampoline as well as a way to get more active.


 Still, the problems continued. And around the age of 11, he started showing symptoms of flatulence  and gas. At times, there would be reports from school of extreme passing of gas.Doctor advised using suppressants like Baeno and Gasex. We also started to eliminate foodstuff that can create gas. Problem – many of these foods were part of his like list including veggies. We had switched him over to brown rice owing to the higher starch content of white rice – now went back to white once again to lower the fiber content. We also regularized the consumption of yogurt and probiotics.

It may seem humorous and silly to be reading about this  but believe me, the whole issue of a teenager passing gas, being uncomfortable with constipation and oblivious to its effect in public is extremely embarrassing for those he is with, apart from being very troubling for him.  There is a lot of effort that goes in to making him learn the need for using a restroom in such cases. And of course, the inherent cause of the problem still remains unidentifiable. 

Then one day, we have him Zinetac (Ranitidine) after a heavy meal to help in digestion. The next day, we noticed a marked decrease in flatulence and gas. So we checked with the doctor, found it safe to give once a day as a protectant against indigestion, and the effect has been good. His bowel movement has regularized and he is having much less gas than usual. We have stopped excessive sugar and sweets in his diet and that has helped as well. We will now be checking for gastro issues with a specialist and also checking on whether past or existing medication that he has been taking (only one) causes this.


And so another challenge to be tackled. Meanwhile, Adi is getting more communicative- slowly initiating more conversation and growing up so fast !