Very interesting story! It sums up many of the things that I think to my self about Autism.
In 1943, a child psychiatrist, Leo Kanner M.D., first described
autism. Since then, the "blame" for
Research was instrumental in dismissing maternal blame theories. What
emerged was a focus on the study of the brain of youth and adults with
autism. Genetic tests, brain scans, and clinical medication trials
continue to reveal how the autistic brain is different. Autism has
entered the mainstream of brain research, like the conditions that often
accompany it, such as epilepsy, sleep disorders, movement problems, and
many psychiatric disorders.
But does autism start, or stop, at the brain?
However, what if autism isn't a "primary" brain problem? What if the
brain is just one of many body organs that are affected by a
wider-reaching "whole body disorder"? We know, for example, that there
are a variety of other medical conditions connected with autism.
Let's start with the gastrointestinal (GI) system. A recent CDC study
involving over 35,000 children found that an autism diagnosis was
associated with a seven times greater risk of frequent diarrhea or
episodes of colitis during the previous year. A number of research
groups are exploring abnormal changes in the GI system of people with
autism, including the nerves that supply the bowel and other intestinal
organs, and also the permeability of the intestinal wall (sometimes
called the "leaky gut").
This particular CDC study also highlighted a 60
percent greater chance of asthma as well as respiratory or skin
allergies in those with autism. While these findings are important, we
continue to have too few studies examining the association between
autism and other medical conditions.
Family members of children with autism will tell you that research is
only now highlighting medical comorbidities that they have pointed out
for decades. In my work as a resident in child psychiatry, I have seen
that constipation, diarrhea, colitis, and food intolerances are not only
common in autism, but are often difficult to treat. There is a dearth
of physicians who are experienced in treating people with autism, a
factor that only heightens the challenges in treating these complex
medical problems. I believe that this has led many parents to turn to
alternative treatments, including gluten-free or casein-free diets, with
some firmly believing they have witnessed marked improvements.
What could be contributing to then heavy medical burden in autism?
Over the years there has been an avalanche of theories about the
cause(s) of autism. Recently, there is evidence that some children with
autism may have a malfunctioning immune system. Let's consider that
Firstly, in family members of people with autism, we know that there
are higher rates of a range of immune related conditions, including
autoimmune thyroiditis, rheumatoid arthritis, celiac disease, ulcerative
colitis, psoriasis, and Type 1 diabetes mellitus. Specific immune antibodies in a pregnant mother's blood
are thought to be responsible for some cases of autism in their
children. These findings support an association between autism and the
The second point to consider is that people with autism may have elevated levels of inflammatory immune chemicals called cytokines in both their brain and spinal fluid.
Research has shown that these inflammatory cytokines are also increased
in other areas of the body, such as the GI system and the blood. One
study indicated that children with autism and GI problems may have
overactive immune cells and inflammation of their intestinal linings,
even when compared to children without autism who have inflammatory
Thirdly, some people with autism appear to have antibodies that
target their own brain tissue, a finding reported by several research
studies. Furthermore, increased antibodies to gluten
have been found in groups of children with autism, a mechanism that
might explain some of the intestinal complaints seen in these patients.
Other research has shown that there may be impaired functioning of the
intestinal wall in autism (the "leaky gut" wall), and also alterations
in the working of the nervous system connecting the GI system to the
brain, especially involving the neurotransmitter serotonin.
What does all of this mean?
Let me be clear: There is an immense amount that we do not know about
autism. Autism may have a thousand different causes and be a
combination of many genetic and environmental factors (see my previous piece).
It does appear, however, that there is growing evidence linking autism,
an abnormally functioning immune system, and a variety of medical
conditions. The exact associations, so far, elude our understanding. But
if there is one promising place to shine the flashlight of research it
is on the immune system as a factor in autism with medical
Imagine the relief ahead if we can not only understand the mechanisms
by which autism is linked to medical illnesses but also find ways to
prevent and treat them? Whether or not autism is a "whole body
disorder," the high medical burden must prompt us to develop
comprehensive services, combining psychiatry with other medical
interventions, done by general practitioners as well as specialist
physicians and therapists. By producing more integrated autism services,
we may one day be able to deliver "whole body health care" for "whole
I found this story on HuffingtonPost.com