The Effectiveness of Special Diets in Autistic Disorders

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Painful digestive problems can trigger problem behavior in children with autism, however an expert panel led by Dr. Timothy Buie of the Harvard Medical School states that there is no evidence that these digestive problems are more common in children with autism, or that special diets work. The report is published in the January issue of Pediatrics.

More than 25 experts met in Boston in 2008 to review the medical research regarding a specific digestive problem called “leaky gut” or “autistic enterocolitis” which causes abnormal GI permeability and increased incident of diarrhea or loose stools. The controversial hypothesis that this disorder is specific to autistic children was first proposed in 1998 by British physician Dr. Andrew Wakefield.

Research from the Mayo Clinic in 2008 found that while serious gastrointestinal diseases, such as Crohns or celiac disease, are not more common in the autistic population, many children do suffer from more frequent bouts of constipation, diarrhea or reflux. Feeding difficulties can also occur as a result of the medications that are prescribed to treat symptoms.

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Autistic children are also more likely to be picky eaters who had difficulty gaining weight. They may insist on the same food over and over, finding comfort in repetition. They may also not consume enough fiber or fluids, which can contribute to constipation.

Lee Grossman, president of the Autism Society says that many doctors have written off autistic children’s digestive problems as “untreatable”. Dr. Buie agrees, saying that the presence of communication and behavioral issues creates barriers to medical care. The advocacy group Autism Speaks hope that the new findings will raise awareness among physicians regarding digestive problems among autistic children and develop more comprehensive care plans for treatment.

Nearly one in five children with autism is on a special diet according to the Interactive Autism Network at the Kennedy Krieger Institute. Most of these eliminate either gluten, a protein found in grains, or casein, a protein in milk. Dr. Samar Ibrahim, a pediatric gastroenterologist at the Mayo Clinic, suggests that these restrictive diets only be used after having appropriate diagnostic testing done. While both of these diets can be nutritionally complete when planned well, a consultation with a registered dietitian or experienced physician is recommended to prevent nutrient deficiencies.

Other nutritional or alternative therapies that parents may adopt in search of a treatment for autism are probiotics, vitamin supplements, such as A, C, B6 or B12, and omega-3 fatty acids. However, there is little evidence-based research that support any of these nutritional supplements as being beneficial unless otherwise deficient in the nutrient.

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