The problems in the digestive system are one of the most frequent consultations in paediatrics, but in the case of the autismare almost a constant, and many of those digestive problemswhich in many cases have a sensory origin, they generate behavioural problemsbut it usually addresses the conduct The digestive problems on the one hand and the digestive problems on the other, as if they were two different entities, thus, incredibly, neither is solved, and these are often persistent for life in people with greater support needs.
Again, the digestive problems in autism are extensively documentedFood selectivity is one of the biggest visible problems in children and is strongly related to sensory aspects, which then turns into neophobia or panic to try new foods, ultra-fast or incredibly slow eating, chewing problems, etc., are closely linked to problems of constipationvomiting, abdominal pain, skin problems, retching, vomiting, sleep problemsirritability, irritability, and a long list of other problems associated with the problems of the digestive systemand this is also linked to microbiota or gut flora problems.
In a study published in January 2020 it was observed that 84.6% of the children 18 show selective eating and rejection of new foods, which is a very alarming fact, as no intervention is provided for 84.6% of the children in terms of eating problems. But 49.3% have "food stealing" behaviours, with the intention of eating only what does not generate negative experiences.
It was found that overall 82.4% of the participants experienced at least one gastrointestinal symptom in the last 3 months; 22.8% had only one symptom, and 22.8% had two symptoms; 22.1% of the participants had three symptoms, while 12.5% and 2.2% had four and five symptoms respectively.
Research reveals that children and adolescents with autism with digestive tract problems present comorbidly challenging behaviours and increased sensory problems.
Another study published in November 2019 analysed whether there were differences in young children with digestive problems between those who had a verbal communication and those who did not, to assess whether communication problems might be involved in a greater severity of these problems. The result was negative, practically the same data were obtained in both groups, although they presented the usual list of symptoms, such as sleep problems, behavioural problems, anxiety, irritability, etcetera, This leads to the hypothesis that interoceptive problems may hinder the correct identification of the discomfort or pain that the child may present. Let us not forget the testimonies of many adults who claim not to be able to feel the sensation of hunger or satiety, for example, or many children who are not aware of the bodily sensations linked to defecating and urinating, an aspect which in turn generates another long list of problems.
What is obvious is that abdominal pain, gastro-oesophageal reflux, diarrhoea, constipation, and the whole long list of digestive complaints generate discomfort, and this discomfort directly provokes a behavioural manifestation, especially in those who are not able to communicate this physical discomfort, or those who, in addition, do not know how to correctly identify this physical discomfort due to problems in the interception.
Hippocrates stated that "All disease begins in the gut". However, despite Hippocrates' assertion, to this day we do not know for sure what the real trigger is, whether there is a genetic factor What influences the alteration of our internal biochemistry, if there is an abnormal functioning of certain organs, if it is the eating disorder itself that causes a bad development of our digestive system, honestly, it is like asking what came first, the chicken or the egg. We do not really know what or who is the real cause, whether it is a hormone that is not produced or processed, whether it is a problem linked to our intestinal flora, whether it has a sensory origin, whether there are motor aspects involved (swallowing problems), whether there are psychological factors (trauma), or whether it is perhaps a combination of all of them at the same time, moreover, there are differences between children, so that the variables to be analysed are immense.
Among the multiple causes attributed to autism, which rather than causes are actually factors that increase the likelihood, we have leptin, or an alteration in it, a study from 2018 21 analysed the levels of leptin in the umbilical cord and then followed up the children who were the subjects of the analysis. weight gain in infants with the likelihood of autismand leptin appears to be involved in this process.
But what is leptin? It is a hormone produced by adipocytes, or fat cells. In fact, this is an example where the brain is controlled by that chemical play produced by parts of our body, high levels or low levels of leptin in the body impact on the sensation of hunger, i.e. fat cells emit a lot of leptin when the amount of fat stored is sufficient, so they send a signal to the brain to inhibit the sensation of hunger. Interestingly, obese people have high concentrations of leptin, but apparently the leptin receptors that give the 'I'm full' signal do not seem to function properly.
Well, this study was done on a sample and follow-up of 822 subjects from the Boston Birth Cohort, and they found that those who gained weight very rapidly in infancy had higher levels of leptin in early childhood and a higher likelihood of later diagnosis of autism. They followed them for 5.2 to 9.8 years to see how many of them received a diagnosis of autism or other neurodevelopmental conditions.
That is, an alteration of leptin levels in the umbilical cord blood is a risk indicator for autism, remember, risk indicator does not imply an absolute question, but an increased probability. In fact, other recent studies 22 also report that alterations in leptin, among others, may be related to neurodevelopmental disorders, including IL-6 (interleukin) and other chemical messengers, many of them involved in the regulation of the immune system. And that immune system, as we have seen, has a strong relationship with our digestive system.
Another factor that is becoming increasingly relevant is that of alterations in the intestinal microbiota. It is not clear whether these alterations are cause or effect, or even both, effect of and causes of. We do know that alterations in the microbiota are related to certain cases of food intolerance and allergies, which have a direct impact on the immune system, and obviously affect a multitude of functions in our organism.
There are genetic factors associated, but this part of the research is still very recent, and there are hardly any studies concerning this particular aspect, little evidence, so we are still in the realm of hypothesis. A German study 23 addressed this aspect related to Haploinsufficiency linked to the FOXP1 gene in a study in mice. This genetic factor appears to be linked (among other things) to a pronounced atrophy of the muscular tunica in the oesophagus and colon, accompanied by motor dysfunction, which directly involves problems in the digestive system, although this type of research is still too early to draw any firm conclusions.
Cristina Oroz under
Extracted from Autism Daily