Encopresis is a common struggle for autistic children. The scientific term comes from the Greek en– (“inside”) and kopros (“stool”). In other words, “you have poop stuck inside you.” When simple constipation turns into a hard, dry blockage, soft stool leaks around the block. The child usually can’t control the leakage. Often, the encopresis develops into a vicious cycle. It hurts to go to the bathroom, because you didn’t go before. So you don’t go to the bathroom again.
Autism makes the situation a little more difficult. Maybe the child was holding it in the first place because of sensory issues, or they’re avoiding pain. Maybe they aren’t able or aren’t comfortable talking about it. It may be harder to get the situation resolved because the child isn’t cooperating—he/she may not be connecting actions and consequences, may be refusing meds, or may be having a meltdown when you suggest a suppository. And meanwhile, the problem drags on, and the child struggles with embarrassment, discomfort, toxic fog, and the inconvenience of leakage.
Standard medical treatment for encopresis usually looks like six months of Miralax. Unfortunately, Miralax isn’t FDA-approved for use with children. Doctors prescribe it anyway. A possible consequence is that you might feel like the chemical laxative is washing out the child’s gut, depleting their healthy bacteria, and cutting their natural melatonin production, which could result in sleep issues. Other, more natural ways to approach the problem include senna tea, psyllium husk (if tolerated), stool softeners, and natural sources of fiber, like Heather’s Acacia. The advantage of Heather’s Acacia is that it’s bland. Even a child with texture-detecting superpowers won’t feel it in their drink.
One option that doesn’t always occur to us is chiropractic. I had the opportunity to talk with Dr. Chad Johnson, a chiropractor in Spokane, Washington. He revealed to me that some chiropractors believe their treatments are effective not only for constipation, but for autism itself. What chiropractic claims to do is relieve pressure on the nerves that transmit signals between the body and the brain. Dr. Johnson has found that freeing up the nerves to function correctly often releases constipation. He has also seen it calm the symptoms of autism.
I challenged him. Many people believe, I said, that cracking your back doesn’t do anything for you. Doctors, particularly, will tell you that chiropractic isn’t supported by research in the same way that modern medicine is. It doesn’t have a solid theory of cause and effect. Chiropractic is just anecdotally-based alternative medicine, they say. A waste of money and time.
“Did you know that only about 13 percent of what medical doctors do is research-based?” Dr. Johnson asked. That wasn’t the pot calling the kettle black. He was pointing out a double standard. Chiropractors have to defend their science in a way doctors don’t have to and really can’t. If we’re honest, most of what doctors do is trial and error, too. We can all point to medical theories and treatments that are biased or haven’t worked.
Dr. Johnson said he had the best kind of evidence he could ask for. His treatments work. That’s not anecdotal proof, he reminded me, but clinical experience. There’s a world of difference. “I’m 100% confident in what I do,” he said. “It’s based on the results that I see.”
When you see a colicky child in great distress, and you know what to look for, and you find it and fix it, he said, and when that child looks up at you with such relief, and maybe goes home and sleeps for 17 hours, that’s all it takes. “I only have to see results in one kid to know the difference. To know that it has to be done.”
Not every chiropractor treats autism, or even children. Dr. Johnson is a colleague of Dr. Tony Ebel, who is a pioneer of sorts in the field of pediatric chiropractic. Dr. Ebel especially focuses on treating kids with neurological struggles, including autism, attention-deficit/hyperactivity disorder (ADHD), sensory challenges, seizures, and immune system issues. Pediatric chiropractic and neurological chiropractic are growing and changing fields. Dr. Ebel gives presentations and does online training through the Epic Pediatric program.
“We do not treat autism,” Dr. Johnson said as we spoke about both encopresis and autism. “We treat kids with autism,” he went on, “who then see a significant benefit to their life and a decrease of symptoms.” His method includes treating the distress or dysfunction that he finds in the nervous system, and then he sees the symptoms decrease.
Three times a week is a good rule of thumb for treatments in the beginning, Dr. Johnson said. A typical course of treatment might last two to six months, depending on the patient. Maybe even up to a year. The goal, especially in the Epic Pediatric method, is to address three main sources of stress: physical, chemical, and emotional. Dr. Ebel calls them ‘The Perfect Storm.’ The physical stress, in particular, means joints that are out of adjustment and disrupting the transmission of nerve signals. It takes time and a good rhythm of treatment to get the body used to working correctly again. And finally, “If I don’t find anything wrong, I don’t adjust,” said Dr. Johnson.
The theory is that most of the body’s parasympathetic nerves emerge at the cervical spine. Those nerves provide control and feedback from the digestive system. When they are disrupted, the body is in fight-or-flight mode. It doesn’t care what the reason is—a disruption of the nerve signal or a tiger in the woods. And when you’re in defense mode, you can’t digest properly. “We usually see results by the third adjustment, if not the first,” Dr. Johnson said.
At Dr. Johnson’s suggestion, we also spoke with another chiropractor. This doctor mentioned that he’s noticed a common problem in kids with autism. Instead of being curved like a banana, their neck vertebrae are straight. That puts a significant strain on the joint between the spine and the skull where important nerves emerge. Dr. Johnson agreed. With adjustments and orthotic devices, he explained, the neck can be retrained. And both chiropractors testified to the effectiveness of the therapies they do, not only for encopresis, but for symptoms associated with autism.
One child couldn’t go to events. He would stand by the wall with his hands over his ears saying “la la la la” to drown out the noise. After treatment, he went to a wedding reception. His parents turned around, and he was out in the middle of the dance floor, playing with other kids.
The reason, Dr. Johnson explained, was that autism is not just about the way the brain processes sensory information. It also has to do with the way sensory information is received and acted on. If nerves are disrupted, that creates a stress on the system. By the same token, if the nerves of the gut are affected, digestion is not the only thing that slows down. And freeing up all those nerves to work well affects the whole sensory triad: thinking, feeling, and body balance. Chiropractic won’t roll back the developmental clock, but the effects of reducing the stress on the nervous system can be dramatic.
How can parents find a chiropractor with experience in pediatrics and neurology? It depends on your situation and where you live. You may be fortunate enough to know a chiropractor you trust, or you might know someone who will give you a quality recommendation. But for parents who are willing to embark on the adventure—and who don’t have a starting point—he gave some clues.
Interview several chiropractors, he said. Ask for a free 10-minute office visit. Then ask questions. What tools does he/she use? What is the philosophy of treatment? How much training and experience does he have with pediatrics and with neurology? And what are the results? Many chiropractors can show you written testimonials. They may even have a YouTube channel with their patients’ video testimonies.
Ask yourself if it feels right, he suggested. Sometimes the success of any treatment is a person-to-person thing. This is an adventure we’re on together. Knowledge about autism and about pediatric chiropractic are growing and changing. We are learning by doing and are joined together as part of a community. But for autism and for related conditions like encopresis, chiropractic is an option well worth exploring.
Coby Ingram is the grandpa-daddy in a spectrum family. He has two grandsons with diagnosed autism. But his youngest daughter—midway in age between them—said recently at her well-child checkup, “I have autism. If I don’t, I’m the only one in the whole family who doesn’t. And what are the odds of that?” The doctor didn’t know what to think. She’s the youngest kid in second grade, and she is one of the smartest. And walks on her tippy-toes. All the time. On the furniture. Coby is a Spanish interpreter because he can do it, and a writer ‘cause he can’t not do it. His current obsessive special interest is autism. Over the last several years, he’s gone from not knowing what it is to knowing quite a bit. He and his family live in rural Eastern Washington.
This article was featured in Issue 60 – Sensory Tools For The Future