As a parent, it can be difficult to watch your child struggle with the abdominal pain, constipation, and other discomfort common for people with autism. Too often, those gastrointestinal (GI) symptoms are accompanied by increased anxiety and oversensitivity.
However, recent research into microbiomes may help. Microbiomes are the colonies of bacteria within and around us that affect our bodily functions, and by altering their makeup—adding “friendly” bacteria to outcompete those causing gas and other symptoms—we can improve digestion, ease GI symptoms, and even improve our moods. Relief for some symptoms may be as simple as introducing beneficial bacteria into the diet, with grocery-store staples like yogurt (labeled with “live and active cultures”) or yogurt drinks like Kefir.
My colleagues and I at The Ohio State University Wexner Medical Center’s Nisonger Center are trying to determine if children with autism can feel better and be less anxious by simply consuming a well-studied mix of helpful bacteria. We soon hope to expand our study to other sites that will hopefully treat those two frustrating conditions without the need for new medications.
The link between autism and GI disorders
In one study evaluating nearly 3,000 children with autism, researchers found as many as 24% had chronic GI problems, most commonly constipation and abdominal pain. Those children also had higher rates of anxiety and over-sensitivity—a problem made much worse when the child had more than one GI challenge.
When one takes a closer look at the microbes in the gut, children with autism appear to have different proportions of bacteria species than neurotypical children. In fact, one study found the proportions of common bacteria types differed significantly.
Members of our research team have also seen similar evidence, including a decrease in the amount of healthy Faecalibacteria bacteria in the stool of children with autism.
We’ve also seen that a mixture of healthy bacteria, taken as a powder mixed with food, can restore those healthy bacteria in patients with GI disorders. In fact, it appears to restore healthy levels for a range of bacteria.
The gut-brain connection
There are several trillion bacteria in the human gut, representing a complex array of species in proportions that vary from person to person. Most of the species are harmless or beneficial, though some cause disease. Even those that can cause harm can be kept under control by simply maintaining larger colonies of the health-inducing species. Some healthy bacteria will be familiar to many of you, such as Lactobacillus, which consumes the lactose sugar in milk, making it more digestible.
In addition to helping us digest our meals properly, as bacteria break down food, they release a wide suite of molecules. Some of those molecules, the microbes’ waste products, travel through our bloodstream to the brain and impact our mood or stimulate the vagus nerve and affect the brain indirectly.
Many of the bacteria waste products are neurotransmitters, the same chemicals that our own cells produce to influence mood. For example, various bacteria in the gut release serotonin and gamma-aminobutyric acid (GABA), both of which can change the mood.
Studies with healthy adults have shown that probiotics can help people feel less distressed, lessening depression and hostility and improving problem solving. The probiotics also appeared to reduce the levels of the stress hormone cortisol in the body. Plus, while beneficial bacteria have a positive effect in the chemicals they release, they also outcompete harmful bacteria, reducing their numbers.
Research with children shows similar impacts from probiotics. In one study, 59 neurotypical children with irritable bowel syndrome experienced significant improvement in abdominal pain and discomfort, bloating and gassiness, and life disruption.
Testing a new approach
Members of our team have already studied stool and mucous microbiome communities in children with autism, and evaluated the same probiotic mix for treating irritable bowel syndrome. For our upcoming study, following the pilot we are currently doing, we will evaluate the probiotic’s impact on easing GI symptoms in kids with autism, and how well it helps control their anxiety and over-sensitivity to stimuli. We hope to treat 60 children, aged 3 to 12, divided among three institutions. To our knowledge, the study will be the first to evaluate probiotics as a treatment for both physical and emotional conditions in children with autism.
Autism is a complex and challenging condition, with multiple, interconnected symptoms. However, we are hopeful that probiotics and a better understanding of the microbiome will help patients overcome some of autism’s most pervasive impacts, improving quality of life for patients and their parents.
For those interested in learning more about the research study and enrollment, you may contact Abbey Driscoll at 614-366-3276 or email Abigail.Driscoll@osumc.edu.
Dr. L. Eugene Arnold is a professor emeritus psychiatry at The Ohio State University Wexner Medical Center. Board certified in child and adolescent psychiatry, Dr. Arnold conducts a number of national studies to improve treatment for both autism and attention deficit/hyperactivity disorder (ADHD).
This article was featured in Issue 62 – Motherhood: An Enduring Love