Thursday, October 29, 2015

Gastrointestinal (GI) disorders

Here is some information I pulled from one of my sources. Yes, autism is a whole body disorder! There is so much more that goes in autism than what I talk about on my blog....there is simply too much to discuss daily which is why I just pick and choose what I feel is the most important of that day. Please let me know if you have any questions on anything. I am full of helps my children to the fullest which is why I am dedicated to educating myself.

Gastrointestinal (GI) disorders are among the most common medical conditions associated with autism. These issues range from chronic constipation or diarrhea to irritable and inflammatory bowel conditions. They can affect persons of any age. But in the context of autism, they have been most studied in children.
For example, the Centers for Disease Control and Prevention (CDC) recently found that children with autism are more than 3.5 times more likely to suffer chronic diarrhea or constipation than are their normally developing peers. Other researchers have found a strong link between GI symptoms and autism severity in children. Some experts have even proposed that toxins produced by abnormal gut bacteria may trigger or worsen autism in some children.
Understandably, the pain and discomfort caused by GI symptoms can worsen behavior and even trigger regression in persons with autism spectrum disorder (ASD). This may be particularly true of nonverbal persons who have difficulty expressing their distress.

Treating GI Disorders in Those with Autism

Autism Speaks Autism Treatment Network is dedicated to enhancing the ability of pediatricians and other doctors to treat associated medical conditions including GI disorders. The ATN's GI Committee has been drafting treatment guidelines for diagnosing and treating constipation, chronic diarrhea and food allergies. (For an Autism Treatment Network clinic near you, please see our ATN directory.)
Chronic constipation: Periodic constipation is normal, but chronic constipation can be a serious condition. It is typically defined as constipation lasting two weeks or more. The abdominal pain associated with constipation can be considerable. Tell-tale behaviors can include arching the back, pressing on the belly and gritting teeth.
Causes of chronic constipation can include a restricted diet that provides insufficient fiber, certain medications and sensory or behavioral issues that interfere with regular toileting. Other contributors can include anatomic, neurological or metabolic problems or abnormal gut motility (a sluggish intestinal tract). Medical tests are needed to identify such underlying causes. Treatments can include both medical and behavioral interventions.
Behavioral management includes dietary changes (increasing fiber, eliminating constipating foods) and management of toileting behaviors (such as teaching a child to sit on the toilet after meals). Medications may include soluble fiber and laxatives such as mineral oil, magnesium hydroxide or sorbitol.
Because constipation is particularly common among children with ASD, Autism Speaks ATN GI Committee has prioritized the development and testing of its constipation guidelines, or “algorithm.” This algorithm guides pediatricians in diagnosing and treating this common condition in a step-wise manner. It also helps them determine when a child should be referred to a GI specialist.
Chronic diarrhea: As with constipation, periodic bouts of diarrhea are normal, but chronic diarrhea (two weeks or more) can be serious. Chronic diarrhea may have a number of causes including intestinal infection, immune dysfunction, inflammatory bowel diseases (Crohn’s or ulcerative colitis), irritable bowel syndrome, celiac disease (gluten intolerance), food allergies, lactose intolerance or excessive consumption of certain foods such as apple juice. In some instances, diarrhea can actually occur as a consequence of severe constipation.
Treatment depends on the cause. For instance, diarrhea due to food allergies, lactose intolerance or celiac disease is usually treated with dietary restrictions. Other times, medications or (rarely) surgery are warranted.
Gastroesophageal reflux disease (GERD): GERD results when the muscle between the stomach and esophagus (food pipe) is lax. This allows partially digested food or liquid mixed with stomach acid to move up out of the stomach. Red flags include throat discomfort and/or feelings of “heart burn.” However children sometimes experience GERD pain in atypical ways, and nonverbal persons can have difficulty communicating their distress.
In persons with autism, GERD pain may result in increased self-injury or other challenging behaviors. It can be helpful to note if such behaviors are triggered or made worse when the individual is lying down (a position that can worsen reflux). Other telltale signs can include unusual body postures or behaviors such as straining the neck, pushing out the jaw or tapping the throat. Other signs may include hoarseness, chronic sore throat, cough or heartburn, dental erosions, food refusal or disturbed sleep.
Such issues should be discussed with a doctor, who can refer to a GI specialist if needed. Helpful behavioral modifications include elevating the head during sleep, avoiding food near bedtime, eating smaller meals and avoiding foods that tend to trigger symptoms. GERD-easing medications include antacids, histamine-2 blockers (Pepcid, Zantac, etc) and protein-pump inhibitors (Nexium, Priolosec, etc). When GERD is severe or chronic, your physician may perform tests to identify acid levels and tissue damage in the esophagus. 

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