People with autism often have gastrointestinal struggles, like diarrhea, constipation, and intestinal discomfort.
For children with autism, communicating these issues can be difficult. Their pain may manifest as behaviors like food aversion, repetitive behaviors, and emotional outbursts, especially if they struggle with verbal communication.
For children who have serious gastrointestinal issues, one new study shows that fecal transplants may help. A group of children on the autism spectrum received intensive fecal transplant therapy and their physical and behavioral issues improved for weeks after the study was completed.
What Is a Fecal Transplant?
You may have heard the term fecal transplant a few times recently. While the term may sound strange, this is a new medical technology that offers important health benefits for people who suffer from conditions that damage their digestive systems, particularly those that ravage their gut microbiome.
Sometimes, medical treatments like an intensive course of antibiotics can kill much of the gut flora, causing constipation or diarrhea. Sometimes, growth of the wrong kind of gut flora can lead to similar symptoms, along with pain and malnutrition. A fecal transplant can help to restore gut health.
In this procedure, a healthy fecal sample is given to the patient to encourage good bacterial growth in the gut, which keeps digestion stable. The healthy donor material will be inserted into the colon using a colonoscope. The patient may also receive a fecal transplant through an enema.
Fecal transplant therapy is sometimes called bacteriotherapy or fecal microbiota transplantation (FMT).
Why Would Someone With Autism Benefit From It?
FMT is used predominantly for the treatment of Clostridium difficile-associated disease (CDAD). This condition kills 15,000 people per year, usually because of colon inflammation. However, fecal transplants seem to work well to manage this condition.
A 2014 study found that, among those who received multiple treatments, the CDAD cure rate was 90%.
Doctors are applying fecal microbiota transplantation to several other gastrointestinal conditions, including the gastrointestinal distress that many people with autism seem to develop. Some early research shows that this can be a helpful way to address gastrointestinal problems in people with autism, especially children. The treatment can also potentially help to manage autism symptoms.
The Scientific Study on Autism & Fecal Transplants
There are some important studies showing the effectiveness of fecal microbiota transplantation and related treatments to help children and adults who have autism.
For example, a study on microbiota transfer therapy (MTT) shows that positively altering gut microbiomes could help to alleviate gastrointestinal distress as well as some behavioral struggles associated with autism. During the study, the MTT procedure involved:
- Two weeks of antibiotic treatment to clear the existing gut flora.
- A bowel cleanse.
- Extended fecal microbiota transplant, starting with a high dose.
- Daily FMT at lower doses for seven to eight weeks.
The study reported an 80% reduction in gastrointestinal symptoms in the participants, who were children with autism between the ages of 7 and 16. Behavioral autism symptoms remained improved, or continued to significantly improve, more than eight more weeks after the study concluded.
Despite these positive results, this study has been criticized. While it does appear that fecal microbiota transplantation offers a great way to treat gastrointestinal distress in children with autism, which can help improve behavioral symptoms because the children are comfortable and able to eat a wider range of foods, one study is far from conclusive.
One major criticism is that the study was “open label,” so every participant knew that they were receiving the treatment, rather than having a control group undergo a placebo treatment. Open-label studies often have a strong placebo effect because the participants believe that the treatment will work. With no control group to compare the actual treatment to, it is hard to determine how much belief, versus medicine, was involved in behavioral improvements.
Risks of Fecal Transplants
In 2020, fecal transplants are still being investigated by the United States Food and Drug Administration (FDA). While many doctors are performing fecal transplants to treat certain conditions, like antibiotic-resistant CDAD, FMT has not been officially approved as a medical treatment.
In September 2019, the FDA issued a warning about risks of infection from this therapy, after two immunocompromised adults received the treatment. One died from E. coli infection, while the other recovered. The FDA issued specific safety recommendations around transplant procedures but still did not approve the procedure.
Fecal Transplants Are Not the Best Option for Autism Treatment in 2020
FMT is an invasive treatment. It should not be used for mild gastrointestinal trouble related to any condition.
It is important to know that an unhealthy gut does not cause autism. The gastrointestinal issues associated with children on the autism spectrum are complex, and they may be due to a combination of genetics, environment, and behavior. There is no conclusive evidence suggesting that gut bacteria are changed because of this condition.
Knowing that autism and digestive struggles are correlated can help doctors recommend good treatments to improve digestion and physical health. When your child feels better, you can begin working with them on feeding problems like food aversions, which requires behavior therapy.
While you may see improvements in your child after implementing dietary changes, supplements, restricted diets, or fecal transplants will not cure autism. There is no cure for this developmental disorder. In 2020, behavior therapy, like applied behavior analysis (ABA), is the best option to reduce the severity and impact of autism symptoms.
How Therapy Can Improve Food-Related Issues
Children with autism who struggle with digestive issues, food sensitivity, and related feeding problems benefit most from working with an ABA therapist to manage behaviors related to food and communication. If the child can communicate when they are uncomfortable or feel sick, that helps long-term management of any digestive problems that come up.
ABA therapy, along with speech therapy, can greatly improve communication abilities in children with autism. Clients often see substantial gains in both verbal and nonverbal communication.
Work with your child’s pediatrician and consider enlisting the help of a nutritional therapist to uncover physical causes of discomfort. You can improve your child’s diet by removing foods they may be sensitive to and introducing new, healthy foods that support their digestion and overall health.
If you are able to improve overall digestion, your child will feel better. And this boost in overall well-being can greatly reduce some of the symptoms of autism. When your child feels better, they are better able to manage their emotions, control their behaviors, and function well on a daily basis.
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- What Are the Causes and Is There a Cure? (July 2018). National Autistic Society.
- What Is It About Autism and Food? (September 2018). Autism Speaks.
- Food, Inflammation, and Autism: Is There a Link? (July 2013). Psychology Today.