“A good reliable set of bowels is worth more to a man than any quantity of brains” claimed 19th Century humorist Henry Wheeler Shaw, and it seems he might not have been as far off as first thought. Several years ago I posted on an Irritable Bowel Syndrome forum about the possible link between an area in the brain known as the gut axis and bowel problems; I called the article “Is it really all in your head after all?” Predictably I started receiving hate mail on the forum and made a swift exit. Six years later I believe that if I wrote the same article, perhaps with a more sensitive title, the idea wouldn’t seem so far fetched.
24% of children with Autism experience persistent gastrointestinal tract problems (Malley and Maning-Courtney, 2003), I am one of them. In fact it was my bowel problems which directed me towards my Asperger diagnosis. It was only when I dropped out of secondary school with vague bowel problems that led me to the doctors and mental health services who finally found the ‘cause’ of all my issues to be Aspergers. However, although the link seems so obvious, it is not one that has been recognised by the professionals. Mine still refuse to acknowledge a link between the two; my GP dismisses it quicker than she can prescribe me a new anti-spasmodic, which is usually already written before I’ve even had a chance to sit down. It is obvious to me that for whatever reason my bowels are affected by my Aspergers. My anxiety goes straight to my guts like an electric stun gun, whilst even the mildest meltdown sends my stomach spinning. The brain and gut are closely connected through the nervous system, and as Autism Spectrum Disorders seem to be caused by the incorrect functioning of parts of the brain, the idea that the two could be linked is a feasible one at the very least.
One theory on why Autism could cause gastro issues is that the symptoms of the disorder are to blame. Many children on the spectrum will experience anger and distress at passing stools, and often hold back their bowel movements or hide whilst doing them. The reason behind this is most likely to be due to the child not being able to understand or be in control of the process. Freud would have called such children anally retentive, and such individuals would have predictably gone on to experience repetitive behaviour problems in later life, such as OCD.
Repetitive behaviours are a common trait for those on the spectrum, and those behaviours in themselves may make the individual more vulnerable to stomach problems. For instance, many children with Autism will display real obsessions with certain types of food and repulsion for others, which may make their diet unbalanced. When I was a child I was the world’s fussiest eater, between the ages of 2 and 5 I would strictly only consume cucumber, ham and marmite toast, and only if they were prepared in a particular way. The word spoilt brat may spring to mind, but honestly my mum tried everything before she eventually gave in, and besides, my chosen diet wasn’t exactly unhealthy. However, as I grew older junk food became a regular fix; Pizza, cheesy chips and Fanta were the most popular items on my strictly limited diet, occasionally interrupted by frankfurter sausages or sausage rolls, with chips of course (yes I was a fairly fat kid). It was during this period that my gut problems began. More specifically it was after I had entered a Fanta competition to win a mobile phone, which resulted in me consuming several cans and a bottle a day of the purple and orange poison (yes I did actually win one, so it wasn’t all in vain). I still have some weird food quirks, like not eating anything moist, but overall my diet is now much better as my gastrointestinal tract is hypersensitive to anything I eat with even the smallest amount of sugar or fat in.
For those who don’t feel the need to find any reason available to blame their parents, there is some evidence that unusual immune cell patterns or destructive microscopic features in bowel tissue are present in some autistic patients. This would make the bowels of such individuals’ digestive tracts much more sensitive.
What I had never considered, however, was that gastrointestinal problems could have caused my Autism. This idea was first put forward by Dr Wakefield, who was also behind the research which suggested the MMR jab might cause Autism. The Leaky Gut Theory proposed that those with autism have quite permeable intestinal tracts, caused by viral infections. This results in certain proteins not being properly broken down, leading to a build of certain substances and toxins, which then in turn causes high pain tolerance, repetitive behaviours and a lack of concentration. This would explain why certain diets can cure some of the troublesome consequences of having an Autism Spectrum Disorder. However, and it’s a big however, although these toxins appear to cause symptoms similar to those seen in individuals on the spectrum, Autism isn’t just a load of symptoms which can be cured, it is an entirely different way of thinking and understanding. It is not the same as having Obsessive Compulsive Disorder; the two just share similarities in their outward appearance. How can toxins change brain pathways so dramatically as to cause Autism? Particularly as Autism is a disorder people are born with, not one that can be acquired. Needless to say it will take a lot more research to convince me my bad bowels are the cause of my problems!
My search to determine the link between the gut and autism thus continues. I found no information in any of my books and very few in scholarly journals, however, when I searched for information on Google, hundreds of pages appeared on the subject. It seems to be one of those links which everyone knows exists, but no research has attempted to back up. This isn’t just a problem for stomach issues and Autism, there are many other comorbid conditions that are so obviously linked to autism, but haven’t been thoroughly researched. The problem lies in the diagnostic manuals and criteria set out for diagnosing autism. Certain conditions can’t be diagnosed together, and certain conditions seem to encompass every possible symptom to the point of ignoring a separate condition altogether. For example, you cannot be diagnosed with an Autism Spectrum Disorder as well as ADHD or Pica, symptoms from these two disorders are included in the Autism diagnosis. The assumption that they are part of the Autism is a dangerous one, a person with Autism is as likely as the rest of the population to have ADHD as a separate condition, and if the Autism was taken away they may still have the ADHD. This leads to symptoms being ignored, which could be treated and managed much better.