Friday, July 10, 2009
Clinic Notes: Autism and Gluten
Several years ago a pediatrician contacted me regarding her two-year old child who had just been diagnosed with autism. She worked in a large university hospital and took her child to the Neurology Department for an evaluation and they told her that autism was a neurological disorder. The followed up with an appointment with the Immunology Department and they told her that autism was an immune disorder. Similarly, in the Gastroenterology Department she was told that autism was a gastric disorder. In desperation she contacted me and asked what kind of disorder was autism. I told her in the end autism is a neurological disorder although gastric and immune factors may be involved in the etiology of autism. Previous studies have found a link between autoimmune disorders such as type 1 diabetes, rheumatoid arthritis and celiac disease. Celiac disease is a gastric disorder, which is treated by a gluten free diet. Gluten is found in wheat products and is in a variety of foods. Many parents have reported improvement in behavior in their children with autism on a gluten free diet. Unfortunately, this claim has not been confirmed in a double-blind study. In a double blind study the person giving the substance, in this case gluten or the absence of gluten, and the person receiving the substance do not know which they are giving or receiving. This is the standard for controlling placebo effects. I would like to see this study done, but I would like to see children in the study restricted to children with autism who also have gastric problems. This still wouldn't be a perfectly controlled study because the children not receiving gluten may simply feel better and therefore act better.