Posted on 03 January 2013 by autism
One of the things that I have seen in my practice with respects to chronic constipation, I’ve spoken about constipation before, but one thing we are starting to recognize is that many kids on the spectrum not only have problems and digestive issues which we’ve known for a while but the regulatory aspect with respects to the nervous system’s input to help with that sensation to have a bowel movement is compromised. So you know the things like magnesium and vitamin C and probiotics and sometimes laxatives can help and they are necessary for chronic states of constipation. What often goes unrecognized in persistent constipation when kids are not responding to dietary intervention, fiber, these other supplements is the potential for an underlying worm infection.
I have actually used a remedy called Vermox, also known as Mebendazole. Mebendazole or Vermox is actually an anti-worm medication, it comes in a chewable tablet that’s specifically used for pin worms. Typically one dose of 100 mg chewable tablet is appropriate for most pin worm infections. But sometimes we need to use it a little bit longer, particularly for things like round worms or other types of worm infections that are more persistent so I’ll commonly, if I am going to dose Vermox we’ll dose it instead of one time, one day, use 100 mg chewable tablet twice daily for 3 days. And this has worked quite well for some kids with chronic constipation and helping to relieve that constipation. If that happens then we know that a worm infection is very likely. And I say likely because it’s difficult actually to find a worm on a stool test so you may have done a comprehensive digestive stool analysis and not found a worm and that is not uncommon.
What I’ve also done for certain cases of constipation where they are not resolved because of other remedies is use the Vermox for 3 days then take a 2 week break and repeat it again for another 3 days at 100 mg chewable tablet twice daily for 3 days. So a common prescription could just be Vermox, 100 mg chewable tablet, 1 twice daily for 3 days and then have an automatic refill that is refilled 2 weeks later and take it again. So this is something to consider, discuss with your doctor if your child continues to have chronic constipation and the other remedies or laxatives, etc. just aren’t working.
Posted on 03 January 2010 by autism
I have talked a lot about constipation. Constipation is a big problem in our society, not only in kids but in adults. Ideally we should be having a bowel movement for every meal that we eat in a day. Now that seems like a lot so what I try to shoot for with my patients is at least, minimally to have two bowel movements a day. If we can get one bowel movement in a day with most people we are doing pretty good. Now with kids on the spectrum it does get a bit challenging.
I have talked before in previous videos about some issues related to constipation with kids on the spectrum. Lets talk real quickly about the child who has a difficult time passing stool but has the urge to go. If they have the urge to go but they just have a difficulty time passing it, there could be problem with the stool being too hard. So one thing you may do is just increase the fluid intake of your child. That will help to get more fluid in the digestive tract, help soften the stool and sometimes that can help. Fiber supplements whether it is Tru Fiber or other types of fiber supplements that are gluten free, they can help to add bulk to the poop and that can also then help with the ease of passing. In those cases if you are going to use fiber supplements you certainly are going to want to increase their fluid intake.
One herbal remedy that can be helpful is something called Slippery Elm. Slippery elm is an herb and it does essentially what its name implies. It makes things slippery so basically it helps to make the poop slippery. What it does is it helps to increase the mucous production inside the digestive tract and makes the lining of the gut more slippery but it also makes the fecal matter more slippery so it is easier to pass. Slippery elm is generally available at most health food stores. You can either get slippery elm as a bulk powder or in capsules that can be opened up with juice or mixed with food if your child has a difficult time with taste. Slippery elm is a very safe herb to take, I have taken it myself, I have many, many patients take it, adults, teenagers, children and it can be very effective. There is no specific dose for slippery elm based on weight or age.
So in most cases with a slippery elm capsule start with one capsule, maybe two, it might take 3. Sometimes I have had some kids who are 4, 5, 6, 7, 8 years old who need sometimes to take anywhere between 3 and 6 slippery elm capsules a day to make their poop just slippery enough so it is easier to pass. So if there is an issue with your child as far as constipation goes where they have the urgency to go but are having a really difficult time really moving their stool, make sure they are keeping their fluids up but slippery elm could be an option as well to help things move a little easier.
Posted on 22 December 2009 by autism
I want to touch on the issue of bowel movements in children again because this is an important concept to understand. I have seen a lot of kids in my practice who have loose stools and chronic diarrhea. But I have also seen quite a few kids on the spectrum who also have chronic constipation, I have talked about this quite a bit. There are a couple of different things to consider with respects to constipation.
One is, does your child have the sensitivity or the urgency to have a bowel movement. Meaning can they feel when they need to have a bowel movement. If they can, and basically which means they are actually trying to go to the toilet or you know they are trying to have a bowel movement whether it is their pull-up or their diaper that is a good sign because it is showing you they have the neural connections to demonstrate to their brain that their bowel has fecal matter in it that needs to be excreted.
Some kids with either a change in diet, if you are doing a gluten and casein free diet sometimes you are lacking fiber, so adding more fiber can help or they are not drinking enough fluid or they are not getting enough probiotics or there is a lack of minerals in the body like magnesium and kids may become constipated so they may have the urgency to go but they just can’t get the poop out because it is too hard and compacted. That is usually an easier form of constipation to deal with because you can just use some types of laxatives over the counter or supplement laxatives like probiotics or vitamin C and magnesium which can help them have a bowel movement easier.
The other scenario is with kids who just lack the sensation in the body that they even need to have a bowel movement. This is usually a little more difficult to deal with because they just don’t have the urge to go and the fecal matter can build up and build up and build up to a point where it gets so big and massive that they may just have an explosion because their bowel can’t handle anymore of it but they may be left with a lot of fecal matter in their digestive tract. This is more of a difficult situation because you are talking about a neural connection between the brain and the nervous system and to the gut and just not a good feedback mechanism to tell that child hey I actually need to have a bowel movement.
Posted on 21 December 2009 by autism
As I discussed in part 1 of this series, constipation can have many negative effects on behavior in children with Autism. I discussed the effects of autointoxication, whereby toxins from un-expelled feces are reabsorbed and recirculated through the body which can lead to behaviors such as aggression and irritability as a result of that constipation.
You can also get direct absorption from toxins from the digestive tract from the yeast and bacterial overgrowth. I have seen it clinically many, many times in my practice over the years. An onset of constipation can lead to behavioral problems, lack of eye contact, it will even lead to lack of speech in many kids. So if you are seeing improvement in the therapies you are doing, it doesn’t even have to be biomedical therapies, it can be speech, occupational therapy, behavioral therapy but then they start to regress and you can’t figure out why, maybe there is an underlying constipation problem and they are not having bowel movements as normally as they should.
Ideally they should have a bowel movement once a day or even twice a day. The other thing to watch for with constipation is I have heard a lot of parents say their child has a bowel movement every day but how big is it and what is its shape and size. They may have a bowel movement that is fairly large but there may be a lot more stool left in your child’s digestive tract that they are not getting rid of. Or they could be pooping out little small pellets that are really hard and dry. So the assessment of the digestive tract is key.
A simple thing you can do is to take your child to your doctor, pediatrician and have an abdominal x-ray done and see if there is a large amount of fecal matter stored in their digestive tract. So the bowels become a seat of not only nutritional input into our bodies from food but they also become a seat for toxicity for our body if there is a tendency for constipation. That constipation can also lead to behavioral problems too.
Posted on 21 December 2009 by autism
Why do some kids on the Autism spectrum when they become constipated become aggressive, become very irritable and agitated, lose eye contact, losing focusing and attention? A lot of people have constipation issues but they are not aggressive. A lot of people have constipation issues including neurotypical kids many times, don’t lose attention and focusing but why does it seem to happen with some children on the spectrum?
There could be an underlying pain response so just being constipated and not being able to have a bowel movement could lead to irritability because it is painful. Because many kids on the Autism spectrum can’t speak and they can’t communicate their needs they will either act it out whether that is hitting themselves, head banging or just being irritable.
There is another reason too, it is called autointoxication. What happens is the digestive tract is the large portal of entry of nutrients into our body. It is this tube that runs through the middle of our digestive system. It can also be a major seat of toxicity because it is also the main route to get rid of toxins through our body as well. If we become constipated we block the ability to get rid of those toxins and some of those toxins can actually be reabsorbed back into the blood stream and then dumped out into general population. There are toxins from yeast, there are toxins from bacteria that are known to actually cause imbalances in brain chemistry. For a child who already has a susceptibility to neuro chemical imbalances, anything else that adds insult to injury can potentially worsen behavior.
What happens is there is a venous system called the portal venal system that returns blood back to the liver of things that have been removed from the digestive tract and if you have a constipation issue, particularly in the large bowel you may get toxins that would normally get excreted out through fecal matter and bowel movements, it gets reabsorbed, taken back into the liver, dumped back into the blood stream and starts to recirculate over and over again causing chemical imbalances.
Posted on 07 December 2009 by autism
We know that constipation can be a big problem for kids on the spectrum. I have talked about this in previous recordings. There is an excellent fiber supplement which you can get. New Beginnings Nutritionals has a product called Tru Fiber.
Tru Fiber is a granule form of fiber, it is very easy to mix into juice or water and does not have a bad taste. Kids take Tru Fiber in my practice without issue. The dose of Tru Fiber is anywhere between ½ – 1 scoop 1 to 3 times per day, you kind of have to regulate it with your child to see what helps. Most kids in my practice are using 1 scoop twice a day in many cases.
Tru Fiber is a good fiber source and the other benefit to the Tru Fiber it that it is what is called a prebiotic. Prebiotics are various substances that help to support the underlying natural bacteria in the digestive tract. The digestive system is full of natural bacterial, acidophilus bifidobacter for example. You can think about Tru Fiber as fertilizer for those natural bacterial. And if you are using any kind of probiotic whether it is Culturelle, Therbiotic complete, Probiotic Support formula, etc. there is a wide variety of probiotics, which are bacterial supplements on the market. Those help supply natural bacteria to the digestive system. The Tru Fiber taken along with those probiotics essentially is like giving a fertilizer to help the probiotic to help with natural growth of the natural bacteria in the digestive system.
So not only is Tru Fiber a good fiber source to help your child have more regular bowel movements but it is like fertilizer in essence for the natural bacteria. Again the product is called Tru Fiber and you can get it from New Beginnings Nutritionals.