Leaky Gut and How it Affects Health and Autism Spectrum Disorders (ASD)

/ Autism Spectrum Disorder, Special Needs / By

What Is Leaky Gut Syndrome?

A leaky gut is a hypothetical condition based on the concept of relatively increased intestinal permeability or hyperpermeability. And therefore, the intestinal walls permit larger molecules, especially toxins, through.

It has received increasing attention because of its association with several gastrointestinal (GI) and non-GI diseases, such as autism spectrum disorder(ASD), irritable bowel syndrome, some neurological disorders(e.g. Alzheimer’s disease, Parkinson’s disease), asthma, type 2 diabetes, etc. 

Proposed Pathogenesis and Mechanisms of Leaky Gut Syndrome and Autism Spectrum Disorders

  • Alteration in the organic composition of the stool in children with ASD compared to other children, for example 1. Lower levels of short-chain fatty acids ;and 2. Increased levels of IgA.
  • Increased gut permeability may be due to zonulin, an enzyme associated with the regulation of intestinal permeability. Another cause may link to decreased levels of intestinal tight junction components.
  • Increased brain permeability due to increased levels of claudin in the ASD brian.
  • Increase gut bacterial metabolites such as bisphenol A(BPA) and serum endotoxin levels. 
  • Alteration in microbial composition in autistic children: Biological markers of bacterial translocation showed a significant difference between austistic children and other children.
    1. The significantly decreased ratio between the phyla Bacteriodetes to Firmicutes
    2. The lower concentration in Fusobacteria and Verrucomicrobia
    3. Elevated concentration in Akkermansia muciniphila, Anaerofilum, Barnesiella intestinihominis, Clostridium spp, Dorea spp, Enterobacteriaceae, Faecalibacterium spp, Roseburia spp, Parasutterella excrementihominis, Prevotella Capri, Prevotella oris and Turicibacter spp: The abundances of Candida, Corynebacterium, Dorea and Lactobacillus.

Symptoms And Signs Of The Leaky Gut Syndrome

  • A burning feeling of ulceration in gut
  • Painful indigestion from the loss of intestinal mucosa
  • Diarrhoea
  • Gas and bloating from fermentation by overgrowth bacteria in your gut 
  • Low energy from the reduced ability to draw energy
  • Gastrointestinal mucositis from radiation therapy
  • Skin conditions like acne, rosacea, or eczema
  • Food allergies, sensitivities, or intolerances

Assessment and Diagnosis

  • Lactulose Mannitol: Drink a solution containing the different molecular sizes of sugar, and they are unabsorbed in the intestinal walls. And then measure the concentration of sugar in the urine.
  • Blood test: test concentration of zonulin, calprotectin and lysozyme were marked as biomarkers for the early detection of leaky gut as an etiological mechanism of ASD
  • Tissue biopsy: it is not commonly used, as it is invasive and expensive and mostly reserved for research.
  • Confocal endomicroscopy: shows food associated changes in the intestinal mucosa of patients with leaky gut syndrome
  • Stool Microbiome Testing: measures the amount and types of microbes
  • IgG and IgA Food Intolerance : IgA will be found in serum when mucosal barriers has been compromised. The abundance of IgG may indicate a hypersensitivity reactions.

Treatment and Therapies

  • Probiotics

They are normally used alongside an anti-inflammatory diet for rebalancing gut flora, restoring your intestinal wall and decreasing intestinal inflammation.

  • Prebiotics

β-fructan is scientifically proven to reduce “leaky gut syndrome” and restore the intestinal immune system by affecting gut microbacteria.

  • Diet and Nutrition
  1. Vitamin D: study shows that vitamin D supplementation significantly increased gut microbial diversity and health-promoting probiotics.
  2. L-glutamine: it is an amino acid for maintaining mucosal integrity and mucosal protection.
  3. Low FODMAP Diet:
    • FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols, which are short-chain carbohydrates (sugars).
    • It is a three-step elimination diet or stop eating certain casein.

Conclusion

It is exciting to see more research on the gut-brain connection in autism spectrum disorders, and hopefully, this trend will continue. Addressing gut and physical health issues should be a cornerstone of treatment for all children on the autism spectrum. While other approaches are needed and beneficial, supporting gut function provides a foundation for all other treatments.

References:

1.https://my.clevelandclinic.org/health/diseases/22724-leaky-gut-syndrome#:~:text=Leaky%20gut%20syndrome%20is%20a%20theory%20that%20intestinal%20permeability%20is,letting%20toxins%20into%20your%20bloodstream.

2.https://www.webmd.com/digestive-disorders/features/leaky-gut-syndrome

3.https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451

4.Rao R, Samak G. Role of Glutamine in Protection of Intestinal Epithelial Tight Junctions. J Epithel Biol Pharmacol. 2012;5(Suppl 1-M7):47-54. doi:10.2174/1875044301205010047

5.Yitik Tonkaz G, Esin IS, Turan B, Uslu H, Dursun OB. Determinants of Leaky Gut and Gut Microbiota Differences in Children With Autism Spectrum Disorder and Their Siblings. J Autism Dev Disord. 2022 Apr 20. doi: 10.1007/s10803-022-05540-z. Epub ahead of print. PMID: 35441922.

6.Al-Ayadhi L, Zayed N, Bhat RS, Moubayed NMS, Al-Muammar MN, El-Ansary A. The use of biomarkers associated with leaky gut as a diagnostic tool for early intervention in autism spectrum disorder: a systematic review. Gut Pathog. 2021 Sep 13;13(1):54. doi: 10.1186/s13099-021-00448-y. PMID: 34517895; PMCID: PMC8439029.

7.https://www.gastrojournal.org/article/S0016-5085(14)01149-4/pdf

8.Singh P, Rawat A, Alwakeel M, Sharif E, Al Khodor S. The potential role of vitamin D supplementation as a gut microbiota modifier in healthy individuals. Sci Rep. 2020 Dec 10;10(1):21641. doi: 10.1038/s41598-020-77806-4. PMID: 33303854; PMCID: PMC7729960.

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