Dr. Timothy Buie.
Celiac.com 07/05/2011 - A recent segment of the PBS series, Autism Now,  features an extended interview with Dr. Timothy Buie, who makes some interesting points regarding connections between autism, diet, and gastrointestinal issues.

Regarding celiac disease, Dr. Buie points out that, as diagnostic methods have improved  diagnosis with antibody and genetic testing, researchers have found a much higher frequency of celiac disease than the previously indicated.

For his part, Dr. Buie has come to regard autism as a 'whole-body' experience, "a condition that, in some children, affects their allergic responses and their immune system and a whole host of other systems."

Dr. Buie points out that autism has been characterized as a medical condition only since 1943, and was considered to be a childhood psychosis into the 1980's. Only recently have doctors considered nutritional and other issues to be an important part of autism.

Many autistic children simply do not get adequate nutrients. Because most autistic children are highly selective in the foods that they will eat, autism can present nutritional challenges. Dr. Buie mentions the case of a child who had no source of vitamin C, except for drinking Hi-C., and who developed scurvy when he stopped drinking Hi-C.

However, beyond nutritional challenges, autistic children face higher rates of gastrointestinal problems. Dr. Buie also points to studies that put the prevalence of gastrointestinal problems in children with autism at between 50 and 70 percent.

Still, separating autism-associated problems from common childhood problems can be challenging.  For example, 20 percent of children suffer constipation at some point in their pediatric years. Another quarter suffer from acid reflux that needs to be treated for a period of time. So, telling the difference, or determining if a symptom is unusual or problematic can present its own challenges.

Science is just beginning to make progress in charting other conditions that may be associated with autism. For example, about one in 5,000 people suffer from mitochondrial disease in the general population, while up to 1 or 2 percent of children with autism have mitochondrial dysfunction. Dr. Buie says he believes that data is just preliminary, and that subsequent studies will likely show a higher frequency of mitochondrial dysfunction in those children.

In the article, interviewer Robert MacNeil asks Dr. Buie a series of questions regarding one of the doctor's patients named Nick, an autistic child who faced numerous gastrointestinal issues. Among them, Nick was having chronic diarrhea.

Dr. Buie points out that Nick has several gastrointestinal problems, and "has, clearly, food sensitivities." Even before he saw Dr. Buie, Nick had tried reducing milk and gluten from his diet, and he had seen improvement on that diet.

Nick's endoscopy was largely normal, and because he didn’t have significant inflammation, Dr. Buie was able to exclude allergic change along the lining of the gut.

However, Nick had changes in the lower GI tract that looked like prominent lymphoid reactions -- this finding of lymphoid-nodular hyperplasia that’s common in people with autism.

When MacNeil asks if Dr. Buie thinks that the definition of autism should be broadened, or the description of it, the doctor cites noise sensitivity as one component that should be added to the autism definition.

Dr. Buie adds that other medical conditions that are often seen, like seizure disorders or gastrointestinal disorders, should be considered as part of the clinical picture of autism because they’re common enough that "they will be – as we get smarter about taking care of these kids – part of how we describe this condition."

Read the entire interview and follow the entire Autism Now series on PBS.

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