מחקר חדש של ד"ר בואי מהרוורד
ד"ר בואי הוא ממובילי ה-DAN!, גסטרואנטרולוג המתמחה בילדינו. תודה לעליזה על ההפניה. Professionals and Practitioners: Mass General/Harvard University: GI Study (MA) Tim Buie, MD Harvard University and Mass General Hospital are collaborating on a study to establish a medical protocol for the treatment of autism. Dr. Tim Buie, a pediatric gastroenterologist from Harvard Mass General, has performed more than 500 gastrointestinal endoscopies with biopsies on autistic children. His findings show that more than half of these children had treatable gastrointestinal problems that ranged from moderate to severe including esophagitis, gastritis and enterocolitis along with the presence of lymphoid nodular hyperplasia. In a recent conference Buie echoed the opinion of a growing number of clinical researchers and practitioners treating autistic patients. "These children are ill, in distress and pain, and not just mentally, neurologically dysfunctional," he said. He believes that many of the symptoms of autism such as self abusive behavior including self-mutilation, head-banging, unexplained outbursts, atypical sleep patterns, disrupted sleep or night awakenings, are actually symptoms of pain that a child is not able to communicate. The Harvard research team presented their research proposal to the Northwest Autism Foundation and a select group of doctors and scientists in Portland in Autumn, 2001. Below is a summary of their initial findings: Over 400 patients evaluated, ages 14 Months to 20 Years 3:1 ratio of male:female patients Patients undergoing endoscopic procedure all had GI symptoms of pain or diarrhea Endoscopic findings:Esophagitis in 23 out of 111 (20%) Gastritis in 14 out of 111 (12%); 4 had Helicobacter pylori Duodenitis in 11 out of 111 (10%); 2 had Celiac Sprue (According to Dr. Buie, all children with ASD should get a blood test for Celiac Sprue before going on a GF diet. Once they're on the diet, those antibodies are gone and the test results will be inconclusive.) Eosinophilic Inflammation in 5 out of 111 (5%) Duodenal collection of pancreatic enzymes: 10 out of 90 (11%) had unusually low enzyme activity 2 out of 10 (20%) had total pancreatic insufficiency; 5 had multiple enzyme defects Carbohydrate digestion: Lactase deficiency was found in 55% of ASD children tested Combined deficiency of disacchraridase enzymes was found in 15% Enzyme assays correlate well with hydrogen breath tests Colonoscopy: Colitis was found in 11 of 89 patients (12%), none with features of Ulcerative Colitis or Crohn's Histologic (biopsy reviewed) lymphoid nodular hyperplasia was found in 15 of 89 patients (16%) Eosinophilic inflammation was found in 13 of 89 patients (14%); cause or significance is unclear Conclusions: More than 50% of autistic children appear to have GI symptoms, food allergies, and maldigestion/malabsorption issues. We need large, evidence-based studies need to be done in order to fully understand the gut-brain association in autism. Harvard Medical School/Mass General Hospital: Ladders Program Timothy Buie, MD Harland Winter, MD Rafail Kushak, MD
ד"ר בואי הוא ממובילי ה-DAN!, גסטרואנטרולוג המתמחה בילדינו. תודה לעליזה על ההפניה. Professionals and Practitioners: Mass General/Harvard University: GI Study (MA) Tim Buie, MD Harvard University and Mass General Hospital are collaborating on a study to establish a medical protocol for the treatment of autism. Dr. Tim Buie, a pediatric gastroenterologist from Harvard Mass General, has performed more than 500 gastrointestinal endoscopies with biopsies on autistic children. His findings show that more than half of these children had treatable gastrointestinal problems that ranged from moderate to severe including esophagitis, gastritis and enterocolitis along with the presence of lymphoid nodular hyperplasia. In a recent conference Buie echoed the opinion of a growing number of clinical researchers and practitioners treating autistic patients. "These children are ill, in distress and pain, and not just mentally, neurologically dysfunctional," he said. He believes that many of the symptoms of autism such as self abusive behavior including self-mutilation, head-banging, unexplained outbursts, atypical sleep patterns, disrupted sleep or night awakenings, are actually symptoms of pain that a child is not able to communicate. The Harvard research team presented their research proposal to the Northwest Autism Foundation and a select group of doctors and scientists in Portland in Autumn, 2001. Below is a summary of their initial findings: Over 400 patients evaluated, ages 14 Months to 20 Years 3:1 ratio of male:female patients Patients undergoing endoscopic procedure all had GI symptoms of pain or diarrhea Endoscopic findings:Esophagitis in 23 out of 111 (20%) Gastritis in 14 out of 111 (12%); 4 had Helicobacter pylori Duodenitis in 11 out of 111 (10%); 2 had Celiac Sprue (According to Dr. Buie, all children with ASD should get a blood test for Celiac Sprue before going on a GF diet. Once they're on the diet, those antibodies are gone and the test results will be inconclusive.) Eosinophilic Inflammation in 5 out of 111 (5%) Duodenal collection of pancreatic enzymes: 10 out of 90 (11%) had unusually low enzyme activity 2 out of 10 (20%) had total pancreatic insufficiency; 5 had multiple enzyme defects Carbohydrate digestion: Lactase deficiency was found in 55% of ASD children tested Combined deficiency of disacchraridase enzymes was found in 15% Enzyme assays correlate well with hydrogen breath tests Colonoscopy: Colitis was found in 11 of 89 patients (12%), none with features of Ulcerative Colitis or Crohn's Histologic (biopsy reviewed) lymphoid nodular hyperplasia was found in 15 of 89 patients (16%) Eosinophilic inflammation was found in 13 of 89 patients (14%); cause or significance is unclear Conclusions: More than 50% of autistic children appear to have GI symptoms, food allergies, and maldigestion/malabsorption issues. We need large, evidence-based studies need to be done in order to fully understand the gut-brain association in autism. Harvard Medical School/Mass General Hospital: Ladders Program Timothy Buie, MD Harland Winter, MD Rafail Kushak, MD