Gastro-intestinal and Liver Patho by chenshu

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									Gastro-Intestinal and Liver
Patho-Physiology in Autism
            Jonathan Tommey
       BSc Sports Science / Clinical Nutrition

            Tel: +44 (0)20 8979 2525
           E-mail: info@autismfile.com
           Website: www.autismfile.com




             The Autism File / The Autism Trust
                   Agenda
   My personal experience with autism
   Gastro-intestinal disturbances
   The importance of the liver
   Diagnostic testing
   Leaky gut syndrome
   Healing and feeding the gut
   Conclusions


                 The Autism File / The Autism Trust
                  Agenda
   My personal experience with autism
   Gastro-intestinal disturbances
   The importance of the liver
   Diagnostic testing
   Leaky gut syndrome
   Healing and feeding the gut
   Conclusions


                The Autism File / The Autism Trust
             The Tommey Family
   My son Billy, now 9, was
    diagnosed with severe
    autism at 2 years 5 months




                      The Autism File / The Autism Trust
             Billy’s Early History
   Genetic predisposition – inflammatory diseases and Th2
    dominance within the family
   Not breast fed
   2-5 months DPT; 7-12 Months repeated antibiotics;
    MMR at 12 months – respiratory tract infection
   Hair loss and dry skin with extended abdomen and loss
    of all language
   Poor pallor, puffy face and black eye circles
   Increased allergies to foods and selective eating habits
   Pale lose stools, water retention, through to chronic
    diarrhoea with immediate and continued weight loss
   Disturbed sleep patterns, high pitched screaming
   Isolation (world of his own), loss of eye contact and no
    social interaction with his peers, siblings

                     The Autism File / The Autism Trust
        My Perspective on Autism
   Autism is a syndrome characterised by:
       impairments in social relatedness and communication;
       repetitive behaviours;
       abnormal movements; and
       sensory dysfunction
   Autism is a psychological disorder initiated by
    physiological, metabolic and biochemical abnormalities

   Most importantly, autism is not a brain disorder, but
    is a disorder that affects the brain



                          The Autism File / The Autism Trust
                   Agenda
   My personal experience with autism
   Gastro-intestinal disturbances
   The importance of the liver
   Diagnostic testing
   Leaky gut syndrome
   Healing and feeding the gut
   Conclusions


                 The Autism File / The Autism Trust
    Gastro-Intestinal Disturbances
   Poor digestion – low levels of amino acids, essential fatty
    acids, minerals, vitamins and trace elements
   Diarrhoea, constipation, bloated / abdominal distension,
    flatus, inflammation
   Light coloured, smelly stools often containing undigested
    foods
   Leaky gut syndrome
   Inadequate enzyme function
   Dysbiosis – parasites, pathogenic flora, yeasts and viral
    infectious agents
   Inadequate HCl production/disturbed pH



                       The Autism File / The Autism Trust
                 The Gut Function
   The size of a football pitch
   Constituents parts:
       Mouth - mastication,
        amylase
       Stomach – gastric
        secretions, digestion &
        absorption
                                                        Microvilli in small intestine
       Pancreas – insulin,
        digestive enzymes &
        bicarbonate
       Ileum – absorption,
        fermentation & digestion                                              Ileum inflammation
       Colon – absorption, water
        absorption & digestion
       Rectum - elimination

                          The Autism File / The Autism Trust
         Altered & Disrupted Gut
                 Function
   Exists in 94% of autistic sufferers
   Intestinal permeability
   Inflammation - excessive mucus production, elevated
    lysosome and calprotectin (markers)
   Nutrient deficiencies - B and fat soluble vitamins (A,D,E,K)
   Altered gut ecology - disorganised micro biota, growth of
    yeasts, bacteria, viruses, parasites etc.
   Food allergens and food intolerances
   Benefits from Secretin and Bethanecol (pancreatic
    stimulants)
   Benefits derived from GI support – pro and pre biotics,
    multivitamin and mineral supplementation etc.


                       The Autism File / The Autism Trust
                   Agenda
   My personal experience with autism
   Gastro-intestinal disturbances
   The importance of the liver
   Diagnostic testing
   Leaky gut syndrome
   Healing and feeding the gut
   Conclusions


                 The Autism File / The Autism Trust
    The Key Functions of the Liver
■ Re-packaging nutrients               ■ Manufacture of vitamin D
■ Immune system                          and storage of vitamins
■ Toxin breakdown                        A, B, & E and minerals
■ Hormone production:                  ■ Cholesterol production
  insulin and adrenalin                ■ Conversion of glucose to
■ Protein structure                      glycogen for storage
  manufacture                          ■ Regulation of blood levels
■ Bile secretion - fat                   of amino acids
  breakdown, prevention of             ■ Conversion of ammonia
  constipation, pH balance,              to urea
  reducing food allergies              ■ Destruction of pathogens
■ Regulation of blood                    e.g. bacteria via the
  clotting                               Kupfer cells


                    The Autism File / The Autism Trust
            Detoxification Issues
   Low plasma sulphate levels and elevated sulphite levels
    (molybdenum deficiencies)
   Poor methylation and trans sulphation
   Inflammation leading to reduced glutathione levels
   Deficiencies in co-factors for super oxide dismutase and
    glutathione peroxidase (zinc, manganese, molybdenum
    and selenium)
   Ammonia
   Signs of cellular apoptosis
   Mitochondrial dysfunction
   DNA damage
   Low levels of anti-oxidants, increased heavy metals
   Stress leading to increased oxidative stress
   Inability to handle toxins
                      The Autism File / The Autism Trust
             The Liver and Autism
   Autistics have a poor ability to detoxify and also have:
       Leaky gut syndrome which increases absorption of toxins,
        allergens and pathogens
       Hormone imbalances such as insulin, adrenalin, cortisol and
        serotonin
       Poor digestion of fats
       Candidiasis and constipation
       Low levels of beneficial flora (pH imbalance)
       Increased food allergens
       Low levels of B vits esp. B6, B12, Vit D deficiency and minerals
       Poor liver enzyme function
       Heavy metal toxicity
   The majority of these features are liver activities


                           The Autism File / The Autism Trust
              Liver Detoxification
The liver employs two phases of detoxification using the
  p450 cytochrome enzymes:
 Phase 1 – Activation: Toxins are pulled out of storage by
  activation enzymes, predominantly Super Oxide
  Dismutase (SOD)
 Phase 2 – Conjunction: The toxins are passed onto
  further enzymes, predominantly glutathione peroxidase,
  to be converted into water soluble toxins for elimination

   The liver has to be key to the treatment of autistics



                       The Autism File / The Autism Trust
 Vitamins & Minerals in Support
Phase 1 – Activation
 SOD – zinc, molybdenum and manganese
 Vitamin A (measles drains Vitamin A reserves)
 B2,B3,B6,iron,magnesium,zinc,C,E, beta carotene and
  selenium

Phase 2 - Conjugation
 Glutathione Peroxidase – Selenium
 Vitamin B6, folic acid, magnesium
 Support methylation and sulphation pathways
 TMG, DMG, Folic acid, sulphate, B6, B12



                   The Autism File / The Autism Trust
    Improving the Liver: Nutrition
   Cut out all refined carbohydrates and sugar
   Cut out saturated trans and hydrogenated fats
   Increase water – purified (1.5 litres per day)
   Increase specific vegetables consumption: including:
    garlic, leeks, Jerusalem artichokes, onions, Brussels
    sprouts, broccoli, parsley, beetroot, radish, cabbage,
    collards, kale, watercress, sesame seeds & walnuts
   Increase fruit consumption: including apricot, avocado,
    banana, blackberries, blueberries, pomegranates,
    strawberries, cranberries, lemons, papaya, pineapple,
    watermelon, tomatoes, tangerines, raspberries
   Increase amino acids including: cysteine, methionine,
    taurine, lipoic acid and glycine.
   Drink dandelion tea, tinctures, lemon and green tea
                      The Autism File / The Autism Trust
                   Agenda
   My personal experience with autism
   Gastro-intestinal disturbances
   The importance of the liver
   Diagnostic testing
   Leaky gut syndrome
   Healing and feeding the gut
   Conclusions


                 The Autism File / The Autism Trust
           Each Child is Different
   Each child is diagnosed under the same psychological
    umbrella as any other child with autism
   However, each child is an individual and may have a
    very different underlying aetiology and express very
    different biochemical, metabolic and physiological
    differences compared to others


   Diagnostic testing is at the heart of structured analysis




                       The Autism File / The Autism Trust
             Prioritise Any Tests
Ask yourself these questions:


   Does my child exhibit gut related disturbances?


   Does my child have problems with certain foods?


   Does my child have any symptoms associated with
    dysbiosis and liver stress?



                      The Autism File / The Autism Trust
                 Relevant Tests
   Comprehensive Digestive Stool Analysis (CDSA)
   Intestinal Permeability
   Urinary Peptides
   Vitamin / Mineral Trace Element Disturbances
   Organix
   Food Allergy Panel
   Secretory IgA
   Kryptopyroles
   Sulphate/sulphite in urine
   Methylation markers
   Essential hair analysis, toxic and nutrient elements
   Oxidative stress analysis

                       The Autism File / The Autism Trust
     What to do with the Results?
   Seek appropriate guidance
   Gather information and direction from your selected
    experts; continue if 2 or more agree with the protocol
   Advice must be given as to why each supplement /
    intervention is to be used – what will it do?
   How will it help? What will it address? How long should I
    wait to see results? Could there be negative reactions or
    side affects?
   Follow guidance on dosage, when to give and how much
    and whether it should be accompanied with food, drink
    or given in isolation?
   Will your child swallow capsules or tablets? If not, are
    there any other forms such as liquid, cream, powder?
   Is all of this within your budget?
                       The Autism File / The Autism Trust
              Order of Treatment
   Firstly – improve the liver function
   If your child has increased permeability, dysbiosis,
    allergenic responses and inflammation it is inevitable
    that more toxins will reach the liver and therefore put
    much more stress on it. Do not add more stress to the
    liver by treating G.I. disturbances first
   Second – address the performance of the gut by testing
    for and then treating any intestinal permeability or
    ‘Leaky Gut’




                       The Autism File / The Autism Trust
                   Agenda
   My personal experience with autism
   Gastro-intestinal disturbances
   The importance of the liver
   Diagnostic testing
   Leaky gut syndrome
   Healing and feeding the gut
   Conclusions


                 The Autism File / The Autism Trust
            What is ‘Leaky Gut’?
   The gut lining is inflamed and more porous than normal
   70% of our total immune system surrounds the gut
   The gut will allow pathogens, undigested proteins, fats
    and waste not normally absorbed into the blood system
   Protection by secretions – mucus, sec IgA, epithelium
    and intramural lymphocytes

   Liver stress increases toxic exposure from endotoxins,
    xenobiotics, toxic wastes, polyamines, and allergenic
    peptides

   Poor diet, stress and antibiotics all increase the condition


                       The Autism File / The Autism Trust
Testing for GI Disturbances




        The Autism File / The Autism Trust
The Autism File / The Autism Trust
Digestive Stool Analysis with
   Parasitology (CDSA)




         The Autism File / The Autism Trust
  Organix




The Autism File / The Autism Trust
                   Agenda
   My personal experience with autism
   Gastro-intestinal disturbances
   The importance of the liver
   Diagnostic testing
   Leaky gut syndrome
   Healing and feeding the gut
   Conclusions


                 The Autism File / The Autism Trust
Healing the Gut: Where to Start
   Stop exposures to NSAIDs or cytotoxic drugs
   Reduce inflammation by getting rid of pathogens and
    allergens and correct dysbiosis
   Eliminate allergenic foods
   Check HcL levels and B6 and zinc status
   Address pathogenic bacteria
   Reduce antibiotic usage
   Increase secretory IgA




                      The Autism File / The Autism Trust
               Use of Probiotics
   Benefits of beneficial bacteria
   Fermentation of soluble fibre to SCFA’s
   Butyrate = 70% of colonic fuel
   Vitamin synthesis especially B vitamins
   Degrade Gluten and Casein (mindlink)
   Immuno modulation – stimulation of secretory IgA
   Custom Probiotics d-lactate free formulation
   Lactobacillus GG




                      The Autism File / The Autism Trust
                        Candida

Symptoms

   Poor sleep patterns; inappropriate giggling / laughing;
    intense carbohydrate cravings; fatigue; behavioural
    problems; bouts of screaming; dark eye circles

Causative Issues

   Excessive antibiotic use
   Poor diet: refined carbohydrates and sugar rich foods
   Apples, grapes and raisins
   Immune suppression esp. low TH1and Sec IgA
                       The Autism File / The Autism Trust
                Candida Therapy
   Pharmaceutical interventions – nystatin / diflucan /
    amphotericin B
   Hemicellulases and xylanases break down yeast cell
    membranes
   Pau d’arco
   Capryllic acid
   Goldenseal
   Garlic, oregano, olive leaf extract, grapefruit seed extract
   Probiotics - lactobacillus GG

   No Glutamine as it encourages Candida growth


                       The Autism File / The Autism Trust
     Beneficial Foods for the Gut
   Cabbage, Brussels sprouts, broccoli, raw garlic, onions,
    leeks, radishes, fenugreek, ginger root, hot chilli, lemon
    juice, turmeric, mustard, rosemary, parsley, spinach,
    pineapple and papaya



Foods to avoid:
   Refined carbohydrates promotes dysbiosis
   Excessive protein leads to smelly stools, putrefaction
   All allergenic foods
   Excessive fat intake: red meats, fried food

                       The Autism File / The Autism Trust
                Other Therapies
   Enzymes – important for individuals with leaky gut as
    they breakdown peptides that may pass across the gut
    membrane – allergenic response

   L-Glutamine (not with candidiasis treat first) - 70% fuel
    for small intestine (may cause hyperactivity/excitation) 1-
    3 g/day

   Butyrate – 70% fuel for large intestine, a short chain fatty
    acid derived from fermentation of soluble fibre



                       The Autism File / The Autism Trust
                     Agenda
   My personal experience with autism
   Gastro-intestinal disturbances
   The importance of the liver
   Diagnostic testing
   Leaky gut syndrome
   Healing and feeding the gut
   Conclusions


                   The Autism File / The Autism Trust
                    In Summary
   Support the liver with beneficial foods, nutrients and
    herbs
   Use relevant diagnostic tests to identify and isolate
    Gastro intestinal disturbances
   Remove pathogens and allergens
   Stimulate and balance immune response and reduce
    inflammation
   Heal the gut
   Re-test for Gastro-intestinal disturbances



                       The Autism File / The Autism Trust
 Through close diagnosis and a
    focus on the liver, we can
improve the condition and lives
 of those suffering from autism



          The Autism File / The Autism Trust

								
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