Autism is a developmental disorder characterized by severe abnormalities in communication, social awareness and skills, and behavior. Before the 1980s, autism occurred in 2 to 5 of every 10,000 children. Today about 1 in every 110 children gets autism. This rapid increase cannot only be attributed to improved diagnosis, and also indicates there is more to the disorder than simply genetics. Indeed, autism is a combination of genetic predisposition with environmental factors that triggers its development.

One aspect of contributing factors, at least in a subset of children, involves gut dysfunction. Many reports describe gastrointestinal symptoms and abnormalities in up to 84% of children with autism.[1] From constipation, diarrhea, abdominal discomfort, food sensitivities and abnormal gut flora to immune dysfunction and gut and systemic inflammation, the digestive system plays a central role in many cases of autism.

One gut abnormality—lactose intolerance—found in people with autism was recently reported in the journal Autism. Intestinal disaccharidase activity was measured in 199 individuals with autism. Disaccharidase is an enzyme that breaks larger sugars (disaccharides) like lactose, maltose and sucrose into smaller sugars like glucose. Deficiency of lactase enzyme, the enzyme that breaks milk sugar, or lactose, into galactose and fructose, was found in 58 percent of autistic children and 65 percent of autistic adults. In children, boys under 5-years-old had 1.7-fold lower lactase activity than girls of the same age, indicating the problem may be more severe in boys. The study concluded that lactase deficiency is common in autistic children and may contribute to abdominal discomfort, pain and the observed abnormal behavior seen in autism. Further, the study points out that most autistic children with lactose intolerance are not identified when doctors take a clinical history.

A decrease in activity of a variety of carbohydrate-digesting enzymes has been reported in children with autism.[2] Carbohydrase and disaccharidase enzyme deficiency results in the incomplete breakdown of carbohydrates in the small intestine. These partially undigested carbs move into the colon where they are greeted by a large supply of “hungry” bacteria—including potentially pathogenic bacteria. This may explain the increased presence of Candida and Clostridia species found in the guts of autistics.[3][4]

Carbohydrate-digesting enzymes are not the only digestive enzymes that may cause problems in autism. Fat malabsorption is seen in some autistic children, resulting in fatty, loose, floating, foul-smelling stools, also known as steatorrhea. Further, a particular enzyme known as dipeptidyl peptidase-4 (DPP4) may be deficient in those with autism. This enzyme breaks a specific peptide bond in gluten and casein proteins. In fact, it is thought that a deficiency in this enzyme is responsible for the incomplete breakdown of casein and gluten peptides (known as gluteomorphins and casomorphins) that act as opioids in the central nervous system and are thought to contribute to autistic symptoms. Following a gluten-free and casein-free diet has been found helpful in many autistics because it eliminates exposure to these peptides, often relieving symptoms. Supplemental DPP4 can be given in cases where accidental ingestion of gluten- or casein-containing foods is suspected, but it is not recommended as a replacement for the gluten-free, casein-free diet.

In all, we see a variety of enzyme deficiencies in autism and it would be wise to supplement with a digestive enzyme formula that includes a variety of enzymes. Further, due to the many digestive abnormalities seen in autism, the HOPE Formula (High-fiber, Omega oils, Probiotics and digestive Enzymes) is a wise daily maintenance program to support gut health.

[2] Horvath K, et al., “Gastrointestinal abnormalities in children with autistic disorder.” J Pediatr 1999;135:559-63.

[3] Finegold SM, et al., “Gastrointestinal microflora studies in late-onset autism.” Clin Infect Dis. 2002 Sep 1;35(Suppl 1):S6-S16.

[4] Shaw W, et al., “Assessment of antifungal drug therapy in autism by measurement of suspected microbial metabolites in urine with gas chromatography—mass spectrometry. The Clinical Practice of Alternative Medicine Magazine. 2000;1:15-26.

Leonard Smith, M.D.

Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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Renew You Challenge

Let’s start this week off right!

Weekly challenge (I mean, opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar. Join us!

The digestive tract is about 30 feet long, and it takes anywhere from 24 to 72 (or more, yikes!) hours for food to travel all the way through. If you experience constipation, exercise can really help get things moving. I recommend aerobic exercise at least three times a week for 30 minutes. Find some aerobic activity you enjoy to help you stick to the routine, and try to change it up so you don’t get bored.

Stretching exercises are also helpful. This week, for stimulating digestion, try this yoga sequence I found on health.com. You could add this to the end of your routine to help get things moving.

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Gastroenterologists from Johns Hopkins University are reporting something I don’t find surprising at all—kids are experiencing more serious and chronic bouts of constipation. Why? Lack of physical activity, inadequate water intake and fiber-poor diets are the biggest culprits.   

As I said, it’s not surprising. Traditional medicine defines constipation in children as three or fewer bowel movements per week, for at least three months (not necessarily consecutive) per year. They say that these children need to be treated early and aggressively. They also say, “no amount of fiber or prune juice will help a child with serious chronic constipation.”

Wanna know what I say? I say if children are not experiencing a bowel movement every day, they are constipated. If they miss a day, they are constipated and should be treated for it.  How’s that for early? Sure, if a child is only having three bowel movements per week for three months, fiber and prune juice might not be enough. But more importantly, we need to not let the problem get that far. In fact, it starts in infancy, with a proper diet (including plenty of breast milk!).

One bowel movement daily—that should be the norm, OK?

The researchers do recommend plenty of water intake, plenty of exercise, a high-fiber diet rich in fruits and vegetables, and a diet low in processed foods and foods that are high in fat and sugar. They also recommend the use of a stool or box to prop up legs into a more natural position.  They also stress the importance of teaching kids to never “hold” or ignore the urge to move the bowels.

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Renew You Challenge

Let’s start this week off right!

Weekly challenge (I mean, opportunity!) to help set you off on the right foot and in the right direction for bringing health to your week. You could even add it to your calendar. Join us!

Irritable bowel syndrome (IBS) is a common gut disorder characterized by abdominal pain and discomfort, and altered bowel habits—constipation, diarrhea, or usually, alternating between both. People with IBS have a decreased health-related quality of life. Often, they also experience such conditions as fibromyalgia, depression, or even colon cancer.

It is known that women with IBS are less physically active than healthy women, and that women with IBS who do participate in regular physical exercise experience less fatigue or bowel complaints. A study published in the American Journal of Gastroenterology takes this association one step further by testing whether increased physical activity decreases IBS symptoms, and whether it increases quality of life.

As it turns out, regular exercise—20 to 60 minutes of moderate-to-vigorous physical activity 3 to 5 days per week—improved gastrointestinal symptoms and quality of life in people with IBS. The researchers recommend that physical activity be used as a primary treatment modality for IBS. 

I recommend exercise a lot because I believe it should be a part of everyone’s routine. It helps improve gut function, yes, but it also helps improve just about every area of health. So this week, if you or someone you know has IBS and you aren’t getting enough physical exercise, get moving. Find some form of exercise that makes you feel good, and just do it.

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 Constipation is a common childhood condition, unfortunately. Even worse is the mainstream definition of constipation—less than three bowel movements per week. Say what! If you or little Johnny are only pooping three times a week, we’ve got a problem. Regular elimination helps remove toxins from the system. And the longer feces sit in the colon the more toxic it gets!

A recent study evaluated the effect of the probiotic Bifidobacterium breve in children with constipation. Twenty children between the ages of 3 and 16 took the probiotic daily for a 4-week period. Bowel movement frequency and stool consistency improved significantly in these children. That means their constipation improved. The results of this pilot trial are promising, and will lead to a larger randomized controlled trial.  

Bifidobacteria are the most prevalent probiotic bacteria in the large intestine, or colon, of children. Normal bifidobacteria colonization occurs when babies are born vaginally, and is improved during breastfeeding. Antibiotic treatment can interfere with colonization, especially during the first months and years of life. Maintaining a healthy balance of bifidobacteria is associated with intestinal health, which is the foundation of total body health.

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There is still a general belief with medical doctors and the public as well that Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) are mostly stress-related psychological disorders. I have personally had many patients who were reluctant to discuss their bowel problems for fear of being labeled a “psych” case. Many practitioners still aren’t aware there can be legitimate causes of disease that come from both mind and body.

With IBS and IBD, as with most discussions, there is often an element of truth on both sides or there would be no controversy. First, let’s look at the validity of the stress factors. People with genetic short serotonin transporter systems react negatively to stress-related increases in cortisol (a stress hormone) than people with normal serotonin transport systems.1 Second, ALL people react to significant stress, which can produce damage to the gut epithelial lining. However, people with a history of IBD generally show more gut lining damage than those without IBD. The damage includes: increased levels of stress hormones, activation and degranulation of mast cells, mitochondrial damage in epithelial cells, and mucosal protein oxidation which can create multiple problems with permeability (leaky gut) and immunity.2 Again, this happens to everyone under stress, but is worse with IBS and IBD because stress can trigger a relapse of either condition.

On the other hand, there are many reports that suggest anywhere from 20 to 60 percent of IBS and IBD patients have had a serious gastrointestinal infection days or weeks before they began having symptoms of chronic bloating, abdominal pain, diarrhea or constipation (or both diarrhea and constipation) that may have lasted years. A study was done on 111 patients with IBS using the lactulose breath test (measures hydrogen and methane gas produced by too many of the wrong bacteria) and 84 percent of patients were positive, which indicates small intestinal bacterial overgrowth (SIBO). Those who were treated with a non-absorbable antibiotic, Neomycin, had a statistically significant improvement both in symptoms, and normalization of the breath test.3 A more recent study4 showed that patients with IBS, but without constipation, treated with rifaximin (a broad spectrum non-absorbable antibiotic) for two weeks provided significant relief of IBS symptoms including: bloating, abdominal pain, and loose or watery stools.

Both of these studies strongly suggest that bacterial overgrowth, which creates a low-grade infection, is a major part of IBS, and can be treated with antibiotics. In addition, I think the standard of care today strongly suggests using probiotics while on antibiotics. This has been shown to lower the incidence of antibiotic associated diarrhea (AAD), and especially Clostridium difficle diarrhea, which can lead to total removal of the colon or even death.

Probiotics alone have been shown to significantly help with IBS. More specifically, probiotics enhance gut barrier function, inhibit pathogen binding and modulate gut inflammatory response. They reduce visceral hypersensitivity associated with both inflammation and psychological stress. More importantly, probiotics can alter colonic fermentation and stabilize the colonic microbiota, show that dietary exposure to pathogens maybe less likely to create another relapse of symptoms.5

Once again we can see that the use of high fiber, essential oils (omegas), probiotics and digestive enzymes (Brenda Watson’s HOPE Formula) can be beneficial in preventing or treating intestinal inflammation—be it IBS or IBD.

1. Way BM. “The Serotonin Transporter Promoter Polymorphism Is Associated with Cortisol Response to Psychosocial Stress.” Biol Psychiat. 2010 Mar 1;67(5):487-92.
2. Farhadi A, et al. “Heightened Responses to Stressors in Patients with Inflammatory Bowel Disease.” Am J Gastro. 2005;100:1796–1804.
3. Pimentel M., et al. “Normalization of Lactulose Breath Testing Correlates With Symptom Improvement in Irritable Bowel Syndrome: A Double-Blind, Randomized, Placebo-Controlled Study.” Am J Gastro. 2003;98:412-19.
4. Pimentel M., et al. “Rifaximin Therapy for Patients with Irritable Bowel Syndrome without Constipation.” N Engl J Med. 2011 Jan;364:22-32.
5. Spiller, R. “Review article: probiotics and prebiotics in irritable bowel syndrome.” Aliment Pharmacog Ther. 2008 Jun;28(4):385-96.

Leonard Smith, M.D.
Dr. Leonard Smith is a prominent Board-Certified, general, gastrointestinal and vascular surgeon who had a successful private practice for 25 years. In addition to his active surgery practice, he also incorporated lifestyle, diet, supplementation, exercise, detoxification, and stress management into many of the therapies he would prescribe. Many of his patients with cancer, cardiovascular disease, and other serious illnesses did so well under his treatment regimes that he began to devote most of his career to foundational health care and preventive medicine.

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The day after Thanksgiving, my new PBS television special, The Road to Perfect Health, started airing nationwide and the response has been incredible. It was such a long but rewarding journey to bring all the elements of this new show together, and I’m so happy to finally be able to share the message of vibrant health with audiences all across America.

So many people in our lives are suffering—waking up every day with problems like poor digestion, fatigue, weight gain, anxiety, joint pain and so much more—but it doesn’t have to be that way. The secret to a healthy body begins with a healthy digestive system, and the information in The Road to Perfect Health will teach you all about what’s going on inside your gut and why it’s so important to keep your digestive system running smoothly.

Join me and together we’ll look at the trillions of good bacteria living inside your gut that help your body absorb nutrients, defend against toxins, fight off illness and disease, and yes, even help with problems like constipation, irritable bowel and other digestive issues. Those good-for-you bacteria are called probiotics, and they’re the key to a strong Gut Protection System—or GPS for short!

Just like the GPS in your car, all those good bacteria in your gut help keep you on the path to better health. But what happens when your GPS isn’t working right? You can get lost, and just like getting lost on the road, we sometimes lose our way on the road to better health and end up stuck in a rut of illness and poor digestion.

I hope you’ll tune in this month to learn the secret to rebuilding your health from the inside out. It’s time to balance your gut and heal your body! Check your local PBS station for dates and times.

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Folks, I can’t tell you how excited I am that in just a few days my new PBS special, The Road to Perfect Health, will begin airing nationwide. It’s been such a long but rewarding journey to bring all the elements of this new show together, and I’m so happy to finally be able to share the message of vibrant health with audiences all across America.

So many people in our lives are suffering—waking up every day with problems like poor digestion, fatigue, weight gain, anxiety, joint pain and so much more—but it doesn’t have to be that way. The secret to a healthy body begins with a healthy digestive system, and the information in The Road to Perfect Health will teach you all about what’s going on inside your gut and why it’s so important to keep your digestive system running smoothly.

Join me and together we’ll look at the trillions of good bacteria living inside your gut that help your body absorb nutrients, defend against toxins, fight off illness and disease, and yes, even help with problems like constipation, irritable bowel and other digestive issues. Those good-for-you bacteria are called probiotics, and they’re the key to a strong Gut Protection System—or GPS for short!

Just like the GPS in your car, all those good bacteria in your gut help keep you on the path to better health. But what happens when your GPS isn’t working right? You can get lost, and just like getting lost on the road, we sometimes lose our way on the road to better health and end up stuck in a rut of illness and poor digestion.

I hope you’ll tune this month and through December to learn the secret to rebuilding your health from the inside out. It’s time to balance your gut and heal your body!

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Okay, so maybe it isn’t a headline you expect to see very often, but lately things are changing, and I say they’re definitely changing for the better. More and more people are becoming aware of the vast numbers of microscopic bacteria living inside their bodies, and a whole new field of science has emerged to study the literally trillions of microorganisms that grow and thrive inside us—helping us do everything from digesting our food to boosting our immune defenses and protecting us against illness and disease.

To help you get an idea of just how important these bacteria are, consider this: In the human body there are 10 times more microbial cells than human cells. Just think about that for a second—it means that roughly 90% of our genetic makeup is microbial. Whoa! I don’t know about you, but I think it’s pretty amazing that something we can’t even see can be such an important part of who we are.

In the gut especially, there are about 100 trillion bacterial cells. Some are good, some are bad, and some are neutral, but the key is making sure you always have more good than bad (somewhere around 80% to 20%), because the good guys—called probiotics—help to nourish and protect not just your digestive tract, but your whole body.

In just the last few years scientists have made some pretty amazing discoveries about the role of probiotics in human health, and studies show that taking a daily probiotic supplement can help with digestive conditions such as irritable bowel, diarrhea and constipation, as well as aid in vitamin production, weight loss, mental health, and of course building up our immune defenses by crowding out harmful, disease-causing bacteria.

So the next time you hear someone talk about bacteria, resist the urge to cringe and remember the good guys! Probiotics literally means “for life,” and no wonder. I heard this great quote the other day by Dr. Jeffrey Gordon at the Center for Genome Sciences at Washington University, and it really sums it up: “Most people have this view of our encounters with microbes from the perspective of disease. But that couldn’t be farther from the truth. Most of our interactions with microbes are beneficial and are healthy.” Like I said, hooray for bacteria!

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Doing what I do, I have a lot of folks come to me with problems like heartburn, constipation, gas and bloating—things that make you think right off the bat, “That’s a digestive issue.” But what about problems like fatigue or weight gain? Even allergies, joint pain or skin problems? What a lot of people don’t realize is that all of these things are connected, and they all come back to your gut.

I have a new book coming out called The Road to Perfect Health, and in it I talk about the vast numbers of bacteria in your body, especially in your digestive tract (which is where roughly 80 percent of your natural defenses are found). And when a healthy digestive balance is upset because of things like poor diet, stress or other factors, the result can be not only poor digestion, but a total breakdown in health.

If you’ve been having persistent health problems that you and your doctor just can’t seem to figure out no matter what you try, it may be time to look at what’s going on in your gut. And to do that, there are two absolutely essential tests that I recommend starting with. One is called a comprehensive stool analysis (CDSA or CSAP) and it’s really pretty remarkable. It evaluates your poop (now don’t cringe, this is important!) and looks at things like how you are digesting your food, as well as your levels of good and bad bacteria, whether pathogenic organisms such as C. difficile are present, what your yeast levels are, and if there are parasites in the gut.

The CDSA will also show you whether you have Leaky Gut Syndrome or inflammation in your digestive system, and it will show you how well your gut immunity is working, along with important gut health markers such as pH, blood, short-chain fatty acids and even how well your pancreas is functioning. These are all extremely important aspects of gut health that together can help you get to the bottom of what is going on in the rest of your body. Again, I can’t stress enough how connected your overall health is to what’s going on in your gut!

The other test is a gluten sensitivity test. Why gluten sensitivity? Because wheat gluten is a major (if not the worst) food irritant to the digestive system, and it is in a huge number of products on the market today—not just bread. Seriously folks, more than 40 percent of Americans are gluten sensitive and most don’t even know it, and 2 million of those have a serious autoimmune disorder called celiac disease, which causes the body to try to attack gluten in the system. And because even a lot of GI doctors don’t understand the difference between gluten sensitivity and celiac disease, most will either label you as having celiac or nothing, which can be extremely frustrating when you don’t feel well and are trying to figure out what’s wrong (read more about this here).The bottom line is that people are having all these problems which could lead to bigger problems later on, and the reality is those problems can be helped.

Both of these tests are non-invasive and can be done right at home (visit www.labtestingdirect.com and www.enterolab.com for more information). Then, all you have to do is send the tests to the lab for analysis (prepaid envelopes are provided) and hopefully take the first step toward getting your health back on track. If they seem expensive, think about it this way: how much money do you spend each week or each month on frivolous things you really don’t need? Isn’t your health a hundred times more important than a $4 latte every morning? And even if your insurance doesn’t cover the cost right away, you may be eligible for reimbursement, so I beg you—make this investment in your health. It’s worth it to get to the root of your problems and start enjoying the vibrant health and energy you deserve!!

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