Constipation-Diarrhea Behavior (CDB) Complex In Autism

Majid Ali, M.D.

New York . 212-873-2444

New Jersey 201-996-0027


What Is Constipation-Diarrhea Behavior Complex?

I coined this term Constipation-Diarrhea Behavior Complex (CDB) for a symptom complex which I was able to detect and effectively treat in all my patients on the autism spectrum. The term is self-explanatory but only partly. The core of this specially disturbing symptom complex is that it results from disrupted gut-brain (“entero-neural” ) cross-talk. 
 
Parents of nearly all patients on the autism spectrum seen by the authors  suspected allergy in their children. Properly done skin allergy tests and sensitive and specific blood enzyme essays for specific antibodies (called IgE antibodies) not only validate the diagnosis of the parents but often exceeds their sense of the magnitude of the problem. The diagnostic categories include eczema, skin rashes of other descriptions, wheezing, asthma, frequent ear infections and sore throats, and gastrointestinal symptom-complexes which are often diagnosed as GERD-gastritis complex, irritable bowel syndrome, and colitis.

For readers with biology background and professionals,  the background information for the autism CDB complex is covered at length in Integrative Immunology and Allergy, Volume IV, The Principles and Practice of Integrative Medicine.
 
Notable in the context of immunity and allergy in autism are the matters of the altered gut ecology with dominance of oxygen-shunning yeast (oxyphobic) species.
 

I urge patients, parents and friends of the autism spectrum disorder to consider

Dr. Ali’s no-cost Autism Spectrum Course

of articles, short video clips, and one-hour long video seminars.

(the website of Children Health Corps), 

About CHC

kirtoHere is our mission

The purpose of Children’s Health Corps is to shout out a warning that often goes ignored – the environment is telling us that challenges our children face such as autism, chronic infections, diabetes, stress and anxiety can be seen to have origins in our global ecosystem.

This site is based on the works of Majid Ali, MD whose over 50 years in medicine has given him a unique perspective in the evolution of children’s health issues that will effect the 21st century.


Featured article

Human Canaries on the Autism Spectrum

Majid Ali, M.D.
Children and others on the autism spectrum make a clarion call for the future of humankind. They teach us that humans have a finite capacity to sustain and survive existential threats to their brain cells. Specifically, they inform that environmental toxicities that put in jeopardy the oxygen order and energetics of their brain cells can be expected to affect all humans with time. Simply stated, they are human canaries on the autism spectrum.

Fatigue Canaries

I opened my book The Canary and Chronic Fatigue Syndrome (1994) with the following words: “Chronic fatigue sufferers are human canaries—people who tolerate poorly the biologic stressors of the late 20th cenutury…[They] are telling us something important about the shape of things to come. None of us are really immune to oxidative stressors that fatigue them.” My point then: Given planetary chemicalization and “angerization” trends, Nearly all humans in the future can be expected to develop fatigue that is considered undue today. How could I have imagined that in merely two decades I would hear the same clarion call from children with autism and related disorders on the spectrum.

Autism Canaries, One in 29 Boys

Consider the following quote from the November 6, 2012 issue of New York magazine: “Before 1980, one in 2,000 children was thought to be autistic. By 2007, the Centers for Disease Control were reporting that one in 152 American children had an autism-spectrum disorder. Two years later, the CDC updated the ratio to one in 110. This past March, the CDC revised the number upward again, to one in 88 (one in 54, if you just count boys, who are five times as likely to have one as girls). A South Korean study from last year put the number even higher, at one in 38. And in New Jersey, according to the latest numbers, an improbable one in 29 boys is on the spectrum.”

Autism Is Not a Psychologic Disorder

Nor is it a psychiatric disorder. To think so, as I have shown in articles on my Oxygen Modebelow to order l of Autism, is a grave injustice to children and others on the autism spectrum. Psychologists and psychiatrists do not study nor practice nutritional medicine. Nor do they study or practice environmental medicine. Stress simply cannot be managed without effectively addressing nutritional and environmental issues relevant to individuals on the spectrum. I discuss this subject at length in two video seminars linked below. Please click on the boxes to order them

Our planet is warming and so are we. Our planet is acidifying and so are we. Our planet is fermenting and so are we. Our planet is chemicalized, overpopulated, and angerized.  All these factors are seriously affecting animals and plants. We cannot be immune these adverse effects. In this article, I reproduce from The New York times an extraordinary group of photographs and accompanying texts. In other articles in this series, I offer additional comments on these important subjects.

Evolution Under Our Noses

This is evolution under our noses. This, of course, is not new. What is new is the scale of the change. Humans can think only on linear scales. For example, I can say that going at 50 miles an hour, my car will travel 100 miles in two hours. This is clear cut math. That is not the way of nature however. Natures moves on an exponential scale. The changes are not clear cut because nature moves within its own parameters with steps and counter-steps, masking the rate of change. There are of cours exceptions to it on geologic scales when violent volcanic or asteroid activity can change thing smore quickly on th eevolutionary scale.

Climatic Changes of Chaos Scale


Parents of nearly all patients on the autism spectrum seen by the authors  suspected allergy in their children. IgE-antibodies with specificity for mold, mite, and pollen antigens were detected by blood tests or by skin testing in nearly all patients with autism who underwent such testing as well. Clinically, atopic disorders, such as eczema, skin rashes of other descriptions, bronchospastic episodes were encountered with high frequency (Tables 4 and 5). Equally important are the clinical observations of physicians who administer sublingual antigen immunotherapy to control allergic diathesis for reducing irritability and behavioral  disruptions of ASD. The subjects are covered in Integrative Immunology and Allergy, Volume IV, The Principles and Practice of Integrative Medicine.26 Notable in the context of immunity and allergy in autism are the matters of the altered gut ecology79,80  aspects of this dimension involved dominance of oxyphobic species over oxyphillic species.
 
In a recent publication, I defined two discrete dimensions of ASD were described:  (1) the “3S dimension of ASD comprising the disturbances of speech, sociability, and stability of mood”; and (2) the “2E enteroendocrine dimension of ASD” with its allergic, immune-inflammatory, digestive-absorptive, hyperinsulinic-hypoglycemic, and gut microbiome-related manifestations. Specifically, the altered gut ecology33  aspects of this dimension involved dominance of oxyphobic species over oxyphillic species.34These new findings provide the scientific underpinnings of the comments concerning allergic and immune-inflammatory dimensions of ASD.
 

 


 
Two Dimensions of the Autism Spectrum The 3S and 2E  Perspective
Below is text from a recent article on the subject.
 
A strong clinical sense of “duality of autism” – neurological and entero-immune symptom-complexes  – has been inescapable from the authors’ experience with treating ASD for some decades.65 The impetus for delineating two defined dimensions of ASD, which incorporate endocrine aspects, came from the seminal work of He et al.35 who discovered the existence of a specific group of stem cells in the hindgut of Drosophila fruitfly that can directly sense mechanical signals through the stretch-activated ion channel Piezo. The authors used the term enteroendocrine cells for these cells and extended the range of previous observations concerning nutritional, pathogenic, cytokines-related, and chemical signals that regulate the proliferation and differentiation of fly intestinal stem cells.53,54
Word associations sometimes turn into image associations. Reading about stretch mechanoreceptors in enteroendocrine stem cells in the paper by He et al.27 conjured before the formulator of the PCP autism model an image of a colicky autistic child in the throes of a sugar-spike-to-insulin-spike-to-hypoglycemic-low-to-mood-changes. He had witnessed a disconcerting sudden mood shift with a glucose-insulin roller coaster effect in a five-year old boy on the spectrum some days earlier. Sheer imagery of stretch receptor activated in a fruitfly gut linking up with intestinal colic of a little boy prompted him to submit a communication on the subject to the journal Nature (e-published by the journal67) in which he delineated two seemingly discrete – in reality, wholly integrated within –  dimensions of autism spectrum: (1) the “3S dimension of ASD comprising the disturbances of speech, sociability, and stability of mood”; and (2) the “2E enteroendocrine dimension of ASD” with its allergic, immune-inflammatory, digestive-absorptive, hyperinsulinic-hypoglycemic, and gut microbiome-related manifestations. Specifically, the ecologic aspects of this dimension involved dominance in the gut of oxyphobic  species over oxyphillic species54,55; the former being mostly yeast and yeast-like species that produce diverse mycotoxins, some of which, like arabinose, directly impede ATP generation in Krebs cycle and further fan fires of mycotoxicosis.  The speech, sociability, and behavioral aspects of the disorder are well-described. What is not often not duly recognized and optimally treated is the entity designated here as the enteroendocrine dimension of autism here. It comprises: (1) abdominal colic and bloating; (2) food intolerance and allergy; (3) altered gut microbiome; (4) immune-inflammatory lesions involving the gut; and (5) early endocrine disruptions, notably hyperinsulinimic-hypoglycemic shifts. As children on the spectrum grow, adrenal stress and generally mild thyroid dysfunction develop and further complicate the clinical picture. Both dimensions of ASD pose long-term threats to: (a) mitochondrial function, attenuating oxygen signaling; (b) insulin homeostasis, attenuating insulin signaling; and (c) deepening the mold-allergy-to-mycotoxicosis continuum.

As Roots Are to Roses, So the Bowel to the Brain 

The authors offer these simple words to the parents of patients on the autism spectrum, and the patients themselves when they are old enough to clearly comprehend the implicit meaning of the analogy, specifically: (1) the essential nourishing and protective roles of the gut for the brain; (2) the integrated neurological and enteroendocrine dimensions of the intestinal stem cells; (3) the seed-feed-and-weed garden analogy for underscoring the crucial restoration of gut microbiome and bowel ecology (addressed in Part Three of this report); (4) simplification and facilitation of the patient-physician communications for enhanced patient compliance and superior long-term clinical outcome.
He et al.35 found a population of unipotent stem cells (enteroendocrine precursors) that can directly sense mechanical signals in vivo to adjust their differentiation accordingly, and that this mechanosensing is mediated through Piezo activation and cytosolic Ca2+ increase. They suggest a potential direct linkage between food digestion with generation of enteroendocrine cells, which regulate various physiological functions, including stem-cell proliferation, intestinal motility, digestion and appetite. These mechanisms appear to  enable the midgut to respond to particular mechanical challenges and maintain tissue homeostasis.

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