香港腸道微生態心理健康中心/ 心油心理健康中心
Hong Kong Gut Microbiota Mental Health Centre
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Gut Microbiota and Autism
Autism, commonly referred to as autism, is a neurodevelopmental disorder that begins in early childhood. It is characterized by three main symptoms: speech, social difficulties, cognitive and behavior challenges, and repetitive behaviors or interests. Recently, researchers in Europe and America have begun to refer to it as Autism Spectrum Disorder (ASD), which encompasses not only autism but also atypical autism, Asperger syndrome, Rett syndrome, childhood disintegrative disorder, and other unspecified pervasive developmental disorders. Some children exhibit symptoms as early as 6 to 24 months, while others may develop normally and then experience regression at ages 2 to 3, losing language and social skills.
Autism was once considered untreatable, and past therapies mainly focused on symptom management rather than underlying causes. Treatment goals aimed to help individuals lead independent lives, such as restricting foods for children with allergies or behavioral training for those reluctant to communicate, but only a few achieved this goal. However, research into gut microbiota in the new century has brought hope to this field.
Gut microbiota plays a crucial role in the onset of autism. Abnormal microbiota and related metabolic issues, along with dysfunction in the gut-brain axis, may be primary mechanisms behind autism. Timely restoration of healthy gut flora is essential to improve metabolism and immune function, regulating the gut-brain axis and correcting brain and behavioral abnormalities. The microbiota present in autistic children is significantly different from that of healthy children, with notable changes in gut bacteria, fungi, and even viruses.
Additional microbiota abnormalities occur in other areas: oral microbiota changes show an increase in harmful bacteria, such as Haemophilus in saliva and Streptococcus in plaque, while beneficial bacteria like Propionibacterium and Bifidobacterium decrease; urine microbiota shows increased Streptococcus and decreased Pseudomonas; skin microbiota may also change.
Children with autism often exhibit metabolic abnormalities. Gut microbiota influences individual metabolic profiles, and abnormal gut flora can lead to metabolic issues, often presented through symptoms like bad breath and foul stools. Gastrointestinal problems are common in autistic children, many of whom are picky eaters and may experience diarrhea, abdominal pain, or constipation.
The development of the gut-brain axis is often abnormal in autistic children. Autism is not merely a neural or psychological disorder; in addition to cognitive and developmental challenges, patients frequently exhibit systemic symptoms, including imbalances in microbiota, gastrointestinal issues, and immune irregularities (food intolerances and chronic inflammation).
Restoring healthy gut flora can improve metabolic issues and gut-brain axis function, regulating brain and behavioral development and correcting most physiological and psychological abnormalities associated with autism. Research has shown that specific lactobacilli and fecal microbiota transplants can significantly improve autism symptoms.
Gut microbiota development synchronizes with brain development; thus, its condition affects brain growth and behavioral development. Disruption at various developmental stages can lead not only to physical ailments but potentially to neurological and psychological disorders. Promptly rebuilding healthy flora through diet, probiotics, and fecal microbiota transplantation can improve or even correct these abnormalities.
Studies from Prof. Jin Feng's team from The Chinese Academy of Sciences have also found that, with the right approach, autism can be effectively reversed. Supplementing with specific lactobacilli, adjusting the diet, and reducing factors that may disrupt gut flora, such as processed foods and sugary beverages, can lead to significant improvements in digestion, immunity, behavior, and emotional health in children with autism.
Author: Dr. Shan Liang
Below is One of the Cases: A 4-Year-Old Boy
When the 4-year-old boy first arrived, his speech was delayed. He primarily communicated in short phrases of 2 to 3 words and it was uncertain whether he understood what others were saying. He had no eye contact and preferred to play alone, as if living in his own world. His emotions were volatile, leading to frequent outbursts, regardless of where he was. If he felt upset, he would sometimes destroy things at home, and at restaurants, he would throw food on the floor and yell if he didn’t like something. He still needed to use diapers for bowel movements, had poor sleep, waking up 1 to 2 times a night and taking 1 to 2 hours to fall back asleep. His appetite was minimal; he insisted on specific routes to get anywhere and preferred the same form of transportation and elevator each time. Teachers reported that he often left his seat during class and struggled to concentrate.
One month later, his speech improved significantly, allowing him to express his wants more clearly, with longer sentences. His emotional control was markedly better, and bowel movements changed from once every three days to daily. He interacted more with family, frequently wanting to play with his parents, and he began to imitate others. His parents remarked, “It’s like our child has woken up.” His sleep issues were resolved, and his appetite normalized. He showed improved focus and was able to sit still for longer periods. He no longer gets upset when waiting in line.
Now, six months later, his progress has been remarkable. His mother mentioned that when they go out, no one can tell he was once a child with special needs. Although his speech has improved significantly, there is still room for growth, as fluency develops with more speaking and listening practice. He is highly interested in learning to speak, and his mother hopes he can quickly catch up with his peers in sentence usage.
His parents expressed that their child’s transformation over the past six months has been substantial, and seeing his progress feels like the best gift from God.
Sharing from the Hong Kong Gut Microbiota Mental Health Centre
Since 2020, most of the children participating in the program have shown significant improvement. This is certainly noteworthy. We have also observed substantial progress not only in younger children but also in participants over 10 and even over 20 years old. Below are some case studies:
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