Autism or Celiac Disease?
by Laura Roe Stevens
Autism is garnering a lot of media attention with the recent news that as many as one in 150 American children may be affected with the disease. (See our story on the recent CDC report, Is Autism Increasing?.) However, there is another disease that presents itself with similar symptoms and behavioral characteristics in children, yet is rarely known. Chances are you may not have heard of Celiac Disease—a completely treatable disease through dietary changes. So what is it? Laymen may refer to it as a severe allergy to wheat. I decided to chat with Jeffrey M. Aron, MD, a San Francisco–based gastroenterologist and leading expert on the disease to learn more.
Q: What exactly is Celiac Disease?
Dr. Aron: Celiac Disease is the only auto-immune disorder where we know specifically the offending substances—grain proteins—and the details of the body’s immune response to them. Thus, Celiac Disease is a “paradigm” disease—unlocking the interaction of the vast digestive tract and its immune, nervous, and endocrine components and the environment. (It is also highly associated with Type I Diabetes mellitus in children.) We know, for example, that the onset of an overactive immune response to the environment in the gut has profound effects on brain and nervous system function. This has enormous applications to other conditions such as the Irritable Bowel Syndrome, Inflammatory Bowel Disease, Crohn’s disease, and ulcerative colitis.
Q: How does the disorder most commonly present itself?
Dr. Aron: While most physicians and laypersons believe that Celiac Disease most commonly presents with digestive symptoms; that is just the “tip of the iceberg.” The vast majority of symptoms (well below the surface of the iceberg) present with undiagnosed anemia (low hemoglobin count), osteoporosis and osteopenia, autoimmune diseases such as rheumatoid arthritis and lupus, a vast array of neurological and psychiatric disorders, and dental enamel erosions. Many do not manifest any symptoms at all. They may be one of those “lucky ones” who can eat anything without gaining weight, eliciting the envy of others.
Q: What are the most common symptoms seen in young children?
Dr. Aron: In children, the most common presentations are behavior and learning disorders. Unexplained seizures, disorders of gait and balance (ataxias), failure to thrive, and various abdominal complaints: pain, bloating, abnormal bowel habits.
Q: Why are some children misdiagnosed as having autism when they have Celiac?
Dr. Aron: It is not surprising that, given the protean neurological manifestations of Celiac Disease, that there is considerable overlap with the diagnostic features of autism. However, there are no rigorous studies to demonstrate an increase of Celiac Disease in those diagnosed with Autism.
Q: Have you treated any children thought to be Autistic, who then responded and improved once on a gluten-free diet?
Dr. Aron: Being an adult gastroenterologist, I have not treated any children with Autism, although patients and their families have reported family members who have Autism and have shown marked improvement (when on a gluten-free diet).
Q: Would you recommend parents of autistic children to try gluten-free diets to see if their children improve?
Dr. Aron: Basically, the gluten-free diet is completely harmless. It’s not like giving a drug with dangerous side-effects. The only negative features are inconvenience and some added expense, two rather inconsequential factors where one’s child is concerned. Furthermore, there will be no interference with any other diagnostic test or therapy, so go ahead, there’s nothing to lose! At California Pacific Medical Center, we have major research efforts in Celiac Disease, Irritable Bowel Syndrome, and Inflammatory Bowel Disease, and I am honored to be leading these endeavors.
For more information about this disorder, check out Dr. Aron’s research on his Web site.