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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 14, 2016; 22(46): 10093-10102
Published online Dec 14, 2016. doi: 10.3748/wjg.v22.i46.10093
Can probiotics benefit children with autism spectrum disorders?
Fernando Navarro, Yuying Liu, Jon Marc Rhoads
Fernando Navarro, Yuying Liu, Jon Marc Rhoads, Department of Pediatrics, Division of Gastroenterology, the University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX 77030, United States
Author contributions: Navarro F and Rhoads JM wrote the manuscript; Liu Y performed the literature search, reviewed manuscript, and added references.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jon Marc Rhoads, MD, Professor of Pediatrics, Department of Pediatrics, the University of Texas Health Science Center at Houston McGovern Medical School, 6431 Fannin Street, MSB 3.137, Houston, TX 77030, United States. j.marc.rhoads@uth.tmc.edu
Telephone: +1-713-5005663 Fax: +1-713-5005770
Received: August 28, 2016
Peer-review started: September 1, 2016
First decision: September 20, 2016
Revised: October 5, 2016
Accepted: November 12, 2016
Article in press: November 13, 2016
Published online: December 14, 2016
Processing time: 106 Days and 1.2 Hours
Abstract

Children with autism are commonly affected by gastrointestinal problems such as abdominal pain, constipation and diarrhea. In recent years, there has been a growing interest in the use of probiotics in this population, as it hypothetically may help to improve bowel habits and the behavioral and social functioning of these individuals. The gut microbiome plays an important role in the pathophysiology of organic as well as functional gastrointestinal disorders. Microbial modification with the use of antibiotics, probiotics, and fecal transplantation have been effective in the treatment of conditions such as recurrent Clostridium difficile infection, pouchitis, and irritable bowel syndrome. The present review presents a number of reported clinical, immunological and microbiome-related changes seen in children with autism compared to normally developed children. It also discusses gut inflammation, permeability concerns, and absorption abnormalities that may contribute to these problems. Most importantly, it discusses evidence, from human and animal studies, of a potential role of probiotics in the treatment of gastrointestinal symptoms in children with autism.

Keywords: Microbiome; Gastrointestinal; Inflammation; Functional bowel disease; Probiotics; Autism

Core tip: Important new information has identified an abnormal intestinal microbial community in children with autism, an abnormality reported in many gastrointestinal (GI) conditions, including inflammatory bowel disease and irritable bowel syndrome (IBS). There is a complex interplay in these conditions between GI function (motility, secretion, permeability), the immune system, and the microbiota. Many parents of children with autism complain of GI symptoms, and they administer probiotics, a treatment which has been found to be safe and effective for adults with IBS. Future investigations are needed to determine if probiotic treatment would benefit the symptoms and behavior of these children.