Gastrointestinal, Behaviour and Anxiety Outcomes in Autistic Children Following an Open Label, Randomised Pilot Study

Leanne K Mitchell1, Helen S Heussler2,3,4, Christopher J Burgess2,5

  • 1Child Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia. leanne.mitchell@uq.edu.au.

Insights

Synbiotics alone or with gut-directed hypnotherapy significantly improved gastrointestinal symptoms in autistic children. Gut-directed hypnotherapy additionally reduced anxiety and irritability, supporting its use alongside synbiotics for autism spectrum disorder and gut-brain interaction disorders.

Area of Science:

  • Neurogastroenterology
  • Microbiome research
  • Developmental pediatrics

Background:

  • Alterations in the microbiome-gut-brain axis are linked to autism spectrum disorder (ASD) and disorders of gut-brain interaction (DGBI).
  • DGBI are common in autistic children, exacerbating behavioral issues and anxiety.
  • Probiotics, prebiotics, and gut-directed hypnotherapy (GDH) show promise for improving gut symptoms in children.

Purpose of the Study:

  • To compare the efficacy of synbiotics versus synbiotics plus GDH in improving gastrointestinal (GI) symptoms in children with ASD over 12 weeks, with follow-up at 24 weeks.
  • To assess the impact of these interventions on behavioral and anxiety symptoms.
  • To explore changes in gut microbiome composition as a secondary objective.

Main Methods:

  • A randomized controlled trial involving 40 children with ASD (aged 5.00-10.99 years) allocated to either synbiotics (SYN group) or synbiotics + GDH (COM group) for 12 weeks.
  • Primary outcome: change in total GI scores.
  • Secondary outcomes: changes in anxiety, irritability, and GI pain scores; exploratory analysis of gut microbiota composition.

Main Results:

  • Both groups showed significant reductions in total GI scores post-intervention and at follow-up (p < 0.001), with no significant difference between SYN and COM groups.
  • The COM group demonstrated significant reductions in anxiety (p = 0.002) and irritability (p < 0.001), which were not observed in the SYN group.
  • Only the COM group maintained significant reductions in GI pain scores at follow-up (p < 0.001).
  • Significant changes in gut microbiota, including increases in Bifidobacterium animalis and Dialister, were observed in both groups.

Conclusions:

  • Synbiotics, with or without GDH, can effectively improve GI symptoms in children with ASD and comorbid DGBI.
  • Combining synbiotics with GDH offers additional benefits for anxiety and irritability in this population.
  • These interventions may serve as valuable adjuncts to standard care for autistic children experiencing gut-brain interaction issues.

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