By Lisa Ackerman and Linda Betzold
Dedicated to fellow “poop peepers” like me!
Many children with autism suffer from many issues involving the gut and their bowel movements (or lack there of). So much so that not a meeting goes by, nor a support phone conversation, that does not involve a discussion of “how are your child’s poops?”
Based on the obsession to help children “go” daily, one would conclude this process is a newly found hobby. Many TACA families take great care in discussing, analyzing and fretting over their child’s poops! (So you are not crazy! Join the club!)
For our kids (and all humans) moving our bowels daily is a key component to basic and good health. If a child:
- Is having loose bowel movements that happen too quickly after eating (for example less than one hour) — there are issues to address.
- Is having bowel movements two, three, four or more days apart; then they are not stooling often enough — there are issues to address.
- Is having bowel movements that contain undigested food particles, and you recognize the good in the toilet or diaper — there are issues to address.
- Has a bloated belly beyond the age of two — there are issues to address.
- Performs self stimulatory behaviors such as toe walking, flapping or posturing just before or while stooling (posturing appears to provide comfort and may include applying pressure to the abdomen by leaning against a blunt object, like arm of sofa, therapy ball, mom’s knee, etc.) — there are issues to address.
- Alternates between constipation and diarrhea — there are issues to address.
- Produces stool that has a very odd odor, color and/or texture — there are issues to address.
- Has fallen behind or hit a plateau on his/her growth chart — there are issues to address.
- Has been unable to potty train passed a reasonable age (6, 8 10 years of age) — there are issues to address.
If the bowels are not moving daily, it can be toxic to overall health. It can be damaging to the gut, and it can be painful to the child. If a child on the spectrum is experiencing any issues with bowel movement, it is critically important to find a doctor to assist. In addition, for all children, eating a balanced diet including a good amount of water, exercise, fiber and a variety of foods, including fruits and vegetables (or fruit and veggies in disguise!) is very important for good health! It is extremely important to work with your child on balance in the diet. Limit intake of sugar, fast foods, too many foods from one food pyramid category and not the others, and foods with little nutritional value.
Proper medical testing can also assist in identifying the problems with bowel movement and other gut-related issues.
Different Kinds of Constipation
When we think of constipation, we usually think of stool that looks like little, hard rocks and is really hard to push out. That kind of constipation usually resolves with more water, fruit, veggies and fiber in the diet. This isn’t usually the kind of constipation we are talking about with our kids. It’s not a matter of texture; it’s a matter of frequency. Our kids stool is often mushy; it should be easy for them to pass. But they often have to strain and work very hard to get this mushy stuff out. Most of the time our kids are not having daily bowel movements, even though the stool is soft or loose and should be easy to pass every day. Our kids may only poop once a week! This is called soft stool constipation, and this is the kind of constipation that is most common in our kids. And it is the sign of an unhealthy gut.
- Dietary intervention — try GFCFSF for sure. Further intervention may be necessary, so you may also want to talk to your doctor about a rotation diet, the Specific Carbohydrate Diet, or in extreme cases, an elemental diet.
- IgE and IgG food allergy testing can give you clues about what other foods may be causing trouble; deleting those foods from the diet may alleviate constipation.
- Digestive enzymes may help kids with constipation. Kirkman, Houston and Enzymedica are brands that are well liked by parents. Some kids cannot tolerate supplemental digestive enzymes, so some families use the “green juice.” Take fresh organic veggies and puree them in the food processor or blender, including spinach, apple, whatever is tolerated. Then give one tablespoon of the “green juice” with each meal. The naturally occurring enzymes in the raw food will help digestion. Talk to your doctor about the best option and dose for your child.
- Cook with flaxseed meal/powder — 1 to 4 tablespoons per recipe (i.e., 12 muffins, 1 loaf of GFCFSF bread, etc.)
- Can you say Fruit Eze? This product is a prune and fruit paste that works as a great mock jam on GFCFSF toast, sandwiches, pancakes, or waffles
- Epsom salt baths — 1 cup of Epsom salts and a pinch of aluminum-free baking soda in the tub every night. Drinking the bath water is okay if you are constipated.
- OxyPowder is oxygenated magnesium that can have powerful results.
- Fruit and more fruit! Bake with pureed fruit or Gerber’s baby food if fruit textures are not tolerated. (Use 2 to 4 tablespoons per recipe. It will give a nice texture. Be sure to cut back on other water/liquids in the recipe.)
- Drink lots of filtered water during the day, and then drink some MORE water! Bottom line — make sure kids are drinking enough water, especially during hot weather! The rule of thumb is to consume one quart of water for every 50 pounds of body weight.
- Exercise is very important to someone with constipation. The more you move, the more your bowels move!
- Magnesium citrate can be your friend (or your enemy if you overuse). Take the Recommended Daily Allowance (RDA) based on the weight and age of our child. It can help soften the stool, and make it easier to pass. See our Physician’s Desk Reference (PDR) below for dosing and supplement information. You an also check with your doctor about appropriate dose.
- Vitamin C is a helpful antioxidant for our kids, and it can also help keep the stool soft and easy to pass. Use the buffered vitamin C; it’s easier on the tummy. Check with your doctor about an appropriate dose for your child.
- Make sure your child is getting enough healthy fats in his/her diet. Some examples would be fish oil, cod liver oil, evening primrose oil, coconut oil, walnut oil, almond oil, MCT oil, olive oil, and more. Talk to your doctor about which oils and how much of each would be good for your child. (Be careful when you cook to only use oils that will not become transfat when heated; you may safely heat coconut oil and palm oil.)
- Probiotics (the good bacteria that should live in your gut) can help with constipation. Make sure they are dairy free. It’s good to rotate and use different strains (a DAN doctor or good nutritionist can help you determine what you need). Some need to be refrigerated, and some don’t, so check the label. Prebiotics (the stuff that feed the good bacteria) can also be helpful.
- Fermented foods have good live bacteria in them and can really help keep the poop moving. GFCFSF yogurt and kefir can be made or bought. So Delicious makes a coconut yogurt in three flavors that is GFCFSF and really tasty! Body Ecology Diet has a good kefir starter with instructions for making it; you can make it with young coconut water, almond milk, rice milk, hemp milk, etc. Sally Fallon’s book Nourishing Traditions has instructions for making kombucha and fermented veggies, like sauerkraut. Make sauerkraut from red cabbage (it’s easy!) and puree a tablespoon in a half cup apple sauce. It will turn a great pink color and taste really good. No kidding! Freeze it and make popsicles!
- Smooth Move Tea by Traditional Medicinals is available at health food stores. It can be used for a period of time to help a child have daily bowel movements. Check the label for instructions from the manufacturer.
- Herbs may help, including but not limited to senna, slippery elm, cascara sagrada, rhubarb root, yellow docket, licorice, black walnut and Oregon grape. Colon Clenz by BodyGold is a combination of herbs designed to help constipation. Senna comes in a liquid form; Senna Relief Syrup from Major or Senexon Syrup from Rugby/Watson may be helpful. Check the label for ingredients your child may not tolerate. Consult your doctor about using herbs with your child.
- Test for allergies (IgE and IgG sensitivities) — this could be the start of the problem and easily help you resolve the problem. If you become aware of the foods your child cannot tolerate and learn to avoid them, that little tummy will feel better and move better.
- Milk of Magnesia — Check with your doctor on recommended dose, but this over-the-counter helper is GFCFSF (always check label, because ingredients can change). It works gently and should not cause cramping.
- Some supplements can cause constipation (producing more hard, solid stool), including calcium, 5-HTP and iron. When starting or increasing these supplements, watch the bowels carefully and talk to your doctor about changing the amounts or adding magnesium citrate or something else to keep stool soft and easy to move.
- Dulcolax is an over-the-counter medication that causes motility (muscle action of the GI tract) to kick in. It is an extremely SMALL that can be taken, and voila, poops be happening. Please note that according to the manufacturer, this pill should not be crushed before taking it. It needs to dissolve in the small bowel, not the stomach. It also contains red dye and can cause cramping for some individuals.
- Aloe vera is great stuff for the GI tract. George’s Aloe, found at Mother’s, Whole Foods, and on-line, is a liquid that has no taste or smell. So it’s easy for our kids to take and can help get those poops moving. Typically two ounces twice a day will do the trick, but check with your doctor to get the recommended dose for your child.
- Fiber can help our kids with constipation. Be careful with fiber; your child must be drinking enough water with it or it may backfire on you! Check with your doctor about brands and dose. Some brands families have used include Fibersure, ClearFiber and TruFiber. Always check the ingredients on the label, they change on occasion and sometimes may contain wheat or soy products.
- Sometimes constipation can be caused by too much yeast or bad bacteria in the gut. Anti-fungal medication or an antibiotic may help relieve constipation. Of course, you must talk with your doctor and get a prescription. The Biofilm Protocol can make these medications even more effective; talk to your doctor about using the Biofilm Protocol with any antimicrobial agent you may want to try to help your child.
- Bethanechol (also called urocholine) is a medication that increases acetylcholine in the body. It is sometimes part of Dr. Mary Megson’s vitamin A protocol. Acetylcholine is needed to make peristalsis happen (the muscle action of the gut), and can help some kids with constipation. It requires a prescription, so talk to your doctor and see if it might be appropriate for your child.
- Many doctors prescribe MiraLax for constipation; it holds water in the bowel, making the poop soft and easy to pass. When mixed in liquid, it is in every way undetectable, so it is easy for kids to take. MiraLax is polyethylene glycol, so do some research and decide if it’s something you want to try. And, of course, talk to your doctor.
- Anti-inflammatory and/or immune modulating medications prescribed by a qualified, informed pediatric gastroenterologist after an appropriate evaluation can help constipation dramatically.
- There are a few things you can try if you are REALLY in trouble. You can try glycerine suppositories from the local drug store. You can try Fleet enemas from the drug store; use the child size or half of the adult size. You can try Dulcolax suppositories from the drug store. Before trying any of these things, PLEASE CHECK WITH YOUR DOCTOR FIRST. These are definitely a last resort.
If your child is pooping daily and still seems uncomfortable, he or she may not be getting enough stool out every day. It is important to consider these suggestions with your doctor and make sure that your child is having complete and regular bowel movements.
A few more thoughts …
- Stool impaction is incredibly painful, and it sometimes happens to our kids. An exam and x-ray of the abdomen (called a KUB) can help diagnose an impaction, which will likely require MEDICAL ATTENTION. Watch for distended tummies, night waking because of pain, and sometimes dramatic changes in behavior as clues. Sometimes children with stool impaction will produce thin, ribbony stool in the toilet, another clue that there may be an impaction. Sometimes children with an impaction may have diarrhea every day or every few days. It can be a little confusing or misleading, but diarrhea is the only thing that can squirt around the impaction. This can be another clue that there is an impaction. Please see a doctor for help immediately. A good gastroenterologist can make a huge difference in finding and solving the root problems unique to your child.
- The best pediatric gastroenterologists that understand and treat the GI issues of children with autism are Dr. Arthur Krigsman of Pediatric Gastroenterology of New York and Texas, www.autismgi.com, and Dr. Timothy Buie at Massachusetts Hospital for Children, a teacher at Harvard Medical School, www.massgeneral.org/children/specialtiesandservices/ladders/default.aspx. In many cases, if children on the autism spectrum are experiencing severe, prolonged GI-related problems, a trip to either one of these professionals is recommended.
Frequent diarrhea that occurs once a day (or sometimes nine or ten times a day!) is a serious medical issue. Many times children will experience diarrhea with a cold, flu, allergy or other related health issue at some time in their lives. If diarrhea continues for a prolonged period of time such as four or more days, please contact your doctor immediately.
Sometimes autism spectrum kids alternate between constipation and diarrhea. These children can be dealing with multiple bowel issues, and the pendulum swings back and forth in extreme ways. Finding a balance with diet, natural or prescribed remedies, and working with your doctor is key to meeting your child’s needs.
Possible issues causing the diarrhea could be:
- Too much fruit intake.
- Too much magnesium intake.
- Too much vitamin C intake.
- Too much essential fatty acid intake.
- Too much fiber intake.
- Drinking too much bath water containing epsom salts.
- An allergic response to food(s) or an additive(s).
- The presence of undesirable parasites or bacteria in the gut.
- Inflammation in the intestines
- And other issues!
Things that may help alleviate diarrhea:
- Dietary intervention — try GFCFSF for sure. Further intervention may be necessary, so you may also want to talk to your doctor about a rotation diet, the Specific Carbohydrate Diet, or in extreme cases, an elemental diet.
- IgE and IgG food allergy testing can give you clues about what other foods may be causing trouble; deleting those foods from the diet may alleviate diarrhea.
- Digestive enzymes may help kids with diarrhea. Kirkman, Houston and Enzymedica are brands that are well liked by parents. Some kids cannot tolerate supplemental digestive enzymes, so some families use the “green juice.” Take fresh organic veggies and puree them in the food processor or blender, including spinach, apple, whatever is tolerated. Then give one tablespoon of the “green juice” with each meal. The naturally occurring enzymes in the raw food will help digestion. Talk to your doctor about the best option and dose for your child.
- Since increasing fruit/veggie, fiber, magnesium citrate, vitamin C or essential fatty acid intake can cause loose stools, possibly decreasing the daily intake of one or more of these will help alleviate diarrhea.
- In some cases probiotics and prebiotics can help diarrhea the same way they help constipation. By making sure there is a healthy population of good bacteria, you crowd out the bad bacteria and yeast.
- Fermented foods can help diarrhea the same way they help constipation. By getting a lot of good live bacteria into the GI tract, you crowd out the bad “bugs.”
- Colostrum and transfer factor can be helpful in getting rid of diarrhea caused by a dysregulated immune system that is reacting to every food being eaten by the child. Of course, check with your doctor first.
- Anti-inflammatory or immune modulating medication prescribed by a qualified, informed pediatric gastroenterologist after an appropriate evaluation can help diarrhea dramatically.
BOTTOM LINE — Prolonged diarrhea and/or constipation are NOT acceptable for any child and require medical treatment. It is time to seek medical attention if these symptoms continue more than four days.
More Complex Issues Require More Complex Action
Some families find that despite their best efforts at attempting to encourage healthy, daily bowel movements through dietary intervention, allergen removal, supplementation and other remedies mentioned here, they don’t find success. If a parent finds that their child still has bowel movement/gut issues, a trip to a qualified, informed gastroenterologist is required. This is especially is a child is not making progress in traditional therapies (ABA, Floortime, speech, OT, etc.). If the biomedical interventions do not seem to be effective, and especially if the child has sleep disturbances, self-injurious behaviors, repeated stool impactions, constantly uses MiraLax, or has other consistent serious GI issues, it may be time to get more professional help for your child.
First Step — Finding a Specialist
Consider consulting a pediatric gastroenterologist if your child has ongoing, unresolved issues with bowel movements. Unfortunately current and traditional gastroenterology standards and testing may reveal that a child on the spectrum has “no” problems. It is important to note that treating autism spectrum kids and this particular GI disease is a new area for most gastroenterologists. Parents may need to seek help well outside of their local area in order to get appropriate evaluation and treatment.
Living with prolonged, untreated gastrointestinal issues is not recommended. It is painful and impacts overall health in a serious way. A consultation and complete evaluation with a qualified, informed pediatric gastroenterologist is recommended for children with ongoing GI-related issues.
Should I Consider This Treatment For My Child?
Parents of children who have any of the following ongoing issues and are not responding to other biomedical treatments aimed at the GI tract should consider seeing a qualified, informed pediatric gastroenterologist.
- Chronic diarrhea and/or constipation
- Distended, bloated tummies, especially after the age of two
- Stool that has an odd texture, color and/or odor
- Undigested food is visible in the stool
- Self-injurious behaviors or aggression towards others
- Unexplained tantrums
- Posturing behavior — applying pressure to the abdomen by leaning against a blunt object, like arm of sofa, therapy ball, mom’s knee, etc
- Posturing or pain during the bowel movement process (squatting, leaning over with chest on lap, crying/screaming, etc. Some children become very hyperactive prior to a bowel movement. Some children posture in order to sleep at night; they may sleep laying over a therapy ball or face down curled up with knees under chest.)
- Sleep issues — difficulty falling asleep, waking during the night
- Not making progress in their therapeutic interventions (ABA, Floortime, speech, OT, etc.)
- Weight loss or failure to grow/gain weight for more than six months
- Recurring gut imbalance (yeast, bacteria or parasites) that does not respond to treatment
- Failure to potty train passed a reasonable age
- A verbal child may or may not tell you that his/her tummy hurts. A child with ASD who does not complain about abdominal pain does not necessarily have a healthy GI tract.
Who Are The Best Doctors?
The best pediatric gastroenterologists that understand and treat the GI issues of children with autism are Dr. Arthur Krigsman and Dr. Timothy Buie.
Dr. Arthur Krigsman
Pediatric Gastroenterology of New York and Texas
He has two practices: one in Austin, Texas and one in Far Rockaway, New York on Long Island. Does not take insurance.
You may contact both practices by calling 718-327-2200.
Dr. Timothy Buie
Massachusetts General Hospital for Children, Lurie Family Autism Center/LADDERS. Takes insurance.
He practices in Lexington, Massachusetts and may be reached at 781-860-1700.
What Are The Issues for Children on the Spectrum?
With appropriate evaluation, one or some combination of the following issues, ranging from mild to severe, are frequently found in children with autism spectrum disorders.
- Lymphoid nodular hyperplasia throughout the GI tract (swelling of lymph nodules)
- A variety of types of inflammation in the esophagus (usually eosinophilic; sometimes Barrett’s Esophagus)
- Gastroesophageal reflux disease (heartburn)
- A variety of types of inflammation (sometimes ulcers) in the stomach
- A variety of types of inflammation in the small intestine (sometimes ulcers)
- Inflammation in the large intestine ranging from mild colitis to ulcerative colitis
- Sometimes inflammatory polyps are found in the GI tract
What Happens at Gastrointestinal Assessments?
Typically a complete assessment would include:
- General patient intake information
- Physical examination
- Parent’s written narrative of child’s gastrointestinal and developmental history
- Review of all current medical issues — signs and symptoms you see in your child
- Parents provide results of any previous testing done
- Gastroenterologist may request further testing (blood, urine or stool) based on child’s issues and history
- Colonoscopy, EGD (upper endoscopy), and pill cam study (tiny camera in a capsule that takes photos of the small intestine) study may be recommended in order to biopsy and diagnose child’s particular issues
- Appropriate procedures will be scheduled
- Phone consultation afterwards to review biopsy results and map out detailed plan of treatment
Since most families will need to travel a significant distance to see Dr. Krigsman or Dr. Buie, most of the preliminary work can be done by phone, fax, e-mailing photos, etc. A physical exam can take place when family travels to do the endoscopic procedures.
Call and make an appointment as soon as possible; there are long wait lists for Dr. Krigsman and Dr. Buie.
The sooner you schedule, the sooner you will get the help your child needs!
What Does the Procedure Look Like?
Typically a family flies into New York, Austin or Boston on a weekend. The initial consult takes places on Monday with the procedures and biopsies on Tuesday. The child will stop eating food and take in only clear liquids starting Sunday night. A bowel prep to clean out the GI tract will be done on Monday night. Families can usually leave the Wednesday morning, after receiving doctor’s approval.
How Does a Family Prepare Their Child For the Procedures?
- Call and get the process going; do all the preliminary paperwork (and possibly testing), etc. and return it to the gastroenterologist’s office as soon as possible
- If it’s required, get pre-approval from your health insurance provider. Once an appointment is scheduled, work with the doctor’s office to get insurance approval for the procedures.
- Talk to other families who have gone though this process; get their feedback and advice. Mentors are available through TACA. (Parents get especially worried about the period of time their child cannot eat solid food and doing the bowel prep process. It’s not as bad as it sounds; talk to other families who have gone through it.)
- Prepare your child using social stories about what will take place and discuss everyone’s expectations. Plan a special reward to be given after the procedures are over. TACA has several social stories for this procedure depending on the child’s age and comprehension level.
What Do Treatments Look Like?
Treatments greatly depend on observations during the endoscopic procedures and the biopsy results. Common treatments for the conditions found in our children include:
- Dietary intervention (GFCFSF, Specific Carbohydrate Diet, elemental diet, etc.)
- Digestive enzymes (Creon or Zenpep may be prescribed; or over-the-counter (Kirkman, Houston, Enzymedica, etc.) may be recommended)
- Anti-inflammatory medications (Pentasa, Sulfasalazine, etc.)
- Immune suppressing or modulating medications (to address inflammation which is often autoimmune; Prednisolone, Entocort, Rhinocort, Nasonex, etc.)
- Acid suppressing medications (Prevacid, Zantac, etc.) to address gastroesophageal reflux disease (heartburn)
Regular gut cleanouts can be a helpful thing. Every 6 to 12 months, take a day to eat lightly and “clean house” in the GI tract. The following is a standard pediatric cleanout protocol that has worked for my family for years.
- You’ll need liquid magnesium citrate and Fleet enemas or Dulcolax suppositories from the local pharmacy
- Eat lightly, drink LOTS of water or clear liquid, and give two doses of liquid magnesium citrate two to three hours apart in the early afternoon
- Give a pediatric Fleet enema (or half of adult enema) or a Dulcolax suppository that evening (three to four hours after second dose of liquid magnesium citrate)
- You can give another pediatric Fleet enema or Dulcolax suppository the next morning to complete the clean out.
Common Questions Concerning Endoscopic Procedures
How soon can my child eat after the procedures?
If no pill cam study is being done, a child may begin to eat and drink in recovery before leaving the out-patient facility. If a pill study is being done, the child may drink clear liquids sparingly during the first three hours after pill cam is activated. The child may then drink clear liquids liberally for the next five hours after that. (Pill cam recording device battery lasts eight hours.) Eating solid food may resume eight hours after pill cam is activated.
How soon after the procedures can I leave?
Once your child has woken up sufficiently from anesthesia and can hold down liquid, you can leave the out-patient facility. You can most likely travel home the next day, after doctor’s approval.
How long do the procedures last?
Usually procedures last one to two hours, depending on how many and which ones are being done.
What is involved in doing a pill cam study?
The pill cam is a tiny camera with a light inside of a capsule about the size of a 1,000 mg cod liver oil capsule. A child can swallow the pill cam or it can be placed in the first part of the small intestine (duodenum) during upper endoscopy. The pill cam takes two photos per second for eight hours and gives visual information about the entire small intestine. It does not have the ability to take biopsies. A recording device that records the photos for eight hours is belted at the child’s waist. The pill cam battery lasts eight hours, and then the study is complete. The pill cam will pass through the colon and leave the body in a bowel movement. You do not have to worry about retrieving it. It can go down the toilet or end up in a diaper.
How can I afford these procedures?
Check the TACA website for financial ideas/sources. Dr. Buie offer limited assistance to families in great need. This depends on funding availability and the family’s financial qualifications for the programs. Contact the LADDERS Foundation for more information.
My child can swallow a pill. Can we just do the pill cam procedure and skip the anesthesia and endoscopic procedrues?
The pill cam only gives you a visual picture of the small intestine. It provides no information about the esophagus, stomach or large intestine. By only doing the pill cam, you could miss many other issues the child is having. Also the pill cam only gives us visual information; it cannot take biopsies. With the endoscope the gastroenterologist will be able to get into the first and last part of the small intestine to do biopsies (the duodenum during EGD and the ileum during colonoscopy). Usually at the first visit, all three procedures are recommended.
Can we skip the procedures and just try some medication and see if it helps?
It is never appropriate to treat without confirming a diagnosis. It’s not done in any other area of medicine, unless the signs and symptoms guarantee the diagnosis. The same group of signs and symptoms can be the result of a variety of different conditions that will require very different treatment. For example, if a child is vomiting frequently, it could mean many things. The vomiting could be caused by a severe food sensitivity, severe reflux, stomach inflammation, small bowel inflammation or some combination of these things. The endoscopic procedures with biopsies and the pill cam study are needed to arrive at the correct diagnosis. Good diagnosis leads to appropriate treatment. That’s the road to healthy, comfortable kids.
Should I be concerned about my child undergoing general anesthesia?
Your child will need to have general anesthesia in order to perform conoloscopy and upper endoscopy. Children with autism often have trouble processing medication. Anesthesia drugs are no different. In order to educate yourself about anesthesia and make the best choices for your child, please read Anesthesia and The Autistic Child by Sym C. Rankin, RN, CRNA, http://www.autismfile.com/Library/Documents/AutismFile_US33_Rankin.pdf. Talk to your doctor about any special issues your child may have when it comes to anesthesia. A pre-procedure consultation with the anesthesiologist is customary; this is the time to bring up your concerns and map out an appropriate plan for your child.
A Parent’s Story About Their Son
Speaker DVDs or on-line
Watch video of Dr. Arthur Krigsman or Dr. Tim Buie giving presentations on the bowel disease common to our kids. You can watch some on-line for free, and you can purchase some DVDs as well.
NOTE: IF A SYMPTOM CARRIES FEVER, LONG PERIODS OF IRREGULAR BOWEL MOVEMENTS WHICH CAN LEAD TO DEHYDRATION OR OTHER ISSUES, EXTREME CHANGE IN BEHAVIOR, OR LOSS OF SLEEP OR APPETITE FOR AN EXTENDED PERIOD OF TIME, PLEASE CONTACT YOUR DOCTOR IMMEDIATELY.
Disclaimer: Talk About Curing Autism (TACA) provides general information of interest to the autism community. The information comes from a variety of sources, and TACA doe not independently verify any of it. The views expressed herein are not necessarily TACA’s. Nothing in this document should be construed as medical advice. Always consult your child’s doctor regarding his or her individual needs.
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