Fecal Transplant Autism Treatment: What You Need to Know

June 7, 2023

Researchers at Arizona State University, Tempe are looking to solidify the connection between Autism and gut health. In a recently released study, they were able to improve the gut and behavioural symptoms of children with Autism using fecal transplants. This recent breakthrough could be the next big Autism cure, and could help with the stomach problems many people especially children, experience.

If you want to learn more about FMT as a possible treatment for ASD (Autism Spectrum Disorder), this article will cover the following:

  • What is Autism and what causes it?
  • The gut microbiome and Autism
  • How to treat Autism with FMT: poop to the rescue
  • Studies on FMT for Autism
  • Think you could use a stool transplant for Autism? Here’s what to do
  • More FMT, Microbiome and Autism News

In treating any illness, it is first important to understand it as best as possible, so let’s first cover what Autism is and what its causes are.

What is Autism and what causes it?

There is no one simple answer to what Autism is or what causes it. There is a broad spectrum of behaviors and characteristics that can classify someone as Autistic. As for the causes, there are factors that predispose children to developing it, but no known “causes.” Both of these questions are answered in more detail below:

What is Autism?

Autism Spectrum Disorder is developed in early childhood, generally starting before the age of 3. It is characterized by a range of symptoms, including issues with repetitive behaviors, speech and nonverbal communication, and social skills. Each case of ASD presents unique symptom patterns.

There is not a singular Autism disorder, but rather a spectrum on which each person with the disorder lies, and each case involves unique strengths and challenges. Along with the range of characteristics common in those with ASD, there are also a few medical issues that often can accompany the disorder:

  • Gastrointestinal (GI) disorders
  • Seizures
  • Sleep disturbances
  • Sensory problems
  • Tuberous Sclerosis
  • Chronic headaches
  • Asthma
  • Allergies
  • Immune disorders

These, among other issues, are common medical problems present in children with Autism.

What causes Autism?

There is a not a known singular cause of Autism. Rather, there are factors that can increase risk and likelihood of developing ASD. These include some genetic predisposition and environmental influences, including:

  • Advanced age of parent
  • Extreme prematurity
  • Low birth weight
  • Multiple births (twins, triplets, etc.)
  • Successive pregnancies that are less than a year apart
  • Not taking folic acid containing prenatal vitamins

Now that we have identified what ASD is and what is known to cause it, you might be wondering about how Autism and gut bacteria could possibly be connected.

The gut microbiome and Autism

Many children living with Autism Spectrum Disorder have coinciding gastrointestinal problems. Researchers believe that there is a connection between the microbiome and the behavioural and gastrointestinal problems of Autism. The effects of Fecal Microbiota Transplants on alleviating both the behavioural and GI symptoms of ASD are now being studied.

Here’s what you need to know about the treatment:

What is FMT?

A Fecal Microbiota Transplant, otherwise known as FMT, is a medical therapy whereby a fecal sample from a healthy donor is transplanted into the gut of an ill patient. When the healthy fecal matter is transplanted into the patient, the healthy microbiota from the donor can have a positive impact on the balance and health of the ill person’s microbiome.

What is the microbiome?

The microbiome is the sum of all the microbiota (bacteria, fungi, protozoa and viruses) that live inside the human body. There are millions of them, and they play an important role in regulating key bodily functions such as digestion, immune response, and, as in the case of ASD, brain health (part of a function known as the gut brain axis).  

What’s the association between the microbiome and Autism?

Many diseases and chronic illnesses are now being linked to the development of the microbiome. The connection between Autism and gut bacteria was made when some physicians noticed that many children with ASD also appeared to have gut issues. Since then, experiments have been performed and more research done, and those with Autism have been found to have significant differences in the bacterial makeup of their gut microbiomes.

What is the Gut Brain Axis?

The Gut Brain Axis is the bidirectional connection between the enteric nervous system (ENS) in the GI tract and the Central Nervous System (CNS) in the brain. This connection involves pathways, both direct and indirect, between emotional and cognitive centres of the brain and intestinal functions.

There is evidence that the microbiome plays a crucial role in the structure of the Gut Brain Axis. This began with evidence from a 1991 report that showed improvement in patients with hepatic encephalopathy after the use of oral antibiotics - which are known to significantly affect gut microbiota. Most recently, there is emerging scientific evidence to support a connection between microbiota and anxiety and depressive behavior.

How can you manipulate the microbiome with someone else’s poop?

Certain microbes in our guts affect the way our gut communicates with our brain, and vice versa. The connection between Autism and gastrointestinal problems suggests that it may be possible to manipulate the microbiome to alleviate some of the symptoms of ASD.

By providing those with ASD with a more balanced microbial palette, we may be able to reduce both GI and behavioural symptoms. The potential of this science has been demonstrated in a study out of Arizona State University, but will need further research to get widespread approval as a therapeutic Autism treatment.

How to treat Autism with FMT: poop to the rescue

We heard firsthand from Dr Thomas Borody from the Center for Digestive Disease in Australia, who has been involved in the Arizona State University studies on the potential of FMT treatment for Autism: “I can't say it changes in 100 percent of children, but the majority... I remember the kid who had the best word improvement from about 20 to 30 words to 800 words.” said Dr Borody, recalling the results of some of his first trials of treating Autism with FMT.

Obviously, this is not a full-blown Autism cure, but it is a step in a very promising direction for the treatment of ASD. It is also a strong step forward in understanding how the gut brain connection functions, which could have implications beyond just the treatment of Autism, to mental health as a whole. So, what exactly do the studies say about the connection?

Studies on FMT for Autism

Studies on the connection between Autism and gut health are still in the early stages, but so far the results are promising. The promise of the results explained below represent a good chance for further study of fecal transplants as a treatment for Autism. So far, a lot of the charge has been led by Arizona State University in Tempe, Arizona.

Gut flora difference

The prevalence of GI symptoms in children with Autism led researchers to look into possible differences in the microbiome make up of those with and without ASD. After a slew of small pilot studies showed significant differences in the gut microbiomes of those with Autism, the Arizona State University performed a larger scale study in 2015 to confirm the results.

Research Team: Arizona State University team led by Rosa Krajmalnik-Brown
Completed: March 2015
Results: Significant microbial differences in gut flora did in fact exist between those with and without Autism Spectrum Disorder. Though the exact way those differences may affect an individual were not specified, the results were enough to consider FMT as a possible Autism treatment.
What’s Next: Arizona State University has continued to explore the connection, in most recent studies, using FMT as a treatment for ASD and it’s partnering GI symptoms.

FMT as Autism therapy

Using the results from the 2015 study that determined significant differences in the gut flora of those with ASD for inspiration, a 2017 study also out of Arizona State University set out to determine if the symptoms of ASD and associated GI issues could be treated with Fecal Transplants.

Research Team: Arizona State University-led team, including collaboration from Northern Arizona University, Ohio State University and the University of Minnesota
Completed: January 2017
Results: A group of children and teenagers with Autism were given FMT over the course of a two-month period. In all cases the children experienced fewer gut-related problems and improvement of their behavioural symptoms. The study also included a 2-year follow up, which showed improved gut and behavioural symptoms further out than directly after the treatments. At the later stage about 60% of the kids were still seeing increased gut bacteria diversity and the retention of the specific bacteria that they were initially missing.
What’s Next: Though the Arizona State University study easily linked improvements in the GI symptoms to the FMT, the behavioural improvements couldn’t be as concretely associated. The next step in studying how the gut microbiome relates to Autism is to specify research and follow up to find out exactly how much of the behavioural improvements were a direct result of the fecal transplants.

UPDATE: At a two year follow up researchers found that participants had experienced 50% improvement in Autism symptoms. Showing that the FMT was having a steady effect on symptom improvement in children. The researchers of the study are now looking into testing out the same protocol on adults living with ASD. And since the release of the two year follow up, the FDA has fast-tracked FMT for the treatment of Autism.

FMT induces Autism symptoms in mice

A study out of the California Institute of Technology implanted mice fecal transplants from humans with ASD to further test the autism/microbiome connection. They found that they were able to induce symptoms of autism in the mice through the microbial transfer.

Research Team: A team of microbiologists out of the California Institute of Technology, led by Sarkis Mazmanian.

Completed: May 2o19

Results: Through inserting stool from humans with Autism spectrum disorder into mice, scientists were able to promote the behavioral symptoms of Autism. Adding to the growing evidence that the symptoms of Autism are largely dependent on microbiome composition.

What's Next: The studies leader, Sarkis Mazmanian emphasized what many have about this kind of research, that more study is needed, saying "We don’t want to give parents, children and loved ones false hope ... We have not solved the problem. All we’ve done is introduce a potential new strategy that needs to be tested in people.”

Think you could use a stool transplant for Autism? Here’s what to do:

The Arizona State University study is a start, but it does not indicate that FMT should yet be widely used as a treatment for ASD. Yes, there is some anecdotal evidence, and the initial results from the studies we mentioned are promising, but due to regulatory bureaucracy, it might be a while before treatment is available outside of studies and trials.  

If you are or a loved one is interested in participating in a study of this sort, there are a few studies going on right now as mentioned above. With the continued rise in interest in FMT treatments, you can be sure there will be more studies popping up. Check out a nearby University or research institute to see if they have any studies you can participate in. You can also check out our list of recruiting FMT studies.

More FMT, Microbiome and Autism News

The Right Mix of Gut Microbes Relieves Autism Symptoms in the Long Run

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How to Improve Gut Microbiome Health: Development from Infant to Adult

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Mother's Gut Health and Autism Connection

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