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‘Poop’ to rescue of autistic kids

There is no cure for children with autism at present. But their behavior could be improved with a “poop transplant.”

Shanghai Children’s Hospital opened the city’s first multidisciplinary outpatient clinic for children with autism last week. Different from normal approaches, doctors introduced a clinical trial using a donor’s stool. The first batch of 60 autistic children are taking part in a clinical trial.

The treatment is called fecal microbiota transplant, in which fecal matter or stool is collected from a tested donor, mixed with a saline or other solution, strained and infused into the colon by doing a colonoscopy or oral capsules.

According to experts, FMT is an effective treatment for patients with recurrent Clostridioides difficile colitis, a serious infection.

But now it is being trialed in many other fields thanks to a greater understanding of the brain-gut axis, which has found a connection between the central nervous and digestive systems.

“FMT has an evolving medical use,” said Dr Zhang Ting, director of digestive disease department of Shanghai Children’s Hospital and an expert at the autism multidisciplinary clinic. “It is a traditional treatment and mostly used for digestive problems.”

After the world-leading medical journal New England Journal of Medicine published a positive reevaluation of the effects of FMT in 2013, medical industries at home and abroad expressed strong interest in the therapy and started various trials.

It has been expanded to treat different diseases, as the intestinal ecosystem is believed to influence immunity, cognition, personality, mood, sleep and eating behavior and can contribute to a range of neuropsychiatric diseases like autism and schizophrenia.

“In medical practice, we found up to 50 percent of autistic children have digestive problems and their intestinal ecosystem is unbalanced,” she said.

“Moreover, children with more serious intestinal problems also show more severe behavioral symptoms. Previous trials have found that while some children whose intestinal microbial environment improves after FMT, their autistic condition also gets better.”

She said each autistic child will undergo strict evaluation before taking part in the clinical trial.

“FMT is not a cure for autism,” Zhang said. “But it can fix certain digestive symptoms and may help some children improve their autistic problems.

“The multidisciplinary clinic is also a new trial to offer such children various treatment in line with their needs, as they needn’t go between departments, because many autistic children have other symptoms such as skin and sleep issues apart from mental symptoms.”

Parents with autistic children are keen to attend the clinic.

“We contacted the clinic soon after learning about this information. We don’t know whether it is useful to my child but we don’t want to miss any chance,” said a local father with an 8-year-old autistic boy.

“Even if there is a very small progress that my son can achieve through the therapy, we are happy and it deserves all the efforts,” he said, calling for more social awareness and support.

Doctors from Shanghai Children’s Hospital are calling for more people to become fecal donors. Healthy people who don’t smoke or drink alcohol and have a healthy diet and regular stools can contact the hospital.

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