top of page
Search

Gut and Psychology Syndrome (GAP Syndrome or GAPS)

By Dr N Campbell-McBride, MD Published in the Journal of Orthomolecular Medicine, 2nd quarter, 2008, vol 23:2: 90- 94.

We live in the world of unfolding epidemics. Autistic Spectrum Disorders, Attention Deficit Hyperactivity Disorder (ADHD/ADD), schizophrenia, dyslexia, dyspraxia, depression, obsessive-compulsive disorder, bipolar disorder and other neuro- psychological and psychiatric problems in children and adults are becoming more and more common (1,2,3,4).

In clinical practice these conditions overlap with each other. A patient with autism often is hyperactive and dyspraxic. There is about 50% overlap between dyslexia and dyspraxia and 25-50% overlap between ADHD/ADD and dyslexia and dyspraxia (3,4). Children with these conditions are often diagnosed as being depressed, and as they grow up they are more prone to drug abuse or alcoholism than their typically developing peers (3,4,5). A young person diagnosed with schizophrenia often suffered from dyslexia, dyspraxia or/and ADHD/ADD in childhood (6). When we start examining the patients with these so-called mental conditions, we find that they are also physically ill. Digestive problems, allergies, eczema, asthma, various food intolerances and immune system abnormalities are universally present amongst them (5,6,8). We have created different diagnostic boxes for these patients, but a modern patient does not fit into any one of them neatly. The modern patient in most cases fits into a rather lumpy picture of overlapping neurological and psychiatric conditions.


Why are all these conditions related? What underlying problem are we missing?

To answer all these questions we have to look at one factor, which unites all these patients in a clinical setting. This factor is the state of their digestive system (7,8,9,10,11,12,13,14,15,16,17). I have yet to meet a child or an adult with autism, ADHD/ADD, dyspraxia, dyslexia, schizophrenia, bipolar disorder, depression or obsessive-compulsive disorder who does not have digestive abnormalities. In many cases they are severe enough for the patients or their parents to start talking about them first. In some cases the parents may not mention their child’s digestive system, yet when asked direct questions, would describe a plethora of gut problems. So, what have digestive abnormalities got to do with these so-called mental problems? According to recent research and clinical experience – a lot! In fact it appears that the patient’s digestive system holds the key to the patient’s mental state.

What is a typical scenario we see in clinical practice?

Before examining the patient it is very important to look at the health history of the parents. Whenever the parents are mentioned people immediately think about genetics. However, apart from genetics there is something very important the parents, mother in particular, pass to their child: their unique gut micro-flora (18,19,20,21). Not many people know that an adult on average carries 2 kg of bacteria in the gut. There are more cells in that microbial mass than there are cells in an entire human body (19,21). It is a highly organised micro-world, where certain species of bacteria have to predominate to keep us healthy physically and mentally. Their role in our health is so monumental, that we simply cannot afford to ignore them (18,19,20,21). We will talk in detail about the child’s gut flora later. Now let us come back to the source of the child’s gut flora – the parents.

After studying hundreds of cases of neurological and psychiatric conditions in children and adults, a typical health picture of these children’s mums has emerged: due to various modern factors a modern mum has seriously compromised gut flora by the time she is ready to have children. Indeed, clinical signs of gut dysbiosis (abnormal gut flora) are present in almost 100% of mothers of children with neurological and psychiatric conditions (21, 22, 23).

A baby is born with a sterile gut. In the first 20 or so days of life the baby’s virgin gut surface is populated by a mixture of microbes. This is the child’s gut flora, which will have a tremendous effect on this child’s health for the rest of his/her life (19,20,21). Where does this gut flora come from? Mainly from the mother at the time of birth. Whatever microbial flora the mother has, she passes to her newborn child. Fathers with abnormal gut flora contribute to the bodily flora of the mother and through her to the gut flora of the child (19,20,21,26).

The role and importance of the gut flora

Gut flora is something we do not think much about. And yet the number of functions the gut flora fulfils is so vital for us that if some day our digestive tracts were sterilised we probably would not survive (19,20,21,26).


The first and very important function is appropriate digestion and absorption of food. If a child does not acquire normal balanced gut flora, then the child will not digest and absorb foods properly, developing multiple nutritional deficiencies (4,22). And that is what we commonly see in children and adults with learning disabilities, psychiatric problems and allergies. Many of these patients are malnourished. Even in the cases where the child may grow well, testing reveals some typical nutritional deficiencies in many important minerals, vitamins, essential fats, many amino acids and other nutrients (4, 22,23 24).

Apart from normal digestion and absorption of food, healthy gut flora actively synthesises various nutrients: vitamin K, pantothenic acid, folic acid, thiamine (vitamin B1), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin B6), cyancobalamin (vitamin B12), various amino-acids and proteins. Indeed, when tested, people with gut dysbiosis present with deficiencies of these nutrients (19,21). Clinical experience shows that restoring the beneficial bacteria in their gut is the best way to deal with these deficiencies (4,19,21,26).

Apart from taking a vital part in nourishing the body, beneficial bacteria in the gut act as the housekeepers for the digestive tract. They coat the entire surface of the gut protecting it from invaders and toxins by providing a natural barrier and producing anti-bacterial, anti-viral and anti-fungal substances (19,20,21,26). At the same time they provide the gut lining with nourishment (19). Beneficial bacteria normally control various opportunistic and pathogenic microbes in the gut. Lack of beneficial bacteria would allow disease-causing microbes to grow and occupy large parts of the digestive system causing damage and inflammation in the gut wall (19,20,21). So, it is no surprise when the gut flora is abnormal, the digestive tract itself cannot be healthy. Indeed most patients with learning disabilities, psychiatric disorders and allergies present with digestive problems: constipation and diarrhoea, infantile colic and abdominal pain, bloating and flatulence, reflux and indigestion (4,17,21,22,23). Examination by gastroenterologists commonly reveals inflammatory process in the gut and many of these patients are diagnosed with coeliac disease (10,11,12,14,15,16,17,27,30). Housing a mass of pathogenic microbes the gut cannot be healthy. Indeed, long before these patients develop so-called mental symptoms they usually suffer from digestive problems and all other typical symptoms of gut dysbiosis pretty much from the start of their lives (4,10,11,17,22,29).

The role and importance of the immune system

A baby is born with an immature immune system (25). Establishment of healthy balanced gut flora in the first few days of life plays a crucial role in appropriate maturation of the immune system (19,20,21). If the baby acquires compromised gut flora from the mother then the baby is left immune compromised (1,21,22). The result is lots of infections followed by lots of courses of antibiotics, which damage the child’s gut flora and immune system even further (2,4,21,25,28).

The beneficial bacteria in the gut ensure appropriate production of different immune cells, immunoglobulins, keeping immunity in the right balance (19,20,21). Damage inflicted upon the gut flora typically leads to an imbalance between major parts of immunity, resulting in allergies, asthma and eczema – symptoms, which children and adults with neurological and psychiatric conditions commonly suffer from (25,26,28,29).

There has been a considerable amount of research published into the state of the immune system in patients with learning disabilities and psychiatric problems (4,28,29,31,32,33,34,35,36,37,38,39,40,41,42,43). The research shows deep abnormalities in all major cell groups and immunoglobulins. The most common autoantibodies found are to myelin basic protein (MBP) and neuron-axon filament protein (NAFP). These antibodies specifically attack the person’s brain and the rest of the nervous system (4,35,38,40,41,43).

To summarise:

A child born from parents with abnormal gut flora did not acquire normal gut flora from the start (4,19,20,21,22). The flora may have been damaged further by repeated courses of antibiotics and vaccinations (2,19,21,45). As a result, these children commonly suffer from digestive problems, allergies, asthma and eczema (22,25,33,38,42,45,46). However, in children and adults who go on to develop neurological and psychiatric problems, something even worse happens. Without control of the beneficial bacteria, different opportunistic and pathogenic bacteria, viruses and fungi have a good chance to occupy large territories in the digestive tract and grow large colonies. Two particular groups, which are most commonly found on testing, are yeasts (including Candida species) and the Clostridia family (4,17,43,44,45,46,47). These pathogenic microbes start digesting food in their own way producing large amounts of various toxic substances, which are

absorbed into the bloodstream, carried to the brain and cross the blood–brain barrier (4,20,21,22,48,49). The number and mixture of toxins can be very individual, causing different neurological and psychiatric symptoms. Due to the absence or greatly reduced numbers of beneficial bacteria in the gut flora, the person’s digestive system instead of being a source of nourishment becomes a major source of toxicity in the body (2,4,6,9,17,19,21,22,27,36,43,46).221

The mixture of toxicity in each child or adult can be quite individual and different. But what they all have in common is gut dysbiosis (abnormal gut flora). The toxicity, which is produced by the abnormal microbial mass in these patients, establishes a link between the gut and the brain. That is why it is logical to group these disorders under one name: the Gut and Psychology Syndrome (GAPS). The GAPS children and adults can present with symptoms of autism, ADHD, ADD, OCD, dyslexia, dyspraxia, schizophrenia, depression, bipolar disorder, sleep disorders, allergies, asthma and eczema in any possible combination. These are the patients who fall through the gap in our medical knowledge. Any child or adult with a learning disability, neurological or psychological problems and allergies should be thoroughly examined for gut dysbiosis. Re-establishing normal gut flora and treating the digestive system of the person has to be the number one treatment for these disorders, before considering any other treatments with drugs or otherwise (19,20,21,22,24,26,50,51).

Gut And Psychology Syndrome (GAP Syndrome or GAPS) establishes the connection between the state of the patient’s gut and the functioning of the brain. This connection has been known by medics for a very long time. The father of modern psychiatry French psychiatrist Phillipe Pinel (1745–1828), after working with mental patients for many years, concluded in 1807: “The primary seat of insanity generally is in the region of the stomach and intestines.” (43). Long before him Hippocrates (460-370 BC), the father of modern medicine has said: “All diseases begin in the gut!” (19,20,21). The more we learn with our modern scientific tools, the more we realise just how right they were!

To learn more about Gut and Psychology Syndrome, how it develops and how to treat it effectively with a sound nutritional protocol please read the book by Dr Natasha Campbell-McBride‘Gut and Psychology Syndrome. Natural treatment for autism, ADHD/ADD, dyslexia, dyspraxia, depression and schizophrenia’.

References 1. Papalos D, Papalos J: The bipolar child. Broadway Books, 2000. 2. Ward NI: Hyperactivity and a previous history of antibiotic usage. Nutr Pract, 2001;Vol 3(3):12. 3. Holford P: Optimum nutrition for the mind. Piatkus. 2003. 4. Shaw W: Biological Treatments for Autism and PDD. Shaw. 2002. 5. Singh V: Neuro-immunopathogenesis in autism. In eds. Berczi I & Gorczynski RM New foundations of biology. Elsevier Science B.V., 2001; 447-458.

6. Cade R et al: Autism and schizophrenia: intestinal disorders. Nutr Neuroscience. 2000; March. 7. Dohan CF et al: Relapsed schizophrenics: more rapid improvement on a milk and cereal free diet. Brit J Psych 1969; 115:595-596. 8. Dohan FC: Is celiac disease a clue to pathogenesis of schizophrenia? Mental Hygiene,1969; 53:525-529. 9. Waring (2001): Sulphate, sulphation and gut permeability: are cytokines involved? In: The Biology of Autism – Unravelled. Conference proceedings 11th May 2001, Institute of Electrical Engineers, London. 10. Wakefield AJ, Anthony A et al: Enterocolitis in children with developmental disorders. AIA Journal, 2001; Autumn. 11. Wakefield AJ, Murch SH, Anthony A, et al: Ileal-lymphoid-nodular hyperplasia, non- specific colitis and pervasive developmental disorder in children. Lancet, 1998; 351:637- 41. 12. Walker-Smith JA: Autism, inflammatory bowel disease and MMR vaccine. Lancet, 1998; 351:1356-57. 13. Kawashima H, Takayuki M, Kashiwagi Y et al: Detection and sequencing of measles virus from peripheral blood mononuclear cells from patients with inflammatory bowel disease and autism. Digest Dis and Scien, 2000; 45: 723-729. 14. Mycroft et al: JIF-like sequences in milk and wheat proteins. NEJM, 1982; 307: 895. 15. Singh & Kay. Wheat gluten as a pathogenic factor in schizophrenia. Science, 1975: 191: 401-402. 16. Sioudrou et al: Opioid peptides derived from food proteins. The exorphins. J Biol Chem, 1979; 254: 2446-2449. 17. Baruk H: Psychoses of digestive origins. In: Hemmings and Hemmings (eds), Biological Basis of Schizophrenia. Lancaster MTP Press.1978. 18. Tabolin VA, Belmer SV, Gasilina TV, Muhina UG, Korneva TI: Rational therapy of intestinal dysbacteriosis in children. M.:Medicina, 1998; 22. 19. Krasnogolovez VN. Colonic disbacteriosis. M.: Medicina, 1989. 20. Lykova EA, Bondarenko VM, Sidorenko SV, Grishina ME, Murashova AD, Minaev VI, Rytikov FM, Korsunski AA: Combined antibacterial and probiotic therapy of Helicobacter - associated disease in children (Russian). Zhurnal Microbiologii, Epidemiologii i Immunobiologii. 1999; Mar-Apr;(2):76-81. 21. Vorobiev AA, Pak SG et al: Dysbacteriosis in children. A textbook for doctors and medical students (Russian). M.: ‘KMK Lt.’, 1998; 64.

22. McCandless J: Children with starving brains. Bramble Books. 2003. 23. Horvath K, Papadimitriou JC, Rabsztyn A et al: Gastrointestinal abnormalities in children with autism. J Pediatr, 1999; 135: 559-563. 24. Schoenthaler SJ et al: The effect of randomised vitamin-mineral supplementation on violent and non-violent antisocial behaviour among incarcerated juveniles. J Nutr Env Med, 1997; Vol 7: 343-352. 25. Kirjavainen PV, Apostolov E, Salminen SS, Isolauri E: New aspects of probiotics - a novel approach in the management of food allergy. (Review)(59refs). Allergy, 1999 Sep; 54(9): 909-15. 26. Lewis SJ, Freedman AR (1998): Review article: the use of biotherapeutic agents in the prevention and treatment of gastrointestinal disease. (Review)(144 refs). Alimentary Pharmacology and Therapeutics. 1998 Sep; 12(9): 807-22,. 27. Dohan et al: Is schizophrenia rare if grain is rare? Biol and Psych. 1984; 19(3): 385- 399. 28. Ferrari P et al: Immune status in infantile autism: Correlation between the immune status, autistic symptoms and levels of serotonin. Enceph, 1988; 14: 339-344. 29. Ashkenazi et al: Immunologic reaction in psychotic patients to fractions of gluten. Am J Psych, 1979; 136: 1306-1309. 30. Dohan CF: Cereals and schizophrenia: data and hypothesis. Acta Psychiat Scand, 1966; 42: 125-152. 31. Singh V et al: Immunodiagnosis and immunotherapy in autistic children. Ann NY Acad Sci, 1988; 540: 602-604. 32. Singh V at al: Changes in soluble interleukin-2, interleukin-2 rector, T8 antigen, and interleukin-I in the serum of autistic children. Clin Immunol Immunopath, 1991; 61: 448-455. 33. Kontstanareas M and Homatidis S: Ear infections in autistic and normal children. J Autism Devel Dis, 1987; 17: 585. 34. Plioplys AV at al: Lymphocyte function in autism and Rett syndrome. Neuropsychobiology, 1994; 7:12-16. 35. Singh V et al: Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism. Clin Immun Immunopathol, 1998; 89: 105-108. 36. Absolon CM at al: Psychological disturbance in atopic eczema: the extent of the problem in school-aged children. Br J Dermatol, 1997; Vol 137(2): 24105. 37. Furlano RI, Anthony A, Day R et al: Colonic CD8 and gamma delta T-cell infiltration with epithelial damage in children with autism. J Pediatr, 2001; 138: 366-72.

38. Warren R et al: Immune abnormalities in patients with autism. J. Autism Develop Dis, 1986; 16: 189-197. 39. Warren PP at al: Reduced natural killer cell activity in autism. J Am Acad Child Phychol, 1987; 26: 333-335. 40. Waizman A et al: Abnormal immune response to brain tissue antigen in the syndrome of autism. Am J Psych, 1982; 139: 1462-1465. 41. Yonk LJ et al: D4+ per T cell depression in autism. Immunol Lett, 1990; 35: 341-346. 42. Wakefield AJ and Montgomery SM: Autism, viral infection and measles, mumps, rubella vaccination. Israeli Med Assoc J, 1999; 1: 183-187. 43. Horrobin DF, Glen AM, Vaddadi K: The membrane hypothesis of schizophrenia. Schiz Res, 1994; 18: 195-207. 44. Wilson K, Moore L, Patel M, Permoad P: Suppression of potential pathogens by a defined colonic microflora. Microb Ecol in Health & Dis, 1988; 1: 237-43. 45. Samonis G et al: Prospective evaluation of the impact of broad-spectrum antibiotics on the yeast flora of the human gut. Eur J Clin Microbiol Infect Dis, 1994; 13: 665-7. 46. Rimland B: New hope for safe and effective treatments for autism. Autism Res Rev Int, 1994; 8:3. 47. Bolte ER,): Autism and Clostridium tetani. Medical Hypothesis. 1998; 51(2): 133- 144. 48. Reichelt K et al: Biologically active peptide-containing fractions in schizophrenia and childhood autism. Adv Biochem Psychopharmacol, 1981; 28: 627-47. 49. Reichelt K et al: Gluten, milk proteins and autism: dietary intervention effects on behaviour and peptide secretions. J Appl Nutr, 1990; 42: 1-11. 50. Macfarlane GT, Cummings JH: Probiotics and prebiotics: can regulating the activities of intestinal bacteria benefit health? (Review) (48 refs). BMJ, 1999 April; 318: 999-1003. 51. Ward NI: Assessment of clinical factors in relation to child hyperactivity. J Nutr Environ Med, 1997; Vol 7: 333-342.





Comments


bottom of page