Published on 12, July, 2020
my 14yo child has just received an ASD diagnosis. The last few years have been extremely hard, with my child suffering severe anxiety.
They are now receiving help and have been prescribed sertraline to help the anxiety, which is starting to work. But they are still suffering from liquid diarrhoea every morning and during the day. Their sertraline dose is still low (only 50mg) and we are going to up it to see if that helps, but any other advice on how to help their gut would be great.
We have looked for links with food intolerances etc., but they have this diarrhoea every single day, it doesn’t come and go. It also only started as their anxiety got bad. But that does mean they have been living with an incredibly upset tummy for over a year now.
I get upset stomach due to stress and anxiety but also dairy! Try cutting it out completly. It's a pain as theres not a wide range of alternatives but it may help. I was being sick daily and upset tummy. I realised it was dairy
Taste buds can't detect Lactose - up to 5% of milk is pure sugar and it's suspended in the watery part so cheese is normally ok. Lactase converts the Lactose into simpler sugars that can be tasted (it's why Lactofree tastes sweeter).
The bacteria in the gut for dairy is a Western-only evolution so the bacteria lives on the narrower parts of the intestine's ridges so it's ripped away first with an upset tummy. It often comes back - but it can be months or years before you can process dairy again.
They stopped having milk already - breakfast cereals were the first to go. They do still eat cheese though.
For food, try simplifying down as much as possible - roast chicken & boiled potatoes work for me - simple salad - lettuce, cottage cheese, beetroot, chedder - tomotoes can be risky- their seeds moreso - just use the flesh. Boiled aggs & omelettes work too. Avoid processed things like spreads - real butter is best. Steak and bacon is good too - nice & lean. Tuna and mackeral work too - the oils seem to be ok.
good - then it just time that will give them the evidence of the patterns of behaviour. Trust is hard to repair.
Done that. They now get to help write their care plan. It is tons better now. They have three safe people (that they chose) to go to and a safe space that is actually safe etc. Just takes a long while for your body to believe what your mind is telling you. I can tell the safe space is starting to feel safe as they now remove their shoes when they go in there. But the fear reaction every morning continues.
The school's attitude is really not going to help them. It's probably why the stress of putting themselves into harm's way is triggering the stress response. 30 weeks a year of living hell - even if the stress source has been removed, the fear will continue - until you get the school into a meeting with you and the kids to define EXACTLY what will and will not happen to them in that environment - they will need almost a written guarantee of the school's behaviour and what to do in a melt-down situation - that might comfort them enough to calm down.
Their home environment is good - a safe space for them. After speaking to the autism person at Camhs it seems we have been doing everything they suggest automatically. It is school that has always been the trigger and that built up into any form of out of the house activity.
The school have been really bad - with the headmaster yelling at them, threatening them with expulsion etc. just because they were having panic attacks and were in the supposed safe space allocated to them. I ended up having to go to the governors to stop it and got the head of CAMHS in the area to come and see the school. It has taken time but I think the school is fixed now. But it is going to take a lot longer for it to feel completely safe for my child. We would have moved them but they have a great support network of friends there
Stress can be a big problem - there's all sorts of reflex gut actions lnked to the brain - most important is fight or flight.
When under attack, the stress goes through the roof and the body shuts down anything that saps energy away from muscles and brain - so the first thing that is shut off is digestion - deal with food later if you survive!
Another reflex is animals soiling themselves - it's gross so the predator might be put off, it smells bad - again to deter the predator and it's excess weight so it is expelled.
Unfortunately, these episodes of stress are over in minutes and, assuming you survive, you go back to living in the woods again.
Continuous self-generated stress goes on for days, weeks, months, years - so the fight or flight system gets screwed up as it's in continuous operation - your digestion system doesn't know what to do - it's stuck in both modes of eliminate and don't digest - it's not good.
A way needs to be found to reduce the stress. I find it's mostly caused by chaos - anything where the outcome is not 100% known - like living.
Puberty is tough too when all the other kids are changing so fast that nothing can be predicted - friends can be fritzy as they explore growing up - they're all practicing political moves against each other and their hormones are all over the place too,
They need a space where there is no stress - a safe haven where their brains can drop into neutral. Weekends and holidays become extremely important and home life needs to be calm and serene with no arguments and fights.
At 14, you should be able to talk about things and find a way to take away some of the stress away from them - you need to be constant and straight and honest - all your decisions need to be based in sense and logic without emotions and 'because I say so' reasoning. They may NEED to retreat to their bedroom after school just to process the events of the day - within that time, they may be at 99% so the slightest thing you do could push them into meltdown.
Organisation needs to be complete - if you're dropping them off somewhere, the pickup location needs to be explicit and sensible - including times - or they will find things to worry about.
You need to do a lot of the thinking for them so any pitfalls are pre-planned and a solution is already found before Mr Cockup comes to town - it makes everyone's life easier in the long term - total honesty and total trust..