%0 Journal Article
%T Improvements in Behavioral Symptoms following Antibiotic Therapy in a 14-Year-Old Male with Autism
%A P. Lucas Ramirez
%A Kelly Barnhill
%A Alan Gutierrez
%A Claire Schutte
%A Laura Hewitson
%J Case Reports in Psychiatry
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/239034
%X This case report describes the benefits of antibiotic and antifungal therapy on behavior in a child with autism undergoing treatment for encopresis. Over the course of treatment, the child exhibited a reduction in aberrant behaviors, increased gastrointestinal function, and improved quality of life. 1. Introduction A fourteen-year-old male child with autism was evaluated at our center following a nine-month history of encopresis. His gastrointestinal history included diarrhea for the first two years of life, related to possible soy formula intolerance. Reportedly, stool consistency improved dramatically at the age of four when gluten, casein, and soy proteins were removed from his diet. At seven years of age, casein was reintroduced, resulting in reported negative and self-stimulatory behaviors and disrupted sleep. After two weeks, casein was once again removed. Gluten was reintroduced six months later. Negative responses, including self-stimulatory behaviors, aggression, and self-injurious behaviors, were reported shortly after these dietary changes. Gluten was once again eliminated from his diet. Over the next few years, dietary elimination became less stringent until there were no dietary interventions or restrictions in place. At eleven years of age, his aggression increased, and the elimination of gluten and casein was again implemented, which the parents reported helped with the management of his behavioral escalations. The use of pharmaceutical agents for behavioral control began when the child was six years old with risperidone and clonidine. At the age of thirteen, valproic acid was added when his aggressive behaviors escalated, made apparent by aggression directed toward his mother. Only mild reductions in negative behaviors were attributed to the use of these medications. For nine months prior to his first appointment at our clinic, the patient was soiling his clothes with daily bowel movements. He was also complaining of pain associated with bowel movements. His stool was reportedly sticky, unformed, and extremely foul-smelling. There were no medical treatment or dietary changes at that time. He was evaluated for encopresis by a pediatric gastroenterologist. An abdominal X-ray did not show constipation, and his physical examination was benign; no treatment options were offered. Constipation management prescribed by a subsequent pediatric gastroenterologist was unsuccessful in resolving the encopresis. 2. Case Presentation At his initial visit to our clinic, at age 14, the patient was evaluated for ongoing encopresis. His physical examination
%U http://www.hindawi.com/journals/crips/2013/239034/