GI testing in Adult Spectrum Disorder

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    I have a 36 yo male patient who is severely impaired with Autistic Spectrum features– some social oddities, “over-thoroughness” to the point of paralysis–e.g. though he graduated from professional school, he could not get his diploma until he completed a paper.. which took him about 2 years to do. He then has flunked his professional exam 4 times. He has ADHD and OCD features with mood symptoms. He is always late and says he has no concept of time. qEEG testing shows attentional and working memory slowing. He has a history of severe diarrhea as a newborn requiring intensive care.

    When I read about dysbiosis as related to Autistic Disorder it always seems to reference children. So is a GI work up still relevant for him? Has damage already been done? I did have him avoid casein for 3 weeks, which I believe he complied with.. he noted no difference. He doesn’t complain of GI symptoms, except perhaps constipation–i.e. he has “near syncope” after the Valsalva maneuver–but anxiety seems to bring out this out also.

    Any suggestions?

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