The frequency of IgE-dependent sensitization to food and airborne allergens in the population of children and adolescents of north-eastern Poland in 1998-2012 and its relation to the age of the studied patients.

Introduction: The long-term observation of the incidence of IgE-dependent sensitization to environmental allergens (food and airborne allergens) of a specific population plays an important role in epidemiological studies. Aim: Retrospective, comparative assessment of IgE-dependent sensitization to food and airborne allergens in the group of patients from the north-eastern region of Poland, in selected years (1998, 2003, 2008, 2012). Long-term assessment of the incidence of IgE-dependent sensitization depending on the age of the patients (1998-2012). Material and methods: A group of 6577 children and adolescents aged up to 18 years with a suspicion of an allergic process, diagnosed in 1998-2012. Skin prick tests (SPT) with selected food allergens and airborne allergens were used to evaluate the sensitization process of patients. Results: A significant increase in the percentage of patients sensitized was found, comparing 1998 vs. 2012: to at least one allergen (35.3% vs. 40.4%); only to food allergens (5.1% vs. 13.1%), and to at least one food allergen (10.5% vs. 20.1%). There were no significant changes in the percentage of children and adolescents sensitized to airborne allergens (22.7% vs. 20.3%). The percentage of sensitization to at least one allergen was lowest in 2-year-old children (30.2%), and highest in 15-year-old children (46.8%). The percentage of patients sensitized to airborne allergens increased statistically significantly with their age: 6.3% in infants, 43.7% in adolescents. Conclusions: During the 14-year-period of the study the authors observed an upward trend in the frequency of sensitization to food allergens. The frequency of sensitization to airborne allergens was similar at the beginning and the completion of the study.

IgE-dependent sensitization to tropho- and aeroallergens with regard to age, sex and birth season of children and adolescents living in the north-eastern region of Poland.

INTRODUCTION: A small number of studies concern trophoallergens and aeroallergens sensitization in the developmental age population in Poland. Only a few studies describe the role of selected factors determining the frequency and type of IgE-dependent sensitization in this population. AIM: To assess the rate of sensitization to chosen tropho- and aeroallergens in the group of sensitized patients living in the north-eastern region of Poland with regard to age, sex and birth season. MATERIAL AND METHODS: Skin prick testing (SPT) with selected food allergens (trophoallergens) and airborne allergens was used to evaluate the sensitization process of patients recruited to this study between 1998 and 2012. A positive result of sensitization was defined when the patient had at least one positive skin prick test with the allergen studied. The skin prick tests were done after written consent had been obtained from the parents. RESULTS: Significant results were as follows: sensitization was more common in boys (41.9%) than in girls (35.7%); the highest percentage of sensitized patients was observed in the group of children aged 13-18 years (45.0%) as compared to the group of children up to 3 years old (the lowest 33.1%). The highest percentage of sensitized patients was observed among children born during winter (41.3%), the lowest among children born in autumn (36.8%). CONCLUSIONS: The assessment of sensitization to chosen trophoallergens and airborne allergens should include the role of age, sex and birth season of the diagnosed patient.

The prevalence of IgE-dependent sensitizations to selected trophoallergens and airborne allergens in the population of children and adolescents of the north-eastern region of Poland.

INTRODUCTION: Good evidence has been provided over the last three to four decades that the prevalence of allergic diseases has been increasing in many developed countries worldwide. Recent data suggest that this increase may now be levelling off. AIM: Retrospective analysis of the prevalence of IgE-dependent sensitization and changes in selected environmental allergens in the population of children and adolescents in the north-eastern region of Poland in the years 1998-2012. MATERIAL AND METHODS: Skin prick testing (SPT) with selected food allergens (trophoallergens) and airborne allergens was used to evaluate the sensitization process of patients recruited to the study in the years 1998-2012. A positive result of sensitization was defined when the patient had at least one positive skin prick test with the allergen studied. The skin prick tests were done after written consent had been obtained from the parents. RESULTS: The retrospective study included children and adolescents aged up to 18 years with a suspicion of an allergic disease, referred to the regional tertiary medical centre for further diagnosis. A total of 6577 patients were studied, including 1556 (23.7%) in 1998, 1473 (22.4%) in 2003, 1690 (25.7%) in 2008, and 1858 (28.2%) in 2012. Sensitization to at least one allergen was observed in 39.0% of the examined children (regardless of the allergen type), of which 8.1% were sensitized to food allergens only, 23.9% to airborne allergens only, and 7.0% simultaneously to food and airborne allergens. During the 14-year study period, an increase was noted in the percentage of the sensitized children from 35.3% at baseline to 40.4% when the study was completed. The percentage of those sensitized to food allergens increased from 10.5% (1998) to 20.1% (2012). The percentage of children sensitized to airborne allergens remained unchanged at the level of 28.2% in 1998 and 27.2% in 2012. CONCLUSIONS: Measurement of skin prick test reactivity to different allergens is a useful and commonly used method in epidemiological studies for the assessment of allergic sensitization and changes in selected populations. The obtained results confirmed the need for systematic epidemiological research into allergic sensitization and allergic diseases among children and adolescents in Poland.

Atopic dermatitis. Interdisciplinary diagnostic and therapeutic recommendations of the Polish Dermatological Society, Polish Society of Allergology, Polish Pediatric Society and Polish Society of Family Medicine. Part II. Systemic treatment and new therapeutic methods.

The treatment goal in atopic dermatitis is eliminating clinical symptoms of the disease, preventing exacerbations and complications, as well as improving patients' quality of life. In cases of severe atopic dermatitis and lack of response it is recommended to introduce systemic therapy. Patients ofter require multi-specialist consultations, and occasionally hospitalization. It is not recommended to use acupuncture, acupressure, bioresonance, homeopathy, or Chinese herbs in the treatment of atopic dermatitis.

Atopic dermatitis. Interdisciplinary diagnostic and therapeutic recommendations of the Polish Dermatological Society, Polish Society of Allergology, Polish Pediatric Society and Polish Society of Family Medicine. Part I. Prophylaxis, topical treatment and phototherapy.

Atopic dermatitis is a chronic and recurrent inflammatory dermatosis with concomitant intensive pruritus, and is diagnosed both in children and adults. Atopic dermatitis-patients are predisposed to have bacterial, viral and fungal skin infections; they also suffer from an increased risk of developing food allergies (especially, at an infantile age), allergic rhinitis, or bronchial asthma (a so-called atopic march). Currently, an increasing atopic dermatitis incidence constitutes a serious medical problem that regards not only dermatology and allergology, but also paediatrics, and family medicine. The basis for atopic dermatitis treatment and prophylaxis is restoration of epidermal barrier functions by means of tailored emollients. Atopic dermatitis therapies should effectively eliminate clinical symptoms of the disease, prevent exacerbations as well as complications, and improve patients' quality of life.

The diagnosis and management of food allergies. Position paper of the Food Allergy Section the Polish Society of Allergology.

The paper concerns the current position of the Polish Society of Allergology Food Allergy Section on the diagnosis and management of food allergies. The aim of this position is to provide evidence-based recommendations on the diagnosis and management of patients with allergic hypersensitivity to foods. This position statement includes a systematic review of studies in three areas, namely, the epidemiology, diagnosis and management of food allergies. While taking into account the specific Polish setting, in this publication we also used the current European Academy of Allergy and Clinical Immunology (EAACI) position paper and other current position statements, including those of the United States National Institute of Allergy and Infectious Diseases (NIAID).

EGFR and Bcl-2 in gastric mucosa of children infected with Helicobacter pylori.

UNLABELLED: The aim of the study was to evaluate the expression of EGFR and Bcl-2 proteins as inhibitory markers of apoptosis in surface epithelial cells and gland cells of antral gastric mucosa in children infected with Helicobacter pylori according to the severity and activity of antral gastritis and to assess the correlation between the number of cells expressing EGFR and the number of cells expressing Bcl-2 in H. pylori infected children. MATERIALS AND METHODS: The study included 44 children: 68.2% with chronic gastritis and positive IgG against H. pylori, and 31.8% with functional disorders of the gastrointestinal tract and with normal IgG against H. pylori. The evaluation of EGFR expression in gastric mucosa was performed immunohistochemically using monoclonal mouse anti-EGFR antibody. The polyclonal antibody was used to determine the expression of anti-Bcl-2. RESULTS: A significant increase in the number of cells expressing EGFR and Bcl-2 protein was found in the epithelial cells in severe as well as mild and moderate gastritis in the group of children infected with H. pylori. An increase in the number of cells expressing EGFR and Bcl-2 protein was also found in the epithelial cells in group I according to the activity of gastritis. There was a statistically significant positive correlation between the numbers of cells expressing EGFR and Bcl-2 in H. pylori infected children. CONCLUSION: Increased expression of EGFR and Bcl-2 proteins in the epithelial cells and a statistically significant positive correlation between the numbers of cells expressing EGFR and Bcl-2 in H. pylori infected children could suggest increased regeneration abilities of gastric mucosa.

Longitudinal observation of children with enhanced total serum IgE.

BACKGROUND: Long-term studies on the evolution of elevated total IgE (tIgE) concentration are in demand. OBJECTIVE: To investigate the prevalence of allergic diseases and influential factors in children with high tIgE levels during a 5-year period. METHODS: Children with high tIgE levels (>100 IU/mL) were study subjects. After the 5-year follow-up, an interview with the parents, clinical examination, and evaluation of tIgE and specific IgE (sIgE) to selected food and inhalant allergens were performed. RESULTS: The mean tIgE decreased significantly after 5 years in girls and boys regardless of the place of residence. Monosymptomatic patients accounted for most cases throughout the study, with the highest tIgE level at the beginning. After follow-up, the percentage of polysymptomatic patients increased. Their mean tIgE level was significantly higher than in the other groups. After follow-up, 11.7% of participants remained asymptomatic, and another 11.7% reported relief from symptoms. Allergy symptoms persisted in most children with normal tIgE levels. The 2-allergen sensitization was the most common through the study. Only patients sensitized to 4 allergens had unchanged levels of mean tIgE after follow-up and those with the highest mean tIgE level had a newly diagnosed sensitization to at least 1 allergen. A significant decrease of sIgE level was observed for food allergens. The values of sIgE to inhalant allergens even increased after the 5-year follow-up, despite decreased tIgE levels. CONCLUSION: In children with allergy and an elevated concentration of tIgE, the increasing or stable value of tIgE could be a useful parameter for the prediction of the development of polysymptomatic allergy.

Atopic dermatitis: current treatment guidelines. Statement of the experts of the Dermatological Section, Polish Society of Allergology, and the Allergology Section, Polish Society of Dermatology.

Atopic dermatitis (AD) is a condition frequently encountered in medical practices across the country. More than 60% of children with AD are at risk to develop allergic rhinitis or asthma (the atopic march). Patients with AD have a unique predisposition to colonization or infection by Staphylococcus aureus. Treatments for AD need to rapidly control symptoms of the disease, improve quality of life and prevent exacerbations. Given the chronic and relapsing nature of the disease, therapies need to encourage good compliance and be well tolerated.

High- and low-dose oral delayed-release mesalamine in children with mild-to-moderately active ulcerative colitis.

OBJECTIVE: The aim of the study was to assess the safety and efficacy of high- and low-dose oral, delayed-release mesalamine in a randomized, double-blind, active control study of children with mild-to-moderately active ulcerative colitis. METHODS: Patients ages 5 to 17 years, with a Pediatric Ulcerative Colitis Activity Index (PUCAI) score of ≥ 10 to ≤ 55 and a truncated Mayo Score of ≥ 1 for both rectal bleeding and stool frequency, were enrolled. They received body weight-dependent doses of oral, delayed-release mesalamine for 6 weeks in a low- (27-71 mg · g(-1) · day(-1)) or high-dose group (53-118 mg · g(-1) · day(-1)). The primary endpoint was treatment success, defined as the proportion of patients who achieved remission (PUCAI score <10) or partial response (PUCAI score ≥ 10 with a decrease from baseline by ≥ 20 points). Secondary endpoints included truncated Mayo Score and global assessment of change of disease activity. RESULTS: The modified intent-to-treat population included 81 of 83 patients enrolled. Treatment success by PUCAI was achieved by 23 of 41 (56%) and 22 of 40 (55%) patients in the mesalamine low- and high-dose groups, respectively (P = 0.924). Truncated Mayo Score (low-dose 30 [73%] and high-dose 28 [70%] patients) and other efficacy results did not differ between the groups. The type and severity of adverse events were consistent with those reported in previous studies of adults with ulcerative colitis and did not differ between groups. CONCLUSIONS: Both low- and high-dose oral, delayed-release mesalamine doses were equally effective as short-term treatment of mild-to-moderately active ulcerative colitis in children, without a specific benefit or risk to using either dose.

Supplementation with long chain polyunsaturated fatty acids in treatment of atopic dermatitis in children.

Some recent studies indicate that unsaturated fatty acids, components of cellular membranes and precursors of immunomodulators, play a significant role in the pathogenesis of some symptoms of atopic dermatitis. Since they cannot be synthesized by the human body, they must be provided with nutrition as the so called exogenous fatty acids: linoleic (a precursor of arachidonic acid) and α-linolenic acid (a precursor of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)). Their deficiency facilitates the development of some disorders, e.g. of the cardiovascular system or of the nervous system, or becomes the cause of intensification of ailments in their course e.g. pruritus and dryness in atopic dermatitis. Though clinical examinations to date confirm the efficacy of fatty acid supplementation in treatment of atopic dermatitis, their results are not explicit.

Chronic non-cholestatic liver disease is not associated with an increased fracture rate in children.

Chronic liver disease in adults is a risk factor of osteoporosis, but little is known about risk of fractures in children with non-cholestatic liver disease. The aim of this study was to investigate associations among the severity of liver fibrosis, bone mass and low-energy fractures in children. History of fractures, anthropometry, and bone mass and size were examined in 39 Caucasian children (25 boys, 14 girls) aged 7.1-18 years (mean 11.9 ± 3.1) with chronic hepatitis B and liver fibrosis evidenced by liver biopsy. Severity of liver fibrosis was based on histological classification according to the method of Batts and Ludwig (mild, 1-2 scores; advanced, 3 scores) and Ishak (1-3 and 4-5 scores, respectively). Bone mineral content (BMC), density (BMD) and body composition were determined in the total body and lumbar spine using dual energy X-ray absorptiometry. Seven subjects (4 girls, 3 boys; 18% of the sample) had low BMD in the total body and lumbar spine region (Z-scores below -2.0). No associations were found among BMC, BMD, bone size and the severity of liver fibrosis. Nine boys (36% of all boys) and one girl reported repeated fractures (forearm, wrist, tibia, ankle, humerus), showing trends similar to the prevalence in general population. Fractures were neither associated with lower BMD/BMC nor with scores of liver fibrosis. Deficits in BMD in children with chronic hepatitis B are not associated with the severity of liver fibrosis. This study suggests that non-cholestatic liver disease does not increase the risk of low-energy fractures during growth. From the practical perspective, however, children with chronic liver disease should be screened for history and clinical risk factors for fractures rather than referred to bone density testing.

Thigh circumference as a useful predictor of body fat in adolescent girls with anorexia nervosa.

BACKGROUND/AIM: Girls with anorexia nervosa (AN) demonstrate severe depletion of body fat. The aim of this study was to determine an accurate anthropometric measurement for clinical assessment of fat depletion in girls with AN in connection with body composition measured by dual-energy X-ray absorptiometry (DXA). METHODS: In 64 female AN patients aged 12.8-23.1 years (mean 16.0 ± 1.8), body mass index (BMI), skinfold thickness (subscapular, abdominal and triceps), mid-upper arm and thigh circumference, fat mass (FM) and lean mass were determined and compared with the data of 71 controls. RESULTS: Girls with AN had lower anthropometric traits and were fat depleted compared to controls (14.9 ± 7.3 vs. 27.4 ± 6.4% of FM using DXA; all p < 0.001). BMI, thigh circumference and subscapular skinfold thickness demonstrated a very similar predictive value for DXA assessment of body fat. Based on the receiver-operating characteristic curve analysis and the determination of the positive predictive value, thigh circumference appeared the most specific and sensitive anthropometric predictor of fatness discriminating between AN and healthy girls, with the AUC value reaching 0.95 (95% CI = 0.92-0.97). Using a cutoff value of 49.6 cm, accuracy was 90.6%, sensitivity 93% and specificity 88.7%. CONCLUSIONS: Thigh circumference strongly correlates with DXA-FM and demonstrates a slight clinical advantage over BMI. This simple measurement might also serve as a useful predictor of body fatness in adolescent girls with AN and should therefore be further evaluated in independent cohort studies.

Epidemiological and clinical picture of parasitic infections in the group of children and adolescents from north-east region of Poland.

The epidemiological and clinical purview of parasite diseases is constantly evolving, mainly due to the changes in human behavior and our environment. The aim of this study was frequency analysis of certain parasite infections, risk factors and clinical symptoms in children and adolescents of north-eastern Poland. 120 children were tested due to the symptoms resembling parasite infection from December 2008 to May 2009. 90 patients (the tested group) aged from 5 months to 18 years were found to be infected with one or more than one of the following parasites: Ascaris lumbricoides, Giardia lamblia, Toxocara spp., Strongyloides stercoralis or Enterobius vermicularis. 30 children with no infections found were the control group. Parasites were found by means of microscope decantation stool tests, RIDA Quick Giardia stool test and ELISA blood test (Toxocara IgG). The patients' parents filled out the survey concerning the probability factors of infection and the ailments that were the cause of parasitical diagnosis. High percentage of either isolated or co-invasive parasite infections was ascertained in the tested group--75%. The prevalence of ascariasis was 55.83%, toxocariasis--16.67%, giardiasis--12.5%, strongyloidiasis--5.83% and of enterobiasis--3.33%. The statistical significance of higher dirty hands-mouth contact frequency and more frequent presence of domestic animals in the tested group than in the control group was ascertained. A highly important correlation between the infection and the occurrence of symptoms from at least 3 various systems was ascertained. The presence of habits involving dirty hands-mouth contact and having domestic animals are significant risk factors of parasite infections. The presence of symptoms from at least 3 systems should compel to parasite infection diagnosis with proper differential diagnosis.

Analysis of clinical symptoms and selected hematological indices in hospitalized children with Ascaris lumbricoides infection from the northeastern region of Poland.

Ascariasis is the most common soil-transmitted helminth infection in the world. The objective of this study was to analyze the clinical symptoms and selected hematological indices of ascariasis in hospitalized children from the northeastern region of Poland. Patients in the Pediatric Ward hospitalized in the Regional Hospital in Dabrowa Bialostocka in the period of 2005-2007 were included in this retrospective study. The intestinal stage of ascariasis was diagnosed on the basis of positive coprological survey performed using the decantation technique. A total of 938 patients were included in the study, 1801 stool samples were evaluated, and A. lumbricoides-positive tests were obtained from 252 children. Ascaris-positive young children (< or = 3 yrs) accounted for 3.0% of all hospitalized children, Ascaris-positive preschool-aged children (4-7 yrs) accounted for 8.1% and school-aged children (8-18 yrs) for 15.8%. Seasonal patterns were observed in the prevalence of A. lumbricoides (maximum in August-December). There was no relationship between BMI z-score, hemoglobin levels and prevalence of infection with Ascaris lumbricoides. Significant predictors of intestinal stage ascariasis in a multivariate logistic regression model were: abdominal pain as a reason for hospital admission (OR-2.19; 95% CI 1.62-2.95; p < 0.001) and age from 4 to 7 years (OR-2.0; 95% CI 1.41-2.80; p < 0.001). The prevalence rate of ascariasis was not higher in the group of patients with atopic diseases (bronchial asthma, allergic rhinitis, atopic dermatitis) and co-existing ascariasis did not affect the eosinophil counts in the peripheral blood. Ascariasis is still a current pediatric clinical problem characterized by non-specific clinical manifestations, which should be taken into consideration in the differential diagnosis of children's diseases.

[Obstructive sleep apnea-hypopnea syndrome in children]. / Odrobnosci zespolu obturacyjnego bezdechu sennego ze splyceniem oddychania u dzieci.

Obstructive sleep apnea is a sleep respiratory disorder characterized by cessation or reduction in air flow through the nose and mouth, leading to a drop in oxygen saturation in the arterial blood, increased respiratory muscle work, arousals and sleep fragmentation. Pathophysiology of the syndrome is multifactorial, with the major role of addenotonsillar hypertrophy and obesity. The frequency of obstructive sleep apnea (OSA) in children grows, which is partly a secondary phenomenon to the rise in the frequency of obesity. The clinical picture is characterized by numerous symptoms that occur during night sleep and at daytime. Apart from difficulties in breathing, snoring and apnea events, the nocturnal symptoms are non-characteristic and can be easily overlooked, especially when a child sleeps alone in a room. In the clinical picture, daytime symptoms may predominate, their intensity being proportional to the degree of airway obstruction (strictures or collapse) and hypoxia. In the morning, the child wakes up tired, with blocked nose, breathes through the mouth, gets tired easily, have concentration problems, is irritated, demonstrates locomotor hyperactivity, which may resemble ADHD symptoms. Long-term disease leads to exacerbation of all-systemic symptoms, results in cardiovascular complications, induces developmental inhibition and cognitive dysfunction, and is responsible for school/social failures and reduced life quality. Most of these symptoms are reversible (partly or completely) after adenotonsilectomy, which is the therapeutic intervention of choice.

[Adaptation of Vespide Allergy Quality of Life Questionnaire for Polish children with venom allergy and for their parents]. / Adaptacja kwestionariuszy jakosci zycia dla dzieci z alergia na jad owadów oraz dla ich rodziców.

Aim of the study was to assess validity and reliability of adaptations of VQLQ for Polish children with Hymenoptera venom allergy and their parents. Sample under study consisted of 73 children aged up to 14 years, who were treated with specific venom immunotherapy (VIT) in 2008 in centres conducting this procedure in Poland, and their parents. Theoretical validity of the scales was assessed with exploratory factor analysis using principal component analysis method. Reliability of the scales was assessed in terms of internal consistency with Cronbach alpha coefficient. Results of analysis showed that both scales measure 4 dimension of quality of life and reliability of scales measuring particular dimensions is at least acceptable in case of scale for children, and high in case of scale for parents. Both adapted scales are valid and reliable tools measuring quality of life in children with Hymenoptera venom allergy and their parents' quality of life in the face of child's allergy.

[Health-related quality of life in children with Hymenoptera venom allergy treated with VIT and quality of life of their parents]. / Jakosc zycia warunkowana stanem zdrowia dzieci z alergia na jad owadów blonkoskrzydlych leczonych VIT oraz jakosc zycia ich rodziców.

UNLABELLED: Hymenoptera venom allergy, although rare in children, by its potential fatalities, leads to many psychosocial consequences, influencing quality of life of children and their parents. Aim of this paper is the estimation of health-related quality of life of venom allergic children treated with specific immunotherapy, and their parents. Assessment of factors influencing health-related quality of life levels was also performed. MATERIAL AND METHODS: Sample under study consisted of 73 children: mean age 10.6, SD 2, 4, treated because of Hymenoptera venom allergy in 5 clinical allergy centers in Poland. Data was collected using VQLQ questionnaire adapted for children and their parents. Determinants of quality of life were assessed with multivariate linear and logistic regression models. Analysis were done with SPSS 15 for Windows package. RESULTS: Girls reported higher level of anxiety than boys (B = 0.47; 95% CI = (0.01; 0.94)). Level of caution in children increased along with increase of their anxiety against re-sting (B = 0.49; 95% CI = (0.27; 0.71)). Level of anxiety of children who were under treatment from 6 months to 2 years was lower than level of anxiety of parents of children treated shorter than 6 months (B = -1.21; 95% CI = (-2.16; -0.25)). The lowest level of caution was reported by parents of children aged 10 year or less (B = -0.86; 95% CI = (-1.67; -0.05)), while the highest was reported by parents of children aged 11 years (B = 0.86; 95% CI = (0.20; 1.53)) in comparison to parents of children aged 12 years or more. Parents' caution increased along with increase of their anxiety (B = 0.61; 95% CI = (0.40; 0.83)). Higher level of limitations was imposed by parents of children treated with rush or ultra rush method, in comparison to parents of children treated with conventional method (B = 1.27; 95% CI = (0.21; 2.33)). Levels of quality of life in children and their parents were strongly dependent in the same dimensions. CONCLUSIONS: 1. Levels of quality of life in particular dimension in children is related to level of the same dimension in parents. 2. Age of children influenced level of caution of their parents. 3. Treatment duration influenced level of anxiety of parents. 4. Safety feeling acquired by parents at the beginning of treatment improves their quality of life in all dimensions.

[Gastrointestinal abnormalities in children with autism]. / Patogeneza zaburzen przewodu pokarmowego u dzieci z autyzmem.

The autistic spectrum disorder (ASD) is a neurodevelopmental disorder characterized by socially aloof behavior and impairment of language and social interaction. This paper is a review of literature on gastrointestinal problems in children with ASD. Gastrointestinal symptoms are described in 9-54% of autistic children, among which most common are: constipation, diarrhea and abdominal distension. The gastro-intestinal abnormalities reported in autism include: inflammation (esophagitis, gastritis, duodenitis, enterocolitis) with or without autoimmunity, lymphoid nodular hyperplasia, increased intestinal permeability, low activities of disaccharidase enzymes, impairment of detoxification (e.g. defective sulfation of ingested phenolic amines), dysbiosis with bacterial overgrowth, food intolerance or exorphin intoxication (by opioid derived from casein and gluten). A beneficial effect of dietary intervention on behavior and cognition of some autistic children indicates a functional relationship between the alimentary tract and the central nervous system. There are no epidemiologic data concerning the incidence or prevalence of gastrointestinal problems within the population of children with ASD in comparison to the population of non-ASD children.