Gut and Psychology Syndrome: GAPS, Part II

Gut and Psychology

Welcome to the second article on Gut and Psychology Sydrome, Gaps, Part II

In my first article, Gut and psychology syndrome: GAPS, Part I, I discussed the findings of  Dr. Natasha Campbell-McBride, MD, MMedSci (neurology), MMedSci (nutrition), who is also the mother of a now recovered child with autism who has coined the term Gut and Psychology Syndrome, or GAPS (2010, p. 6-7) due to the plethora of seemingly disparate diagnoses who all have at their base, compromised gut flora.  Our digestive system, skin, respiratory and excretory organs all co-exist with microscopic flora that if healthy, keep us healthy and if compromised, cause disease.  According to Campbell-McBride (2010), the largest of these many colonies lives in our digestive system, in a highly ordered arrangement wherein in a healthy gut, beneficial flora control all the others.  Campbell-McBride divides the micro-flora into three groups: essential or beneficial flora, opportunistic flora and transitional flora. In this article I will discuss opportunistic gut flora.

Opportunistic flora are a large group of diverse microbes, approximately 500 can be found in the human gut, the most common of which are: Bateriods, Peptococci, Staphalococci, Sterptococci, Bacilli, Clostridia, Yeast, Eterobacteria, Fuzobacteria, Eubacteria, Spirochaetaceae, Spirillaceae, Cantenobactiera, different viruses and many others (Campbell-Mcbride, 2010, p. 41).  In a healthy gut their numbes are limited and tightly controlled by beneficial gut flora.  But if the beneficial flora are weakened or damaged the opportunist gut flora grows out of control.  Many of the by-products of the metabolism of opportunistic flora are toxic to our bodies and they are being constantly produced.  However, some are familiar substances to our body, but because of over-production they can begin to have adverse effects.  For example, histamine is an important neurotransmitter in the brain and spinal cord, but is also involved in local immune system responses as well as regulating physiological processes in the gut.  However, bacteria from the Proteus, E.coli, and Staphylococci, as well as many others also produce histamine.  When these opportunistic bacteria overgrow, they pump excessive amounts of histamine into our bloodstream, thus we get allergies, low blood pressure, excessive saliva, sleep abnormalities, emotional instability and for some, PMS.  These excessive amounts of histamine have been found in people suffering from depression, schizophrenia, additions and , and interestingly, antihistamine drugs are prescribed by psychiatrists to treat schizophrenia (p. 43).   

Certain opportunists, when not controlled by beneficial bacteria damage the gut wall and make it “leaky.”  Opportunistic bacteria from the Spirochaetaecae and Spirillaceae families, because of their spiral shape are able to push apart intestinal cells which breaks down the integrity of the gut wall. According to Campbell-McBride (2010) the most common opportunistic bacteria is Candida albicans, which flourishes on sugar and processed carbohydrates, which unfortunately makes up a large percent of our Western diet.  Candida albicans is able to put its “roots” into the gut wall, creating microscopic apertures that then make it leak. This allows substances to enter our blood streams that should not.  Any leak in the gut lining allows partially digested foods to leave the gut and enter the blood stream.   Because partially digested food is foreign to the bloodstream the immune system attacks it, “This is how food allergies or intolerance develop” (Campbell-Mcbride, 2010, p. 43).

Amines are organic compounds found in the body that are essential for cell proliferation, growth, renewal, and metabolism. They are involved in nearly every step of DNA, RNA, and protein synthesis, and regulate the permeability and stability of cellular membranes.  However, the amine by-products from opportunistic gut flora are known to cause cerebral depression with symptoms of withdrawal, intellectual regression, emotional and behavioral consequences.  

In her clinic Dr. Campbell-McBride (2010) has consistently found overgrowths of opportunistic bacteria in the stool samples of the children she treats.  The most common strains she sees are: Candida albicans, Bacteriods, Clostridia spp., Proteus family, Streptococci and Staphylococci, accompanied of course, with the absence or greatly reduced number of beneficial bacteria.  However, stool samples are not able to tell doctors which bacteria are living on the gut wall.  These important bacteria that maintain gut integrity and its ability to digest and absorb food.  Although there are limited studies of biopsies of the gut wall show that the microbes living on the wall are not always the same as those in the lumen of the gut.  Stool samples are also not able to provide information regarding what microbes may be living in other parts of the alimentary canal (p. 43-44).

According to Campbell-McBride (2010) members of the Clostridia family are almost always detected in the stool samples of people with autism, including Clostridium tetani.  She reports they are also found in the stools of people suffering from schizophrenia, psychosis, muscle paralysis, muscle tone abnormalities and other neurologic and psychiatric conditions.  Tetanus of course is a deadly disease due to an extremely powerful neurotoxin that Clostridium tetani produces.  If we get an open cut outdoors, unless we’ve had a tetanus shot in the last 5-10 years there is always the fear of developing tetnus.  Yet, Clostridium tetani can only harm us if it enters our blood stream.  According to Campbell-McBride, “Clostridium tetani is routinely found in the gut of healthy humans and animals,” however, “GAPS patients do not have a healthy gut wall, which allows the toxin to get into the body” (p. 45).  Sensitivity to light and sound are some of the symptoms of tetanus.  Many individuals with autism also have a sensitivity to light and especially sound.  Campbell-McBride also says the children with autism she sees have muscle tone abnormalities associated with low exposure to tetanus neurotoxin consisting of typically high extensor muscle tone and wonders if that could be one reason why many children with autism toe-walk?  In a study at the University of Reading in the UK, high levels of Clostridia were found in the gut of 150 children with autism (p. 46).  

Another large group of opportunistic flora is sulphate-reducing bacteria. 

Sulphates are needed in the body for many functions including detoxification, normal metabolism of brain neurotransmitters.  Sulphate deficiency has been found in 95% of autistic children.  An overgrowth of sulphate-reducing bacteria would make sulphur it unavailable for use.  These bacteria then turn sulphur into toxic substances like hydrogen sulphide, the gas tha smells like rotten eggs.  Campbell-McBride writes, “Many parents of autistic childen tell me that their child’s stool and flatus has this characteristic smell” (p. 47).    

Cambell-Mcbride (2010) writes:

Well-functioning healthy gut flora would not only keep those pathogens down but would maintain the integrity of the gut wall so it does not let through the toxins from those pathogeneic microbes.  This is Nature’s way of dealing with them, and the smart thing for us is to try and copy it.  (p. 48).  

However, due to the absence or reduced numbers of beneficial bacteria, the digestive systems of GAPS children get taken over by an overgrowth of opportunistic pathogenic microbial flora, “constantly producing a river of toxicity flowing from the gut to the brain” (p. 48). The question is, what damages healthy gut flora?

What Damages Healthy Gut Flora

Unfortunately, the number one agent Campbell-McBride (2010) cites in her book responsible for damaging healthy gut flora is antibiotics.  Not only is it one of the most commonly prescribed medications, but as Campbell-McBride reminds us:

Since the moment we are born we are likely to be exposed to this group of drugs on a regular basis, not only through prescription, but also through food.  Farm animals and poultry are routinely given antibiotics, so all the products we get from them (meat, milk, eggs) will provide us with a constant supply of antibiotics and antibiotic-resistant bacteria, which these animals produce.  Farmed fish and shellfish have antibiotics routinely added to their tanks.  A lot of fruit, vegetables, grains, legumes and nuts are spayed with antibiotics to control disease. (p. 33)

Along with the growing use of antibiotics, a growing body of research shows its harmful effects:

  • Antibiotics have a devastating effect on beneficial bacteria in the human body, not only in the gut but in other organs and tissues.
  • Antibiotics change bacteria, viruses and fungi from benign to pathogenic, giving them the ability to invade tissues and cause disease.
  • Antibiotics make bacteria resistant to antibiotics, so the industry has to work on more and more powerful new antibiotics to attack these new changed bacteria.  A good example is tuberculosis, where wide use of antibiotics has created new varieties of the Mycobacterium Tuberculosis resistant to all existing antibiotics.
  • Antibiotics have a direct damaging effect on the immune system, making us more vulnerable to infections, which leads to a vicious cycle of more antibiotics and more infections. (Campbell-McBride, 2010, p. 33-34)

Campbell-McBride (2010) breaks antibiotics down into several groups.  First, the  penicillins, specifically listing Amoxicillin, Ampicillin, Flucloxacillin and all the other “cillin(s).”  Besides damaging healthy gut flora, they actually promote the growth of pathogenic Proteus, Streptococci and Staphlococci, which allows bacteria normally found only in the gut to move up to the intestines, creating the proper environment for developing Irritable Bowel Syndrome (Campbell-McBride, 2010, p. 34).

Tetracyclines (doxycycline and other “cyclines”) are routinely prescribed to teenagers for acne for as little as three months up to two years.  Tertracycline alters the protein structure in the mucous membranes on the gut wall.  This makes the gut wall vulnerable to invasion by pathogens.  It also alerts the immune system to attack these changed proteins, which begins an autoimmune response in the gut.  Tetracyclines also stimulate growth of Candida, Staphylococci and Clostridia in the digestive tract (Campbell-McBride, 2010, p. 34).  

Aminoglycosides , Erythromycin and other “mycins” have a devastating effect on beneficial bacteria and a prolonged course of treatment can completely eliminate the, leaving the digestive tract open to invasion from pathogenic E. coli and other microbes (Campbell-McBride, 2010, p. 34-35).  

Antifungal antibiotics (Nystatin, Amphotericin) lead to growth of the Proteus family and lactose-negative E.coli.  Campbell-McBride (2010) says the damage is worse when the antibiotics are administered in a low dose over an extended period of time, for example they way they are commonly prescribed for acne, chronic cystitis, chronic ear infections, and other chronic infections (p. 35).

The majority of GAPS patients Campbell-McBride (2010) has seen have been exposed to numerous courses of antibiotics during their lifetime.  The most common reasons in children are repeated ear infections, chest infections, mastitis in mothers who are breast feeding, thus transferring the antibiotics to her baby through breast milk.  Campbell-McBride writes, “Given that many of these children had little chance to develop a healthy gut flora from the beginning, these courses of antibiotics have a devastating effect on their fragile gut ecology” (p. 35).    

Other Drugs

When prescribed for a long period of time, Campbell-McBride (2010) reports most drugs can have a detrimental effect on gut flora.  She lists pain killers (aspirin, ibroprfen etc.) steroids, oral contraceptives, sleeping pills, medicines for heartburn, neuroleptics, cholinolytic and cytoxic drugs.

Other Factors

What we eat has a direct effect on the composition of our gut flora.  Unfortunately, our modern diet of sugary food and processed carbohydrates actually feed our internal fungi like Candida, Streptococci, Staphylococci, Clostridia, Bacteroids and some aerobic opportunistic bacteria.  Sugary carbohydrates also promote populations of worms and other parasites in our gut. If we only get our grains from processes breakfast cereals it may predispose us to Irritable Bowel Syndrome, bowel cancer and nutritional deficiencies (Campbell-McBride 2010, p. 37).  And unfortunately, Campbell-McBride tells us that bottle-fed babies develop completely different gut flora than breastfed babies.  Babies are born with a sterile gut and breastfeeding in the “one and only opportunity” we have to populate the entire surface of their guts with a beneficial bacteria. However, “Bottle-fed babies have their gut populated by a combination of different bacteria, which predisposes them later to many health problems” (p. 37).  Campbell-McBride (2010) writes, “Physical exertion, old age, alcoholism, pollution, exposure to toxic substances, seasonal factors, exposure to ionising radiation and extreme climates all have a profound effect on our friendly gut bacteria” (p. 38).  

Closing Thoughts  

As Campbell-McBride (2010) tells us, each one of us carries a unique mixture of microbes in our gut that can be influenced in a myriad of ways, which can predispose us to a myriad of health problems.  Campbell-McBride writes:

It is a completely unpredictable process and science so far has not developed very reliable methods of testing for the full range of microbes in the gut, let alone treating any abnormalities.  This damage gets passed from generation to generation as a newborn child gets its gut flora from the mother.  And as the damage is passed through generations, it gets deeper and deeper. (p. 38)

It is sobering to think of the astronomical rise in the incidence of autism could be due to our cavalier attitude to our systemic antibiotic use.

In the next article I will talk about the gut-brain connection.


Campbell-McBride, N. (2010).  Gut and Psychology Syndrome: Natural Treatment for: 

Dyspraxia, Autism, A.D.D. Dsylexia, A.D.H.D. Depression, Schizophrenia.  First 

published in the UK in September, 2004 by Medinform Publishing: Cambridge.

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