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Gut and Psychology Syndrome (GAP Syndrome or GAPS)

by Dr N Campbell-McBride, MD
Published in the Journal of Orthomolecular Medicine, 2nd quarter, 2008, vol 23:2: 90-

We live in the world of unfolding epidemics. Autistic Spectrum Disorders, Attention
Deficit Hyperactivity Disorder (ADHD/ADD), schizophrenia, dyslexia, dyspraxia,
depression, obsessive-compulsive disorder, bipolar disorder and other neuro-
psychological and psychiatric problems in children and adults are becoming more and
more common (1,2,3,4).

In clinical practice these conditions overlap with each other. A patient with autism often
is hyperactive and dyspraxic. There is about 50% overlap between dyslexia and dyspraxia
and 25-50% overlap between ADHD/ADD and dyslexia and dyspraxia (3,4). Children
with these conditions are often diagnosed as being depressed, and as they grow up they
are more prone to drug abuse or alcoholism than their typically developing peers (3,4,5).
A young person diagnosed with schizophrenia often suffered from dyslexia, dyspraxia
or/and ADHD/ADD in childhood (6). When we start examining the patients with these
so-called mental conditions, we find that they are also physically ill. Digestive problems,
allergies, eczema, asthma, various food intolerances and immune system abnormalities
are universally present amongst them (5,6,8). We have created different diagnostic boxes
for these patients, but a modern patient does not fit into any one of them neatly. The
modern patient in most cases fits into a rather lumpy picture of overlapping neurological
and psychiatric conditions. 218

Why are all these conditions related? What underlying problem are we missing?
To answer all these questions we have to look at one factor, which unites all these
patients in a clinical setting. This factor is the state of their digestive system
(7,8,9,10,11,12,13,14,15,16,17). I have yet to meet a child or an adult with autism,
ADHD/ADD, dyspraxia, dyslexia, schizophrenia, bipolar disorder, depression or
obsessive-compulsive disorder who does not have digestive abnormalities. In many cases
they are severe enough for the patients or their parents to start talking about them first.
In some cases the parents may not mention their child’s digestive system, yet when asked
direct questions, would describe a plethora of gut problems. So, what have digestive
abnormalities got to do with these so-called mental problems? According to recent
research and clinical experience – a lot! In fact it appears that the patient’s digestive
system holds the key to the patient’s mental state.

What is a typical scenario we see in clinical practice?
Before examining the patient it is very important to look at the health history of the
parents. Whenever the parents are mentioned people immediately think about genetics.
However, apart from genetics there is something very important the parents, mother in
particular, pass to their child: their unique gut micro-flora (18,19,20,21). Not many
people know that an adult on average carries 2 kg of bacteria in the gut. There are more
cells in that microbial mass than there are cells in an entire human body (19,21). It is a
highly organised micro-world, where certain species of bacteria have to predominate to
keep us healthy physically and mentally. Their role in our health is so monumental, that
we simply cannot afford to ignore them (18,19,20,21). We will talk in detail about the
child’s gut flora later. Now let us come back to the source of the child’s gut flora – the

After studying hundreds of cases of neurological and psychiatric conditions in children
and adults, a typical health picture of these children’s mums has emerged: due to various
modern factors a modern mum has seriously compromised gut flora by the time she is
ready to have children. Indeed, clinical signs of gut dysbiosis (abnormal gut flora) are
present in almost 100% of mothers of children with neurological and psychiatric
conditions (21, 22, 23).

A baby is born with a sterile gut. In the first 20 or so days of life the baby’s virgin gut
surface is populated by a mixture of microbes. This is the child’s gut flora, which will
have a tremendous effect on this child’s health for the rest of his/her life (19,20,21).
Where does this gut flora come from? Mainly from the mother at the time of birth.
Whatever microbial flora the mother has, she passes to her newborn child. Fathers with
abnormal gut flora contribute to the bodily flora of the mother and through her to the gut
flora of the child (19,20,21,26).

The role and importance of the gut flora
Gut flora is something we do not think much about. And yet the number of functions the
gut flora fulfils is so vital for us that if some day our digestive tracts were sterilised we
probably would not survive (19,20,21,26).

The first and very important function is appropriate digestion and absorption of food. If
a child does not acquire normal balanced gut flora, then the child will not digest and
absorb foods properly, developing multiple nutritional deficiencies (4,22). And that is
what we commonly see in children and adults with learning disabilities, psychiatric
problems and allergies. Many of these patients are malnourished. Even in the cases
where the child may grow well, testing reveals some typical nutritional deficiencies in
many important minerals, vitamins, essential fats, many amino acids and other nutrients
(4, 22,23 24).

Apart from normal digestion and absorption of food, healthy gut flora actively
synthesises various nutrients: vitamin K, pantothenic acid, folic acid, thiamine (vitamin
B1), riboflavin (vitamin B2), niacin (vitamin B3), pyridoxine (vitamin B6),
cyancobalamin (vitamin B12), various amino-acids and proteins. Indeed, when tested,
people with gut dysbiosis present with deficiencies of these nutrients (19,21). Clinical
experience shows that restoring the beneficial bacteria in their gut is the best way to deal
with these deficiencies (4,19,21,26).

Apart from taking a vital part in nourishing the body, beneficial bacteria in the gut act as
the housekeepers for the digestive tract. They coat the entire surface of the gut protecting
it from invaders and toxins by providing a natural barrier and producing anti-bacterial,
anti-viral and anti-fungal substances (19,20,21,26). At the same time they provide the
gut lining with nourishment (19). Beneficial bacteria normally control various
opportunistic and pathogenic microbes in the gut. Lack of beneficial bacteria would
allow disease-causing microbes to grow and occupy large parts of the digestive system
causing damage and inflammation in the gut wall (19,20,21). So, it is no surprise when
the gut flora is abnormal, the digestive tract itself cannot be healthy. Indeed most
patients with learning disabilities, psychiatric disorders and allergies present with
digestive problems: constipation and diarrhoea, infantile colic and abdominal pain,
bloating and flatulence, reflux and indigestion (4,17,21,22,23).

Examination by gastroenterologists commonly reveals inflammatory process in the gut and many of these patients are diagnosed with coeliac disease (10,11,12,14,15,16,17,27,30). Housing a mass
of pathogenic microbes the gut cannot be healthy. Indeed, long before these patients
develop so-called mental symptoms they usually suffer from digestive problems and all
other typical symptoms of gut dysbiosis pretty much from the start of their lives

The role and importance of the immune system
A baby is born with an immature immune system (25). Establishment of healthy
balanced gut flora in the first few days of life plays a crucial role in appropriate
maturation of the immune system (19,20,21). If the baby acquires compromised gut flora
from the mother then the baby is left immune compromised (1,21,22). The result is lots
of infections followed by lots of courses of antibiotics, which damage the child’s gut flora
and immune system even further (2,4,21,25,28).
The beneficial bacteria in the gut ensure appropriate production of different immune
cells, immunoglobulins, keeping immunity in the right balance (19,20,21). Damage
inflicted upon the gut flora typically leads to an imbalance between major parts of
immunity, resulting in allergies, asthma and eczema – symptoms, which children and
adults with neurological and psychiatric conditions commonly suffer from

There has been a considerable amount of research published into the state of the
immune system in patients with learning disabilities and psychiatric problems
(4,28,29,31,32,33,34,35,36,37,38,39,40,41,42,43). The research shows deep
abnormalities in all major cell groups and immunoglobulins. The most common
autoantibodies found are to myelin basic protein (MBP) and neuron-axon filament
protein (NAFP). These antibodies specifically attack the person’s brain and the rest of
the nervous system (4,35,38,40,41,43).

To summarise:
A child born from parents with abnormal gut flora did not acquire normal gut flora from
the start (4,19,20,21,22). The flora may have been damaged further by repeated courses
of antibiotics and vaccinations (2,19,21,45). As a result, these children commonly suffer
from digestive problems, allergies, asthma and eczema (22,25,33,38,42,45,46). However,
in children and adults who go on to develop neurological and psychiatric problems,
something even worse happens. Without control of the beneficial bacteria, different
opportunistic and pathogenic bacteria, viruses and fungi have a good chance to occupy
large territories in the digestive tract and grow large colonies. Two particular groups,
which are most commonly found on testing, are yeasts (including Candida species) and
the Clostridia family (4,17,43,44,45,46,47). These pathogenic microbes start digesting
food in their own way producing large amounts of various toxic substances, which are
absorbed into the bloodstream, carried to the brain and cross the blood–brain barrier
(4,20,21,22,48,49). The number and mixture of toxins can be very individual, causing
different neurological and psychiatric symptoms. Due to the absence or greatly reduced
numbers of beneficial bacteria in the gut flora, the person’s digestive system instead of
being a source of nourishment becomes a major source of toxicity in the body

The mixture of toxicity in each child or adult can be quite individual and different. But
what they all have in common is gut dysbiosis (abnormal gut flora). The toxicity, which is
produced by the abnormal microbial mass in these patients, establishes a link between
the gut and the brain. That is why it is logical to group these disorders under one name:
the Gut and Psychology Syndrome (GAPS)

The GAPS children and adults can present with symptoms of autism, ADHD, ADD, OCD, dyslexia, dyspraxia, schizophrenia, depression, bipolar disorder, sleep disorders, allergies, asthma and
eczema in any possible combination. These are the patients who fall through the gap in
our medical knowledge. Any child or adult with a learning disability, neurological or
psychological problems and allergies should be thoroughly examined for gut dysbiosis.
Re-establishing normal gut flora and treating the digestive system of the person has to be
the number one treatment for these disorders, before considering any other treatments
with drugs or otherwise (19,20,21,22,24,26,50,51).

Gut And Psychology Syndrome (GAP Syndrome or GAPS) establishes the connection
between the state of the patient’s gut and the functioning of the brain. This connection
has been known by medics for a very long time. The father of modern psychiatry French
psychiatrist Phillipe Pinel (1745–1828), after working with mental patients for many
years, concluded in 1807: “The primary seat of insanity generally is in the region of the
stomach and intestines.” (43). Long before him Hippocrates (460-370 BC), the father of
modern medicine has said: “All diseases begin in the gut!” (19,20,21). The more we learn
with our modern scientific tools, the more we realise just how right they were!

To learn more about Gut and Psychology Syndrome, how it develops and how to treat it
effectively with a sound nutritional protocol please read the book by Dr Natasha
Campbell-McBride ‘Gut and Psychology Syndrome. Natural treatment for
autism, ADHD/ADD, dyslexia, dyspraxia, depression and schizophrenia’.


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