Children with autism have more GI problems

Children with autism spectrum disorder (ASD) are more than 4 times as likely to suffer from gastrointestinal (GI) symptoms as children without the disorder, according to a new meta-analysis.

Looking at data from a total of 15 studies published since 2000, researchers from Atlanta, Georgia, determined that in addition to general GI complaints, kids with ASD are almost 4 times as likely as those without ASD to suffer from diarrhea and constipation and about two-and-a-half times as likely to have abdominal pain. The studies included over 2200 children with ASD.

The researchers point out that we can’t overlook the fact that many children with ASD have strong food preferences, usually favoring starches, snacks, and processed foods to fruits, vegetables, or proteins. This alone could contribute to an increase in GI symptoms.

Another likely contributing factor is that gastroesophageal reflux, gastroenteritis, food allergies, and inflammatory bowel disease are all more common among children with ASD. Behavioral factors also may contribute, such as resistance to toileting.

The investigators conclude that parents and caregivers of children with ASD require more information about possible GI symptoms and their pathophysiology. In addition, because GI symptoms are more common among children with ASD, pediatricians may want to consider lowering their threshold for referral to a gastroenterologist for patients with ASD.

According to the researchers, parents, caregivers, and pediatricians should remember that because many children with ASD have limited verbal communication skills, GI symptoms may present unusually, such as with an increase in behavior problems. Children may exhibit aggression, self-injury, sleep disturbance, or irritability.

The Centers for Disease Control and Prevention reports that 1 in 68 children in the United States meets the diagnostic criteria for ASD. 

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