A new study analysis confirms what many parents of autistic children have been already known: children with autism spectrum disorder (ASD) are four times more likely to suffer from gastrointestinal (GI) complaints and three times more likely to experience constipation and diarrhea than healthy children.
The study, conducted by researchers at the Marcus Autism Center, Children’s Healthcare of Atlanta, and Emory University School of Medicine, had two distinct goals: to better understand the issue and to increase its awareness among medical providers.
“One was to survey what we know about these issues — and we don’t know much,” said coauthor William Sharp, Ph.D., director of the Pediatric Feeding Disorders Program at Marcus Autism Center and assistant professor of pediatrics at the School of Medicine.
“There have been only 15 studies published in the past 32 years that have really good experimental controls. We also hope this study prompts the medical community to increase its focus on the prevalence, cause, and remediation of these issues.”
Although the study confirms the anecdotal experiences of pediatricians and parents, researchers avoid calling it a causal relationship.
“While we detected greater GI symptoms in ASD, our results also highlight a clear need for more research focusing on GI system in this population,” Sharp said.
“This includes what may be contributing to greater GI prevalence in ASD. Clearly, consideration should be given to the high rate of feeding problems and related behavioral issues such as toileting concerns documented in this population. At this time, we do not have evidence suggesting a unique GI pathology in ASD.”
Picky eating is a common problem among children with ASD. They tend to desire a narrow range of highly processed, calorie-dense foods — particularly cheese, chicken nuggets, and French fries — and often reject fruits, vegetables, and proteins.
“The onset of GI problems can be tricky to pin down because ASD children often have a difficult time communicating,” said study coauthor Barbara McElhanon, M.D., pediatric gastroenterologist at Children’s Healthcare of Atlanta and assistant professor of pediatrics at the School of Medicine.
McElhanon noted that she would like to see a standardized measure of GI symptoms and their relationship to diet.
“We should also look at the microbiome to learn what kinds of bacteria are in the bowel in these cases, what’s in their blood work, what are some of the metabolites in their urine,” she said.
“Physicians need to be aware that children with ASD have more GI complaints, and screen them at appointments,” McElhanon said.
“They should be asking the families for information about the nature of the stool as well as behaviors such as increased irritability that occur before the child uses the toilet. Open-ended questions such as, ‘Do you have concerns that your child’s stomach hurts?’ are also helpful.”
By documenting their child’s complaints, diet, bowel movements, and behaviors on a daily basis, parents may discover a pattern that can help doctors pinpoint a potential problem.
Source: Emory University