Table of ContentsView AllTable of ContentsFacts About GI SymptomsImpact of GI IssuesDetecting GI SymptomsAddressing GI ProblemsAvoiding the Placebo Effect
Table of ContentsView All
View All
Table of Contents
Facts About GI Symptoms
Impact of GI Issues
Detecting GI Symptoms
Addressing GI Problems
Avoiding the Placebo Effect
The diagnostic criteria forautism spectrum disorder(ASD) has nothing to say about bowel movements, nausea, or stomach pain. But the fact is that autistic children have significantly more gastrointestinal (GI) problems than their typically developing peers.
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The Facts About GI Symptoms in Autistic Children
Autism spectrum disorder is a developmental rather than a medical diagnosis, but studies suggest that autistic children (as well as their siblings) are at significantly higher risk of GI problems thanneurotypicallydeveloping children of the same age.
Risk of GI Problems
A question remains about exactly how much higher the risk is;some sourcessay it is eight times greater than the norm while others suggest it is significantly less. The same is true of prevalence: some studies suggest that as many as 70% of autistic children have GI issues while others put 23% as an estimate.
These differences may relate to the structure of the study or the cohort of people being studied. For example, a very small study of autistic children in an autism clinic is likely to yield different results than a large study of autistic children in the general community.
Symptoms of GI Problems
While some GI symptoms are obvious, others can be hard to detect in a young child or a child without the ability to describe the sensations s/he is experiencing. Symptoms of GI problems may include:
Why GI Symptoms Are Prevalent in Autistic Children
There are no definitive answers to the question of why GI symptoms are so prevalent in autistic kids, but there are some clues. For example:
How GI Issues Impact Autistic Children
Gastrointestinal symptoms can be painful, frustrating, and distracting. Even neurotypical children coping with stomach pain and constipation (for example) may develop negative behaviors.
Some autistic children lack the ability to explain their pain or discomfort, and so “acting out” becomes their only option. In fact,according to one study: “Restricting to ASD children, those with frequent abdominal pain, gaseousness, diarrhea, constipation or pain on stooling scored worse on Irritability, Social Withdrawal, Stereotypy, and Hyperactivity compared with children having no frequent GI symptoms.”
In other words, autistic children are more likely to have GI symptoms. GI symptoms can lead to negative behaviors, inattention, and other behavioral problems that are often linked to autism. The obvious conclusion: treating GI symptoms may often improve behavior, learning, and social skills in autistic children.
As stated in the study, “Understanding the magnitude of GI problems and their effects on behavior can provide new insight for more effective and appropriate treatment of children who suffer from these problems.” Behavioral issues, while significant, may be only the tip of the iceberg. Children with GI issues lose sleep, another contributor to learning and behavioral problems. And autistic kids are much more likely than their peers to be hospitalized for problems like severe constipation.
How to Detect Gastrointestinal Symptoms in Your Child
Some GI problems are self-evident, even in a child with limited verbal skills. For example, it’s hard to miss diarrhea or vomiting. Other symptoms, though, may not be obvious. Some of the harder symptoms to see include constipation and gas. These symptoms are especially difficult to spot in a child who has always had behavioral issues. While you should certainly contact a pediatrician if you suspect GI problems, you can also keep an eye open for some of these clues:
If your answer to any of these questions is yes, it’s a good idea to contact a pediatrician and ask for a referral to a healthcare provider with experience in treating GI symptoms in autistic children. It’s important to find a provider with specific autism experience and receive an accurate diagnosis.
Addressing GI Problems in Autistic Children
Because the reasons behind and the severity of GI problems vary, treatment varies. In some cases, the problem can be resolved with a simple stool softener. In other cases, however, a change of diet or further testing may be necessary.
Addressing Stress
For some children, stress can be the cause of a range of issues that include GI problems.For autistic children, it may be hard to express or discuss stress or identify its cause.
While you investigate physical problems, you can consider reducing stressful elements in your child’s life. Some of these problems may not be obvious to you, so be sure to check in with your child and their teachers and therapists. Common stressors include:
Addressing Picky Eating
There are many reasons why autistic children may be extremely picky eaters, but the most common seems to relate to sensory challenges and a desire for sameness. Whatever the reason, picky eating (especially when the child refuses any type of fruit or vegetable) can lead to GI symptoms such as constipation and gas.
Investigating and Addressing Intolerances and Allergies
Allergies and food intolerances can cause a range of gastrointestinal problems for many people, autistic or not. If your child seems to be exhibiting GI problems that your pediatrician can’t alleviate, it’s quite possible that your child has a food intolerance that hasn’t yet been diagnosed.
Your pediatrician may then refer you to an allergist, but while true allergies may be revealed through testing, less severe food intolerances may still remain elusive.
Some parents turn to do-it-yourself diet manipulation, placing their child on an “autism” diet such as keto or GFCF (gluten-free/casein-free). If your child happens to have an unidentified allergy or intolerance to gluten, dairy, or certain types of starches, there’s a potential that this approach could be helpful. If your child doesn’t have such allergies or intolerances, though, there’s no reason to think their GI problems will be resolved.
Perhaps the best approach is to work directly with a dietitian or feeding specialist who can help you pinpoint some likely culprit foods and support the process of evaluating outcomes from diet change. Working with a specialist has some additional benefits; dieticians and feeding therapists can:
Because autism traits are so varied and each child grows and matures over time, it can be extremely difficult to determine whether a small change in diet is really making a positive impact. As a result, many people believe they see positive or negative outcomes that don’t really exist based on evidence. This is sometimes called the placebo effect.
To make an accurate assessment ofwhether a therapy is working, you will need to take a baseline measurement of symptoms, traits, and behaviors and then reassess them after trying each therapy.
So, for example, you might measure number, duration, and intensity of temper tantrums per day before and after removing a food from your child’s diet. This can be a tricky project, so having a therapist working with you to create the right measurements and assess outcomes can be very helpful.
Summary
It’s very important to note that, while gastrointestinal symptoms may worsen autism traits, eliminating the GI symptoms will not eliminate the autism itself. Thus:
2 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Son JS, Zheng LJ, Rowehl LM, et al.Comparison of fecal microbiota in children with autism spectrum disorders and neurotypical siblings in the Simons Simplex Collection.PLoS One. 2015;10(10):e0137725. doi:10.1371/journal.pone.0137725Ferguson BJ, et al.Abstract 126.138 Associations between dietary composition and gastrointestinal symptoms in autism spectrum disorder. Presented at: International Meeting for Autism Research; May 10-13, 2017; San Francisco.Additional ReadingBuie T, Campbell DB, Fuchs GJ, et al.Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics. 2010;125 Suppl 1:S1-18.Chaidez V, Hansen RL, Hertz-Picciotto I.Gastrointestinal problems in children with autism, developmental delays or typical development.J Autism Dev Disord. 2014;44(5):1117–1127. doi:10.1007/s10803-013-1973-xSarris, Marina.What causes GI problems in autism?Interactive Autism Network.
2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Son JS, Zheng LJ, Rowehl LM, et al.Comparison of fecal microbiota in children with autism spectrum disorders and neurotypical siblings in the Simons Simplex Collection.PLoS One. 2015;10(10):e0137725. doi:10.1371/journal.pone.0137725Ferguson BJ, et al.Abstract 126.138 Associations between dietary composition and gastrointestinal symptoms in autism spectrum disorder. Presented at: International Meeting for Autism Research; May 10-13, 2017; San Francisco.Additional ReadingBuie T, Campbell DB, Fuchs GJ, et al.Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics. 2010;125 Suppl 1:S1-18.Chaidez V, Hansen RL, Hertz-Picciotto I.Gastrointestinal problems in children with autism, developmental delays or typical development.J Autism Dev Disord. 2014;44(5):1117–1127. doi:10.1007/s10803-013-1973-xSarris, Marina.What causes GI problems in autism?Interactive Autism Network.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Son JS, Zheng LJ, Rowehl LM, et al.Comparison of fecal microbiota in children with autism spectrum disorders and neurotypical siblings in the Simons Simplex Collection.PLoS One. 2015;10(10):e0137725. doi:10.1371/journal.pone.0137725Ferguson BJ, et al.Abstract 126.138 Associations between dietary composition and gastrointestinal symptoms in autism spectrum disorder. Presented at: International Meeting for Autism Research; May 10-13, 2017; San Francisco.
Son JS, Zheng LJ, Rowehl LM, et al.Comparison of fecal microbiota in children with autism spectrum disorders and neurotypical siblings in the Simons Simplex Collection.PLoS One. 2015;10(10):e0137725. doi:10.1371/journal.pone.0137725
Ferguson BJ, et al.Abstract 126.138 Associations between dietary composition and gastrointestinal symptoms in autism spectrum disorder. Presented at: International Meeting for Autism Research; May 10-13, 2017; San Francisco.
Buie T, Campbell DB, Fuchs GJ, et al.Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics. 2010;125 Suppl 1:S1-18.Chaidez V, Hansen RL, Hertz-Picciotto I.Gastrointestinal problems in children with autism, developmental delays or typical development.J Autism Dev Disord. 2014;44(5):1117–1127. doi:10.1007/s10803-013-1973-xSarris, Marina.What causes GI problems in autism?Interactive Autism Network.
Buie T, Campbell DB, Fuchs GJ, et al.Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics. 2010;125 Suppl 1:S1-18.
Chaidez V, Hansen RL, Hertz-Picciotto I.Gastrointestinal problems in children with autism, developmental delays or typical development.J Autism Dev Disord. 2014;44(5):1117–1127. doi:10.1007/s10803-013-1973-x
Sarris, Marina.What causes GI problems in autism?Interactive Autism Network.
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