Identifying health complications in children affected by an autism spectrum disorder (ASD) can become problematic, mainly due to a lack of verbal communication. Researchers from Emory University School of Medicine and Marcus Autism Center in Atlanta have concluded a study revealing that autistic children are four times more likely to suffer from gastrointestinal difficulties, compared to children unaffected by social, communication, and behavioral challenges.

"Our findings corroborate a history of anecdotal reports and case studies suggesting increased risk of GI concerns in autism," said Dr. William Sharp, director of the Pediatric Feeding Disorders Program at Marcus Autism Center, in a statement. "This analysis reinforces the need for greater clinical and research scrutiny in this area to guide best standards of care and to address important questions regarding the detection and treatment of GI symptoms among children with autism."

The research team analyzed data from three public health databases including Medline, PsychINFO, and PubMed. A total of 15 studies investigating a common link between autism and gastrointestinal symptoms such as constipation, diarrhea, and abdominal pain were included in the research. Sharp recognized that due to a combination of behavioral, neurological, and medical issues faced by children with ASD, making an accurate diagnosis can prove difficult.

Compared to children who show no signs of autistic behavior, children with ASD are four times more likely to suffer from gastrointestinal problems. Autistic children are three times more likely to suffer from constipation and diarrhea and twice as likely to complain about abdominal pain. Although Sharp was unable to give a specific reasoning behind a child with autism’s predisposition to gastrointestinal problems, prior research shows that these children may be unable to breakdown and transport carbohydrates due to abnormalities with their intestinal cells.

"In many cases, the only indication of a possible GI problem in autism may be the emergence or escalation of problem behaviors, such as self-injury, aggression, or irritability, that cannot be otherwise explained," said pediatric gastroenterologist at Children’s Healthcare of Atlanta, Dr. Barbara McElhanon. "Relying on these atypical signs to detect possible GI concerns can be difficult for practitioners because repetitive and stereotyped patterns of behavior occur so frequently in ASD and no guidelines exist to help parents and clinicians navigate the diagnostic process."

Sharp and his colleagues stressed the importance of standardized screening and clinical guidelines for conducting gastrointestinal examinations among autistic children. The Autism Speaks Autism Treatment Network (ATN) is a dedicated system of hospital, doctors, researchers, and parents looking to diagnose and treat medical conditions associated with autism. The network’s GI committee is currently in the process of developing treatment guidelines for constipation, chronic diarrhea, food allergies, and other GI symptoms.

"The important point from this research is that children with autism—who have difficulties in communicating their symptoms—need special attention from physicians to determine whether or not a child is experiencing GI distress" Sharp added. "Unfortunately for parents, the unfounded assertion that vaccinations somehow caused an inflammatory GI disease which then caused autism has significantly hindered progress in this field for years. Many studies have now shown no evidence of an association with vaccines, and vaccines are important for child health. That controversy diverted attention from the GI needs of children with ASD, and we hope that our work helps spur renewed investment for addressing these needs."

 

Source: McElhanon B, McCracken C, Karpen S, Sharp W. Gastrointestinal Symptoms in Autism Spectrum Disorder: A Meta-analysis. Pediatrics. 2014.