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Autism and GI Disorders: Largest-Ever Analysis Confirms Strong Link

First meta-analysis of all peer-reviewed research indicates gastrointestinal problems four times more common in children with autism
April 28, 2014

The first meta-analysis of all published research on autism and gastrointestinal symptoms shows that GI disorders are four times more common among children with autism than among other children. The report appears today in the journal Pediatrics.

“With this rigorous, new synthesis of the medical literature, it should be clear to all that GI issues are significantly more frequent among children who have autism,” says developmental pediatrician Paul Wang. Dr. Wang is Autism Speaks senior vice president and head of medical research. He was not involved in the new analysis.

“We were hearing this message from our families well before this article published,” Dr. Wang adds. “This is why Autism Speaks is making a historic investment in research on autism and the GI system.”

Read more about Autism Speaks unprecedented investment in gut-brain research here.

In the new analysis, the researchers reviewed all published research looking at GI symptoms and autism – more than 950 journal articles in all. They then looked at the combined results of the 15 studies they judged as meeting the highest standards of scientific reliability. All were published in the last ten years, with a combined enrollment of 2,215 children with autism.

The analysis showed that, overall, children with autism were four times more likely to have generalized GI problems than were children without the disorder. Chronic constipation and diarrhea were both three times more common among the children with autism. And children with autism were twice as likely to indicate they had abdominal pain.

Communication challenges complicate treatment
Recognizing GI concerns in those who have autism can be complicated by behavioral and neurological issues, notes study co-author William Sharp. Dr. Sharp directs the Pediatric Feeding Disorders Program at Emory’s Marcus Autism Center. In particular, communication challenges can make it difficult for an individual with autism to describe their symptoms. In many such cases, parents and professionals must rely on non-verbal signs to recognize the distress. Indeed, the only indication of a GI problem may be new or worsening behavioral problems.

In their report, Dr. Sharp and colleagues emphasize the need for autism-specific clinical guidelines for GI examinations, particularly for nonverbal patients.

Clinicians in Autism Speaks Autism Treatment Network (AS-ATN) are already pioneering the development of such guidelines. This work is being done through the AS-ATN’s role as the federally funded Autism Intervention Research Network on Physical Health (AIR-P). The first round of these guidelines, published in a special supplement to Pediatrics, includes evaluation and treatment of constipation.

Dr. Wang joins the study’s authors in urging healthcare professionals to take parents’ GI concerns seriously and to consider GI distress when autism’s behavioral symptoms worsen.

Also see these resources on the Autism Speaks website:

* Autism Speaks Announces Unprecedented Investment in Gut-Brain Research

* GI Distress and Autism: Q&A with Pediatric Gastroenterologist Tim Buie

ATN/AIR-P Guide for Managing Constipation in Children

* Study Suggests Probiotic Promotes Gastrointestinal Health in Infants

* Large Study Supports GI Link to Problem Behaviors in Kids with Autism

* Videoblog: Discussing GI Issues at the Autism Speaks National Conference


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