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Gastrointestinal Concerns Addressed with New Clinical Guidelines

January 12, 2011

Gastrointestinal (GI) problems are a commonly expressed concern of parents of children with ASD, but there remains a significant need for clinical guidance and research in this area. In January 2010, a consensus statement and recommendations for the evaluation, diagnosis, and treatment of GI disorders in children with ASD were published in Pediatrics. These recommendations are an important step in advancing physician awareness of the unique challenges in the medical management of children with autism and will be a another step towards the development of evidence-based guidelines that will standardize care for all children with ASD. The reports highlighted the crucial need for information to guide care, and emphasized the importance of fostering more research in this area to support the development of these guidelines.

The consensus statement highlights several important themes, the first emphasizing that GI problems are a genuine concern in the ASD population and that these disorders exacerbate or contribute to problem behaviors. The need for awareness of how GI problems manifest in children with autism and the potential for accompanying nutritional complications and impaired quality of life were also emphasized. In the second paper, the authors make consensus recommendations providing guidance for current general pediatric standards of care that can and should be used by those treating children with ASD.

Autism Speaks is already engaged in the next step which is to move beyond these consensus-based recommendations to develop evidence-based clinical guidelines through the work of the members of its Autism Treatment Network (, a program addressing co-morbid medical conditions in the ASD population. George Fuchs, M.D., a co-author on the two papers and chair of Autism Speaks' ATN GI Committee remarked, “The recommendations provide important guidance for the clinician to adapt the current practices of care (for abdominal pain, chronic constipation and gastroesophageal reflux) for the child with autism. The recommendations complement the ATN's on-going work to develop evidence-based, ASD-specific guidelines. The ATN is currently piloting newly created guidelines and monitoring their effectiveness. We anticipate this data will contribute to an evidence-based foundation to support best practices for GI problems in ASD.”

1. Buie T, Fuchs GJ 3rd, Furuta GT, Kooros K, Levy J, Lewis JD, Wershil BK, Winter H. Recommendations for evaluation and treatment of common gastrointestinal problems in children with ASDs. (2010) Pediatrics. Jan;125 Suppl 1:S19-29.

2. Buie T, Campbell DB, Fuchs GJ 3rd, Furuta GT, Levy J, Vandewater J, Whitaker AH, Atkins D, Bauman ML, Beaudet AL, Carr EG, Gershon MD, Hyman SL, Jirapinyo P, Jyonouchi H, Kooros K, Kushak R, Levitt P, Levy SE, Lewis JD, Murray KF, Natowicz MR, Sabra A, Wershil BK, Weston SC, Zeltzer L, Winter H. (2010) Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report. Pediatrics. Jan;125 Suppl 1:S1-18
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