Recognition and management of bladder bowel dysfunction in children with autism spectrum disorder

Shilpee Raturi1, Fay Xiangzhen Li2, Chui Mae Wong3

  • 1Child Development, KK Women's and Children's Hospital, Singapore shilpeeraturi@hotmail.com.

BMJ Case Reports
|June 3, 2021
PubMed

Insights

Children with autism spectrum disorder (ASD) are at high risk for bladder bowel dysfunction (BBD) due to rigidities and anxiety. Early recognition and simple interventions like parental education can effectively manage BBD in this population.

Area of Science:

  • Pediatric Gastroenterology
  • Neurodevelopmental Disorders
  • Urology

Background:

  • Autism spectrum disorder (ASD) is frequently associated with behavioral rigidities, anxiety, and sensory sensitivities.
  • These characteristics can lead to urinary and fecal retention, increasing the risk of bladder bowel dysfunction (BBD).
  • BBD often goes unrecognized in children with ASD, despite its prevalence.

Observation:

  • A case report details a 7-year-old girl with ASD presenting with acute urinary retention.
  • This case highlights the critical need to investigate the link between ASD and BBD.
  • Underlying factors contributing to BBD in ASD are complex and multifactorial.

Findings:

  • A complex interplay of factors contributes to BBD in children with ASD.
  • These include altered brain connectivity, delayed bladder function maturation, cognitive rigidities, and psychosocial stressors.
  • These factors can trigger events predisposing children with ASD to develop BBD.

Implications:

  • Simple management strategies can significantly improve outcomes for children with ASD and BBD.
  • Key interventions include comprehensive parental education, consistent use of bladder and bowel diaries, and prompt treatment of constipation.
  • Early identification and management of BBD are crucial for improving the quality of life for children with ASD.

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