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Evaluation of functional gastrointestinal disorders in children aged 4-10 years with autism spectrum disorder
Özlem Gülpınar Aydın1, Hüseyin Burak Baykara2, Kardelen Akın3
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, School of Medicine, Dokuz Eylul University, İzmir.
Insights
Children with autism spectrum disorder (ASD) have significantly higher rates of functional gastrointestinal disorders (FGIDs), including abdominal migraine and constipation. Many with fecal incontinence in this group did not show stool retention, suggesting behavioral factors may play a role.
Area of Science:
- Pediatric Gastroenterology
- Neurodevelopmental Disorders
- Autism Spectrum Disorder Research
Background:
- Gastrointestinal (GI) issues are common in children with autism spectrum disorder (ASD).
- Limited data exists on functional GI disorders (FGIDs) in ASD, particularly in Türkiye.
- Known comorbidities include abdominal pain, constipation, diarrhea, and reflux.
Purpose of the Study:
- To investigate the prevalence of FGIDs in children with ASD using the Rome criteria.
- To compare FGID rates between children with ASD and a neurotypical control group.
Main Methods:
- Study included 68 children (ages 4-10) diagnosed with ASD (DSM-5, CARS-2 >30).
- An age- and sex-matched control group of 78 children was included.
- Functional GI disorders were assessed using the Rome III criteria.
Main Results:
- FGIDs were significantly more frequent in the ASD group (76.5%) compared to controls (p < 0.001).
- ASD group showed increased rates of abdominal migraine (10x), functional constipation (7x), and fecal incontinence (6x).
- Most children with ASD experiencing fecal incontinence did not exhibit stool retention.
Conclusions:
- Abdominal migraine, functional constipation, and non-retentive fecal incontinence are common FGIDs in children with ASD.
- Absence of stool retention in fecal incontinence suggests potential social, psychological, or behavioral influences.
- Increased awareness among healthcare professionals is crucial for improving daily life for children with ASD and FGIDs.
Background:
Gastrointestinal system disorders are known to be prevalent among children with autism spectrum disorder (ASD). Some ASD-associated comorbidities are abdominal pain, constipation, diarrhea, gastroesophageal reflux, sleep disturbances, epilepsy, and psychiatric problems. Nonetheless, there is still limited information about the presence of functional GI disorders (FGIDs) among children with ASD, especially in Türkiye. Using the Rome criteria, we aimed to investigate FGIDs in children with ASD.
Methods:
The sample of the study consisted of 68 children aged 4-10 years, diagnosed with ASD according to the DSM-5 diagnostic criteria and had scores greater than 30 on the Childhood Autism Rating Scale (CARS-2) and an age-sex matched control group (n=78). The Rome III criteria were used to evaluate FGIDs.
Results:
The frequency of FGIDs in the ASD group was higher (76.5%) compared to the control group (p < 0.001). Compared to the control group, abdominal migraine frequency increased 10 times (p=0.012), functional constipation 7 times (p < 0.001), and fecal incontinence 6 times (p < 0.001) in the ASD group. Stool retention was not present in most children in the ASD group who were found to have fecal incontinence.
Conclusion:
In this study, the most common FGIDs in the ASD group were abdominal migraine, functional constipation, and non-retentive fecal incontinence. The finding that most children with ASD who had fecal incontinence did not show stool retention implicated social, psychological, and behavioral factors as the causes of incontinence. Raising awareness of healthcare professionals about the frequency of FGIDs in children with ASD will improve many areas in the daily lives of these children.
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