A longitudinal evaluation of gastrointestinal symptoms in children with autism spectrum disorder

Gastrointestinal symptoms are frequently reported in children diagnosed with autism spectrum disorder. This study sought to determine the longitudinal trajectory of gastrointestinal symptoms without a medical etiology in children with autism compared to similar aged participants with typical development. A total of 475 children enrolled in this longitudinal study (322 autism spectrum disorder and 153 typical development groups) were evaluated at up to three time points between 2 and 12 years of age. Nine common gastrointestinal symptoms and formal medical gastrointestinal diagnosis were assessed using a physician-administered parent interview. A rigorous symptom classification was performed by physicians via clinical consensus. The frequency and persistence of gastrointestinal symptoms across childhood were compared between groups. Associations between gastrointestinal symptoms and measures of internalizing and externalizing behaviors, sleep problems, sensory problems, restricted and repetitive behaviors, and social communication were also evaluated. Children with autism presented with more gastrointestinal symptoms at each time point, and they were also more likely to experience multiple and persistent gastrointestinal symptoms. The presence and number of gastrointestinal symptoms were associated with greater impairment in internalizing behaviors, sleep, communication, sensory processing, and repetitive behaviors. Participants in the autism spectrum disorder group reported more gastrointestinal symptoms without known etiology throughout childhood in this longitudinal well-characterized sample.Lay AbstractChildren with autism have been found to experience more medical issues including gastrointestinal symptoms. In this study, participants in the autism group were more likely to experience gastrointestinal symptoms than their typically developing peers. They were also more likely to experience multiple gastrointestinal symptoms at the same time and more likely to have persistent gastrointestinal symptoms throughout their childhood. Increased gastrointestinal symptoms were associated with more challenges with sleep, communication, sensory processing, and repetitive behaviors. Clinicians and parents should become more aware of the high occurrence of gastrointestinal problems in children with autism. If identified, these symptoms are often treatable which may improve their well-being.