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Children with autism spectrum disorder and alterations in eating behavior: could it be gastroesophageal reflux

Christine Audet de Almeida1, Eduardo Sampaio Siqueira2, Marcelo do Rego Maciel Souto Maior3

  • 1Universidade Federal de Pernambuco (UFPE), Hospital das Clinicas, Recife, PE, Brazil; Pós Graduação em Saúde da Criança e do Adolescente da Universidade Federal de Pernambuco, PE, Brazil.

Jornal De Pediatria
|December 7, 2025
PubMed

Insights

Children with autism spectrum disorder (ASD) and eating behavior (EB) alterations frequently show gastroesophageal reflux disease (GERD) warning signs. Esophagitis cases confirm the need for upper GI endoscopy in these children.

Area of Science:

  • Pediatric Gastroenterology
  • Neurodevelopmental Disorders

Background:

  • Autism spectrum disorder (ASD) is associated with eating behavior (EB) alterations.
  • Gastroesophageal reflux disease (GERD) is common in children, and its symptoms can be exacerbated by EB issues.

Purpose of the Study:

  • To investigate the prevalence of GERD warning signs and esophagitis in children with ASD and EB alterations.

Main Methods:

  • A descriptive study included 115 children (3-12 years) diagnosed with ASD.
  • BRCA-TEA and 17-ATN-GISSI instruments identified EB alterations and GERD warning signs.
  • Medical consultations and upper gastrointestinal (GI) endoscopy with biopsies were used to diagnose esophagitis.

Main Results:

  • 60% of children with ASD had EB alterations, and 89.8% of them showed GERD warning signs.
  • 18 children were suspected of having esophagitis, indicating a need for endoscopy.
  • Of 8 children who underwent endoscopy, 3 were diagnosed with esophagitis (erosive and eosinophilic).

Conclusions:

  • Children with ASD exhibit a high frequency of EB alterations, often accompanied by GERD warning signs.
  • Esophagitis is a potential organic complication in this population.
  • Upper GI endoscopy with biopsies is crucial for diagnosing esophagitis in children with ASD and EB alterations.
Abstract

Keywords:
AutismAutism spectrum disorderChildEating behaviorGastroesophageal reflux disease

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