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Constipation outcomes in children with and without autism spectrum disorder: Insights from a tertiary motility

Umair Khalid1, Rishi Bolia1,2, Joshua Bunt3

  • 1Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children's Hospital, Brisbane, Queensland, Australia.

Journal of Pediatric Gastroenterology and Nutrition
|July 7, 2026
PubMed

Insights

Children with autism spectrum disorder (ASD) have worse constipation outcomes and lower treatment adherence than peers without ASD. Autism severity did not significantly impact constipation prognosis in this study.

Area of Science:

  • Pediatric Gastroenterology
  • Neurodevelopmental Disorders
  • Clinical Outcomes Research

Background:

  • Autism spectrum disorder (ASD) frequently co-occurs with chronic constipation, posing a significant clinical challenge.
  • Limited comparative data exists on constipation management and outcomes in children with and without ASD, or across ASD severity levels.

Purpose of the Study:

  • To compare constipation outcomes at 1-year and last follow-up between children with and without ASD.
  • To evaluate the influence of ASD severity on constipation prognosis.

Main Methods:

  • Retrospective analysis of 196 children with chronic constipation managed in a tertiary motility service.
  • Extracted data included demographics, comorbidities, adherence, interventions, and outcomes.
  • Subgroup analyses assessed outcomes across ASD severity levels; statistical comparisons used Chi-square, Mann-Whitney U, and Kruskal-Wallis tests (p < 0.05).

Main Results:

  • The ASD cohort (n=74) showed higher male prevalence, lower medication adherence (56.8% vs. 76.2%), and poorer constipation resolution (11% vs. 25%) compared to the non-ASD group (n=122).
  • Attention deficit hyperactivity disorder (ADHD) was significantly more prevalent in the ASD group (50% vs. 13.9%).
  • Constipation outcomes and compliance were generally similar across ASD severity levels, with lowest toileting compliance noted in Level 3.

Conclusions:

  • Children with ASD experience poorer constipation resolution and lower treatment adherence compared to non-ASD children.
  • ASD severity did not significantly alter constipation outcomes, suggesting a need for tailored interventions.
  • Multidisciplinary strategies are essential to improve adherence and optimize outcomes for children with ASD and chronic constipation.
Abstract

Keywords:
functional constipationpaediatric neurogastroenterology and motilitytreatment adherence

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