Many parents of autistic children have to deal with dietary issues and gastrointestinal problems in their offspring. Immune system issues have been thought to be a trigger for autism since the 1950s. Many researchers believe that gluten and lactose intolerance and other food allergies and sensitivities may be causal factors in the incidence of autism, and the controversial Dr. Andrew Wakefield has suggested that childhood vaccines are at the heart of such allergies and sensitivities.
Constipation is common in children altogether, report the authors of the 2003 study "Constipation with Acquired Megarectum in Children with Autism." Autistic children may experience more severe constipation due to their inability to communicate their discomfort at its outset and because of other behavioral aspects of the disorder.
Not Enough Valid Studies
In a 2006 article written for the "Autism Society," Dr. Tim Buie explains that there is no clear evidence for the idea that children with autism experience gastrointestinal disturbances at a greater rate or in a different way than the normal population. Most of the studies that have found increased constipation, gastrointestinal problems and dietary links in autistic children remain uncorroborated by other researchers. Most of these studies are anecdotal rather than long-term clinical studies, they haven't been compared with mainstream population statistics or they focus on gastrointestinal problems as the cause rather than a symptom of autism.
A Recent Comparative Study
In August of 2009, a study done by S.H. Ibrahim et al. did address some of these research issues. "U.S. News and World Report" writes that the researchers followed both autistic children and non-autistic children for 18 years, noting gastrointestinal problems. The study authors found very little difference in the frequency of problems like diarrhea and gastric reflux between children with autism and those without. They did find a higher percentage of constipation in autistic children but feeding issues like ritualistic eating and picky eating was higher in children with autism as well.
Issues Affecting Diagnosis
Dr. Buie explains that children with autism suffer from language deficits that may prevent early treatment of gastrointestinal problems and that their behavioral issues may not be interpreted as stemming from their pain and discomfort. Many autistic children that do need treatment do not present with strong symptoms of gastrointestinal disturbances, Buie reports, and the diversity of autistic symptoms can also interfere with a doctor's ability to diagnose constipation and other gastro-intestinal problems.
Other Complicating Issues
Autistic children often have very narrow food preferences that can contribute to constipation. It is this kind of increased incidence of picky eating in children with autism that could account for the higher levels of constipation, Ibrahim and his colleagues found. Autistic children may not get enough fiber.
Medications can also play a role. The stimulant medications that autistic children take can affect appetite, digestion or influence food issues, Ibrahim reported.
References
- "Pediatrics"; Constipation with Acquired Megarectum in Children with Autism; Nadem Afzal et al.; October 1, 2003
- "Autism Society"; Gastrointestinal Illness in Autism: An Interview with Tim Buie, M.D.; Kulani MaHikoa; 2006
- "Psychology Today"; Autism and Gastrointestinal Problems: Which Article D'You Read?; Jean Mercer, Ph.D.; February 22, 2010
- "U.S. News and World Report"; With Autism, Diet Restrictions May Do More Harm Than Good; Amanda Gardner; July 27, 2009
