Digestive system disorders are among the most common co-morbidities associated with autism. These problems range from chronic constipation and diarrhea to gastrointestinal pain and inflammation. They can be encountered by a person at any age. However, in the context of autism, these disorders are most well-studied in children.
For example, the U.S. Centers for Disease Control and Prevention recently found that children with autism are more than 3.5 times more likely to have chronic diarrhea or constipation than their neurotypical peers. Other researchers have found a consistent association between digestive symptoms and the severity of autism in children.
Symptoms of digestive disorders
While some digestive symptoms may be obvious, others may be difficult to detect in a young child or in a child who cannot describe his or her own sensations. Symptoms of digestive problems may include:
- constipation;
- diarrhea;
- gas;
- abdominal pain;
- pain during defecation;
- nausea and vomiting.
Why digestive symptoms are so common in children with autism
There is no definite answer as to why digestive symptoms are so common in autism. However, there are several possible explanations. For example:
- At least one study has shown that the gut bacteria of autistic people are different from the gut bacteria of people with typical development. Studies suggest a link between the gut and brain development.
- One study found that neurotypical siblings of autistic children are also more likely to have digestive problems. Perhaps these problems are determined by some hereditary factors that are also linked to autism.
- Autistic children are much more likely to suffer from anxiety than their neurotypical peers. In addition, anxiety disorders such as obsessive-compulsive disorder are much more common in autistic people than in the general population. Increased anxiety can cause many digestive problems.
- Many autistic children are extremely picky eaters, and many have allergies or food intolerances. This can lead to a variety of digestive disorders.
The role of the gut microbiome in digestive problems in autism
A growing body of research confirms that the gut microbiome plays a key role in digestive health and may influence the manifestations of autism. Autistic children often have abnormalities in the composition of their gut microflora – a reduced diversity of bacteria, and increased numbers of certain strains that promote inflammation and digestive problems. This can lead to increased intestinal permeability (called “leaky gut syndrome”), which in turn is associated with inflammation, impaired nutrient absorption, and even behavioral changes. Some studies suggest that correcting the microbiome, such as with probiotics, prebiotics, or fecal transplantation, may help improve digestive function and overall child health. However, this approach requires further study and should be supervised by specialists.
Treatment of digestive disorders in children with autism
Since the causes and severity of digestive problems vary, the treatment methods can also be very different. In some cases, a mild laxative will solve the problem. In other cases, dietary changes or further tests are needed.
1. Stress reduction
In some children, stress can be the cause of a variety of problems, including digestive disorders. Children with autism may find it difficult to express their stress or understand its cause.
While you are looking for physical problems, it is advisable to try to reduce the stressors in your child’s life. Some of these factors may not be obvious to you, so it would not be unreasonable to talk to the child’s teachers or therapists. Common causes of stress include:
- Negative experiences with peers, including bullying;
- Difficulties with academic tasks (many children with autism have learning difficulties);
- Changes in daily routines (many children with autism have difficulty tolerating change);
- Sensory issues, e.g. a child may be very stressed by a loud bell at school, artificial lighting or the smell of a new carpet;
- Significant life changes, such as a change of school, a new baby, divorce or death in the family.
2. Therapies for selective eating
For many reasons, children with autism can have extreme forms of food selectivity. Often this is due to sensory issues and a desire for monotony. Whatever the cause, food selectivity (especially if the child refuses any fruits and vegetables) can lead to digestive problems such as constipation or gas. There are different approaches to correct selective eating, but in practice they are rarely appropriate for children with autism. To correct this problem in autism, the help of a behavioral therapist who specializes in eating behavior is needed.
3. Diagnosis and treatment of food intolerances and allergies
Allergies or food intolerances can lead to a variety of digestive disorders in anyone, regardless of the presence of autism. If your child has digestive problems that do not respond to standard treatment, it is possible that he or she has a food intolerance that has not yet been diagnosed. Your pediatrician may refer you to an allergist, but while true allergies can be detected with a test, food intolerances can be difficult to diagnose.
Often in these cases, parents will begin to manipulate their child’s diet on their own using various diets from the Internet, such as trying a keto or gluten- and casein-free diet. If the child has an unspecified allergy or intolerance to some substances, such as dairy products, the diet may lead to improvements. However, if there are no allergies or intolerances, there is also no reason to believe that diet will eliminate digestive symptoms.
Perhaps the best approach is to work directly with a dietitian, who can help identify the foods that are causing digestive problems, as well as evaluate the results of dietary changes. Working with a dietitian also has other benefits:
- Dietitians can adjust the child’s diet to avoid nutrient deficiencies;
- They can help you find new food options for your child;
- They can help you and other professionals properly evaluate the results of dietary changes;
- Dietitians can help you support long-term nutrition changes.
Conclusion
Digestive problems are common among children with autism and can significantly impact their overall well-being and behavior. Although the exact mechanisms of this relationship are not fully understood, research points to the role of the gut microbiome, anxiety, sensory features, and food selectivity. Understanding these factors allows parents and professionals to find more effective approaches to diagnosis and treatment. A comprehensive approach that includes working with a gastroenterologist, dietitian, behavioral therapist, and other specialists can help improve a child’s quality of life and alleviate digestive-related symptoms.
