A new study adds to evidence that gastrointestinal (GI) symptoms are common in children with autism spectrum disorders (ASD) and can contribute to behavior, sleep, and attention problems.

gastro, gut brain, microbiome

Bibiana Restrepo and colleagues evaluated 255 children with ASD (184 males and 71 females) between 2 and 3.5 years of age, comparing them to 129 age-matched neurotypical controls. Pediatricians gave each child a medical examination, took a medical history, and interviewed caregivers to identify any GI problems the children were experiencing, such as abdominal pain, gas/ bloating, diarrhea, constipation, pain when having a bowel movement, vomiting, difficulty swallowing, or the presence of blood in stool or vomit.

Nearly 48% of children with ASD were reported by caregivers to have GI problems, compared to fewer than 18% of controls. Approximately 30% of children with ASD experienced multiple GI symptoms, compared to approximately 5% of controls.

GI symptoms were equally common in boys and girls in both the ASD group and neurotypical controls, and there were no differences in developmental or adaptive measures associated with GI symptoms within either group. However, GI symptoms were associated with behavior, sleep, and attention problems both in children with ASD and in controls (although the behaviors were significantly more severe in the group with ASD). In the ASD group, an increased number of GI symptoms was associated with physical pains, shorter sleep, an increase in self-injurious behaviors, and an increase in parasomnias (abnormal movements, behaviors, or emotions during sleep).

The researchers say, “Our results contribute to a growing body of evidence suggesting that the presence of somatic complaints, behavioral and sleep problems may be triggered or worsened by coexisting medical issues such as GI discomfort.” They add, “Compared to the large number of parents of young children with ASD reporting GI symptoms, only a small subset of participants [had] a formal diagnosis suggesting that a large proportion of young children with GI symptoms are not being recognized and treated.”

“Developmental-behavioral profiles in children with autism spectrum disorder and co-occurring gastrointestinal symptoms,” Bibiana Restrepo, Kathleen Angkustsiri, Sandra L. Taylor, Sally J. Rogers, Jacqueline Cabral, Brianna Heath. Alexa Hechtman, Marjorie Solomon, Paul Ashwood, David G. Amaral, and Christine Wu Nordahl, Autism Research, August 6, 2020 (free online). Address: Bibiana Restrepo, Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of California at Davis School of Medicine, Sacramento, CA 95817, bmrestrepo@ ucdavis.edu.

This article also appears in Vol. 34, No. 3, 2020, of Autism Research Review International