Bowel Symptoms in Children with Autism

Giuliana Antolovich, PhD, FRACP, MBBS, Janet E Walstab, Anne Marie McVeigh-Dowd, and Catherine Marraffa. Developmental Medicine, Royal Children's Hospital, Flemington Rd, Parkville 3052, Australia

Background: It is reported that children with autism have high rates of gut symptoms, resulting in the use of a range of therapies to modify gut function.

Objectives: To determine how often gut symptoms occur in children in a community based sample of children with autism (ASD), children with other developmental disabilities excluding children with a motor disability (DD) and typically developing children (TD).

Methods: Data was collected by parent completed questionnaire.  Children (n=134) aged four to six years were recruited from kindergartens and early intervention programs.  Results were analysed using SPSS 15.0 and Stata 10.

Results: There were no differences between the three groups demographically, or for measures of general health, uptake of immunizations, and use of complementary therapies. Report of allergy or food intolerance was common in children with ASD (ASD 47.5%, DD 33.3%, TD 13.5%, p < 0.001), and were more likely to have had dietary manipulation (ASD 44.4%, DD 18.2%, TD 15.6%, p <0.001). Chewing or swallowing difficulties, vomiting, abdominal bloating, abdominal pain and diarrhoea were more commonly reported in the ASD and DD groups.  High rates of constipation were reported in all three groups (ASD 80.0%, DD 50.0%, TD 53.8%, p = 0.012).  A large proportion of children with ASD (57.8%) and DD (44.1%) had seen a medical doctor for the management of bowel symptoms (cf. TD 13.2%, p<0.001). Almost half of the parents of children with autism felt their child’s bowel habit was not typical of other children of a similar age (ASD 44.4%, DD 19.2%, TD 5.1%, p<0.001).

Conclusions: Children with developmental disability have higher reported rates of gut symptoms and gut related problems. This raises the possibility that gut related symptoms in children with autism may be a function of their underlying developmental disability, rather than being directly related to their diagnosis of autism.