Gastrointestinal dysfunction in autism: parental report, clinical evaluation, and associated factors

The severity of gastrointestinal symptoms correlates with the severity of ASD.

“Moreover, the severity of these symptoms correlates with the severity of ASD [101,102].”

Food selectivity resulting in imbalances in diet composition may be a factor contributing to GI problems, at least in a proportion of individuals with ASD.

“Food selectivity resulting in imbalances in the diet composition may be a factor contributing to GI problems, at least in a proportion of individuals with ASD [12].”

Parental report of a GI disorder displayed high concordance with clinical diagnosis by a medical professional.

“However, according to a study [12], parental report of a GI disorder displayed a high concordance with the clinical diagnosis by a medical professional.”

Fecal microbiome profiles are most divergent in ASD subjects with GI dysfunction.

“Fecal microbiome profiles are most divergent in ASD subjects with GI dysfunction, a common comorbidity of autism (Chaidez et al., 2014; Gorrindo et al., 2012).”

Constipation has been previously recognized as a significant comorbidity in ASD children.

“Constipation has been previously recognized as a significant comorbidity in ASD children [28–31].”

Previous studies assessing GI symptoms in ASD versus NT children suffer from methodological differences in assessing GI symptoms.

“Review of previous studies suggest that GI symptoms are more common in ASD children than in NT children, but these studies suffer from methodological differences in assessing GI symptoms [28–31].”

GI symptoms are more common in ASD children than in NT children.

“Review of previous studies suggest that GI symptoms are more common in ASD children than in NT children, but these studies suffer from methodological differences in assessing GI symptoms [28–31].”

Most occurrences of GI dysfunction in children with ASD are the result of functional causes, rather than being of anatomic or known physiologic origin.

“Most occurrences of GI dysfunction in children with ASD are the result of functional causes, rather than being of anatomic or known physiologic origin.1, 3, 6”

A variety of GI issues commonly occur in ASD, including lower GI symptoms (constipation, diarrhea) and upper GI symptoms (nausea and vomiting, stomach aches and pains).

“A variety of gastrointestinal (GI) issues commonly occur in ASD, including lower GI symptoms (i.e., constipation, diarrhea) and upper GI symptoms (i.e., nausea and vomiting, stomach aches and pains) (2–10), but the etiology is poorly understood.”

The prevalence of gastrointestinal symptoms in ASD varies from 23% to 70%.

“Although the connection between gastrointestinal problems and autism is still not resolved and the prevalence of gastrointestinal symptoms varies from 23 to 70% [31,125,126,127,128,129].”

The QPGS-RIII has been used to assess GI dysfunction in ASD with clinician-parent agreement at 92.1% for presence of any QPGS-RIII disorder, and fair agreement for functional constipation.

“The QPGS-RIII has been used to assess GI dysfunction in ASD with clinician-parent agreement at 92.1% for presence of any QPGS-RIII disorder, and fair agreement for functional constipation (Gorrindo et al., 2012).”

Constipation is the primary GI comorbidity with ASD, and the odds of constipation increase with greater social impairment and less verbal ability.

“Other studies have reported constipation as the primary GI comorbidity with ASD, where the odds of constipation increase with greater social impairment and less verbal ability 15.”

GI diagnoses were made based on parent report using the QPGS, which a previous study showed is predictive but underestimates constipation diagnosed by a gastroenterologist.

“First, GI diagnoses were made based on parent report using the QPGS, which a previous study showed is predictive but underestimates constipation diagnosed by a gastroenterologist (Gorrindo et al. 2012).”

In ASD, there is a correlation between the degree of social impairment and the likelihood of constipation.

“studies have demonstrated a correlation between the degree of social impairment and the likelihood of constipation [8].”