Gastrointestinal involvement of autism spectrum disorder: focus on gut microbiota
Abstract
Introduction Autism spectrum disorder (ASD) is a neurodevelopmental disorder typical of early age, characterized by impaired communication, social interaction, and repetitive behaviors. ASD patients frequently suffer from gastrointestinal (GI) symptoms. Neuro-psychological functions, intestinal homeostasis, and functional GI disturbances are modulated by the gut microbiota through the so-called ‘microbiota-gut-brain axis’.Areas covered Literature regarding GI symptoms among the ASD community as well as the involvement and modulation of the gut microbiota in GI disturbances of ASD patients was searched. Constipation, diarrhea, reflux, abdominal bloating, pain, and discomfort are reported with variable prevalence. ASD is characterized by a reduction of Bacteroidetes/Firmicutes, of the abundance of Bacteroidetes and other imbalances. ASD patients with GI symptoms present microbial changes with plausible relation with deficiency of digestive enzymes, carbohydrate malabsorption, selective eating, bacterial toxins, serotonin metabolism, and inflammation. The strategies to mitigate the GI distress through the gut microbiota modulation comprise antimicrobials, probiotics, prebiotics, fecal microbiota transplantation, and dietary intervention.Expert opinion The modulation of the gut microbiota in ASD individuals with GI disturbances seems a promising target for the future medicine. A standardization of the research strategies for large-scale studies together with a focus on poorly explored fields is necessary to strengthen this hypothesis.
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A decrease in the abundance of Eubacterium and Enterococcus populations within the gastrointestinal tracts of patients diagnosed with ASD has been observed compared to healthy populations.
“Furthermore, a decrease in the abundance of Eubacterium and Enterococcus populations within the gastrointestinal tracts of patients diagnosed with ASD has been observed when compared to healthy populations [52,107,109].”
From The Gut–Brain–Microbiota Connection and Its Role in Autism Spectrum Disorders (2025) · cites this paper as [109]
Ristori et al. revealed that individuals diagnosed with ASD exhibited a reduced population of bacteria from the Ruminococcus genus, while numerous studies have demonstrated that the population of these bacteria could be augmented.
“Ristori et al. revealed that individuals diagnosed with ASD exhibited a reduced population of bacteria from the Ruminococcus genus; however, numerous studies have demonstrated that the population of these bacteria could be augmented [101,107,109,110].”
From The Gut–Brain–Microbiota Connection and Its Role in Autism Spectrum Disorders (2025) · cites this paper as [109]
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- Authors
- Settanni, C. R., Bibbò, S., Ianiro, G., Rinninella, E., Cintoni, M., Mele, M. C., Cammarota, G., & Gasbarrini, A.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- Agostino Gemelli University Polyclinic (IT)
- University of Rome Tor Vergata (IT)
- Corresponding author
- Gasbarrini, Antonio
- ORCID
- Venue
- Expert Review of Gastroenterology & Hepatology
- Publisher
- Informa UK Limited
- Published
- 2021-01-05
- Volume
- 15
- Issue
- 6
- Pages
- 599-622
- ISSN
- 1747-4124 (ISSN-L)
- 1747-4132
- OpenAlex
- W3117358445
- Cited by
- 98
- References
- 161
- Citations by year
- 2026: 16 · 2025: 16 · 2024: 24 · 2023: 18 · 2022: 16 · 2021: 7
- FWCI
- 0.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Review of Gastroenterology & Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- autism spectrum disorder, gastrointestinal symptoms, gut microbiota, microbiota-gut-brain axis, constipation, diarrhea, gastroesophageal reflux, bloating, Firmicutes/Bacteroidetes ratio, carbohydrate malabsorption, picky eating, serotonin metabolism, inflammation, probiotics, prebiotics, fecal microbiota transplantation, dietary intervention, dysbiosis
- MeSH terms
- Autism Spectrum Disorder, Gastrointestinal Microbiome, Fecal Microbiota Transplantation, Anti-Bacterial Agents, Combined Modality Therapy, Diet Therapy, Gastrointestinal Diseases, Humans, Probiotics, Prebiotics
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