Gastrointestinal Problems in Asperger’s Children

“Is there a correlation between gastrointestinal issues and Asperger Syndrome? Our son seems to be very sensitive to certain foods, especially bread and milk (they cause him to cramp).”

The relationship between gastrointestinal problems and Asperger’s (high functioning autism) is unclear, because most studies have not examined representative groups of kids with Asperger’s compared with appropriate controls. Surveys published in the gastroenterology literature have stated that gastrointestinal problems (e.g., constipation, diarrhea) occur in 46% to 85% of Asperger’s kids. Lower rates in the range of 17% to 24% have been reported in other population-based studies.

One case-control study in the United Kingdom found that only 9% of young people with Asperger’s had a history of gastrointestinal complaints. Conversely, in one cross-sectional study that used structured interviews and matched control groups, a lifetime history of gastrointestinal symptoms (e.g., abnormal stool pattern, frequent constipation, frequent vomiting, frequent abdominal pain, etc.) was found in 70% of Asperger’s kids compared with 42% of the kids with other developmental disabilities and 28% of the kids without developmental disabilities.

In young people with Asperger’s undergoing endoscopy, colitis, duodenitis, gastritis, high rates of lymphoid nodular hyperplasia, and histologically subtle esophagitis have been described. Evidence suggests that some immunohistochemical features may be unique to inflammation associated with Asperger’s.

The existing literature does not support routine specialized gastroenterological testing for asymptomatic “Aspies.” However, if a youngster on the autism spectrum presents with symptoms (e.g., chronic or recurrent abdominal pain, vomiting, diarrhea, constipation, etc.), it is reasonable to evaluate the gastrointestinal tract.

Gastrointestinal discomfort also should be considered in a youngster who presents with a change in behavior (e.g., outbursts of aggression, meltdowns, self-injury, etc.). Radiographic evidence of constipation has been found to be more common in young people with Asperger’s than in controls with abdominal pain (36% vs 10%).

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