RESEARCH ARTICLE

Gastrointestinal Dysfunction in Autism: Parental Report, Clinical Evaluation, and Associated Factors

  1. Phillip Gorrindo1,*,
  2. Kent C. Williams2,
  3. Evon B. Lee2,3,
  4. Lynn S. Walker2,
  5. Susan G. McGrew2,
  6. Pat Levitt4,*

Article first published online: 9 JAN 2012

DOI: 10.1002/aur.237

Issue

Autism Research

Autism Research

Volume 5, Issue 2, pages 101–108, April 2012

Additional Information

How to Cite

Autism Res2011.

Author Information

  1. 1

    Medical-Scientist Training Program, Vanderbilt University, Nashville, TN, USA

  2. 2

    Department of Pediatrics, Vanderbilt University, Nashville, TN, USA

  3. 3

    Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University Medical Center, Nashville, TN, USA

  4. 4

    Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

*Address for correspondence and reprints: Phillip Gorrindo or Pat Levitt, Zilkha Neurogenetic Institute, 1501 San Pablo Street, Los Angeles, CA 90089. E-mail: phillip.gorrindo@vanderbilt.edu, plevitt@usc.edu

Publication History

  1. Issue published online: 17 APR 2012
  2. Article first published online: 9 JAN 2012
  3. Manuscript Accepted: 3 NOV 2011
  4. Manuscript Received: 22 JUN 2011

Funded by

  • National Institutes of Health/National Institute of Child Health and Human Development. Grant Numbers: R21HD065289, R01HD23264
  • National Institutes of Health/National Institute of General Medical Sciences. Grant Number: T32GM07347
  • National Institutes of Health/National Center for Research Resources. Grant Numbers: TL1RR024978, UL1RR024975
  • Marino Autism Research Institute

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Keywords:

  • autism;
  • constipation;
  • diet;
  • functional gastrointestinal disorders;
  • nonverbal communication;
  • social behavior

The objectives of this study were to characterize gastrointestinal dysfunction (GID) in autism spectrum disorder (ASD), to examine parental reports of GID relative to evaluations by pediatric gastroenterologists, and to explore factors associated with GID in ASD. One hundred twenty-one children were recruited into three groups: co-occurring ASD and GID, ASD without GID, and GID without ASD. A pediatric gastroenterologist evaluated both GID groups. Parents in all three groups completed questionnaires about their child's behavior and GI symptoms, and a dietary journal. Functional constipation was the most common type of GID in children with ASD (85.0%). Parental report of any GID was highly concordant with a clinical diagnosis of any GID (92.1%). Presence of GID in children with ASD was not associated with distinct dietary habits or medication status. Odds of constipation were associated with younger age, increased social impairment, and lack of expressive language (adjusted odds ratio in nonverbal children: 11.98, 95% confidence interval 2.54–56.57). This study validates parental concerns for GID in children with ASD, as parents were sensitive to the existence, although not necessarily the nature, of GID. The strong association between constipation and language impairment highlights the need for vigilance by health-care providers to detect and treat GID in children with ASD. Medications and diet, commonly thought to contribute to GID in ASD, were not associated with GID status. These findings are consistent with a hypothesis that GID in ASD represents pleiotropic expression of genetic risk factors.

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