GI distress may be root of some emotional disorders in autistic children, study notes

24 Oct 2018 --- Gastrointestinal (GI) distress could be the source of anger, aggression and other troubling behavioral problems in children with autism, although they are often treated as physiological issues, a study published Journal of Autism and Developmental Disorders has found. GI disorders are four times more common in children with autism than in the general pediatric population.

It can be difficult for parents and primary care providers to detect GI disorders in children with autism as many of them are non-verbal, and due to sensory processing impairments in autism, even some verbal children cannot pinpoint the location of their discomfort.

“Gastrointestinal problems can be painful and disabling, and they can have profound effects on a child's behavior,” says Kara Gross Margolis, MD, Associate Professor of Pediatrics at Columbia University Vagelos College of Physicians and Surgeons, who has treated GI disorders in numerous children with autism.

In the study, 131 parents and children with autism were presented with 35 questions designed to assess visible signs of three common GI conditions: constipation, diarrhea and reflux disease. Such signs include gagging during meals, applying pressure to the abdomen and arching the back.

The researchers then asked pediatric gastroenterologists, who were unaware of the parents' answers, to evaluate the children.

Based on these data, the researchers identified 17 items most likely to identify these common gastrointestinal problems. These 17 items were able to identify 84 percent of children with GI disorders correctly.

Although one-third of the children who screened positive for a GI disorder didn't have one, “for a screening device, this false-positive rate seems acceptable to us,” Margolis says, “given that the test correctly identified over 80 percent of the participants who had GI problems.”

The screening questionnaire needs to be validated in an independent group of children before it can be used reliably by parents and primary care providers as a reliable tool. Further studies are underway at CUIMC.