How are GI Disorders and Autism Linked?

For many, gastrointestinal (GI) disorders and autism symptoms go hand in hand. The chances of GI symptoms in autistic kids are four times more common than for non-autistic children, as per a Journal of Pediatrics report, which also demonstrated greater levels of gastrointestinal issues in all four core areas viz general digestive issues, constipation, diarrhea, and abdominal pain.

Below, we discuss GI disorder overlap with autism, common signs that suggest your child may be having both GI issues and autism, the correlation between autism and GI symptoms, as well as simple yet practical strategies you can implement to help. 

GI Disorder Overlap with Autism

The medical community still doesn’t know what causes autism, leaving parents, caregivers, and families frustrated and guessing answers. Common explanations often fall short for families desperate for assistance and support. 

This neurodevelopmental condition, which is marked by impairments in social communication and often comes with restricted interests and repetitive behaviors, has numerous unanswered questions and the reasons are still not well understood.

Although autism mainly impacts the brain, links to other body systems have recently been demonstrated. Gastrointestinal disorders with autism have, in particular, been shown to be directly related and GI seems to affect autistic people more predominantly than neurotypical people with gastrointestinal disorders like diarrhea, constipation, and bloating being frequently experienced by autistic kids compared to neurotypical children. 

Experts also say that individuals with autism and GI disorders are also more likely to experience more severe symptoms of autism and managing the GI symptoms often helps reduce the behavioral and social difficulties associated with the autism spectrum. To help you create a feeding plan for addressing gastrointestinal disorders with autism, we recommend talking to a professional nutritionist. 

Some people opt to eliminate casein and gluten from their regular diets in order to alleviate symptoms related to both autism and GI disorders, but it’s critical to replace these food items with more nutritious ones  such as fresh fruits and vegetables. Otherwise, you may supplement their diet with an evidence-based supplement, though it’s more important to maintain a balanced diet, which often requires the assistance of a nutritionist. 

What Causes GI Disorders in Autism?

The medical world is yet to understand the reason why GI issues are so prevalent in autism or why the two conditions co-occur and their symptoms overlap. Some studies have suggested that particular genetic changes that occur in some individuals on the autism spectrum also have an impact on the GI system, but there might also be a certain sensory element involved. Many individuals with autism are very sensitive to sensory input, such as sights, sounds, smells, or touch, so they might experience more severe GI symptoms than others. 

Studies have also demonstrated that several other factors are associated with greater prevalence rates of psychiatric issues in children, teens, and adults, including having:

• More signs and symptoms of autism
• More difficulties with basic daily living skills like feeding themselves or brushing the teeth 
• A low disposable household income

Researchers recommend noting GI-related issues in autistic children because these complaints can help mental health practitioners like doctors, psychiatrists, and psychologists to address behavioral issues for which the individual may be seeking help.

Understanding the Link Between Autism and GI Issues 

Mental health providers usually identify the autism spectrum as a neurodevelopmental condition depending on academic and behavioral impairments observed in children and young people but affected individuals are also vulnerable to the following digestive or gastrointestinal (GI) problems

• Esophagitis
• Stomach acid reflux disorder 
• Gastritis
• Colitis
• Celiac illness
• Crohn’s illness.

Additionally, studies show that 23 percent of 340 children with autism felt queasy and 23 percent of autistic children had diarrhea while 65 percent of the reported experienced constipation. That means autistic individuals are more vulnerable to symptoms of many other digestive or gastrointestinal issues, including but not limited to

• Flatulence
• Nausea 
• Reflux
• Frequent belching
• Bloating
• Diarrhea
• Abdominal pain

Seeking the assistance of a qualified medical practitioner is essential to address, manage, and treat GI symptoms and autism-related symptoms. Prescription and OTC medications often aid in the treatment of bloating and the discomfort associated with GI disorders.

Signs that Suggest Your Child May be Experiencing Autism Alongside GI issues 

It’s critical to understand how GI disorders affect one’s behavior. Research shows that autistic children with upper gastrointestinal problems often engage in aggressive behaviors, with nausea contributing to violent outbursts.

Autistic children, preteens and teens aged between 6 and 18 years old who experience anxiety are also more likely to experience lower abdominal pain, diarrhea, or constipation. 

Numerous studies investigate the frequency of GI issues and their impact on autism symptoms. Researchers found that bloating, flatulence, stomach pain, diarrhea, constipation, and discomfort during bowel movements are linked to increased hyperactivity, stereotypy, social withdrawal, and irritability in autistic individuals.

People with autism who might be unable to express themselves or small kids who struggle to compose coherent sentences or who might be unable to talk at all might be unable to communicate their pain and discomfort. 

In such cases where children and young people have gastrointestinal issues, but are unable to communicate their feelings, look out for these signs and symptoms: 

• Excessive or frequent coughing
• Rubbing the chin or face 
• Putting a lot of pressure on the belly

Before the diagnosis of any GI disorder, individuals experiencing it may display symptoms such as

• Irritability
• Aggressiveness
• Trouble sleeping
• Hyperactivity
• Inattentiveness
• Eating issues like food aversion or rejection

Even if an individual is getting proper treatment for behavioral issues, determining the underlying causes of the problem behaviors might show they are distressed and need medical attention.

Behavior as a Sign of Gastrointestinal Distress

Parents and caregivers should watch out for all sorts of behaviors as a way of communication and often that communication is about discomfort or pain. 

Aggression or self-harming behaviors are not part of the diagnostic criteria for autism, but when these behaviors occur, it’s critical to figure out whether they suggest that an adult with autism is in distress. Gastrointestinal issues often cause the kind of pain that can result in problem behaviors (or increased frequency of behaviors) that are characteristics of autism.

Good examples of traits or behaviors that could suggest pain in autistic people include

• Mouthing and self-biting behavior
• Chewing paper, clothes (e.g. sleeves), and other items 
• Ingesting pica or non-food items
• Aggression toward others 
• Rubbing one’s abdomen against tables and other types of furniture
• Scratching or rubbing the throat or neck area 
• Bolting or escaping 
• An increase in vocalizations or repetitive behaviors 

Parents, caregivers, or autistic adults should track when, where, and how often these problem behaviors occur. They can then discuss this information with a gastroenterologist to ensure an accurate diagnosis. If gastrointestinal distress is identified as the cause, treating the GI issue often leads to significant improvement in the behavior.

But remember, GI distress is not always to blame; mental health problems like anxiety, dental issues, and other forms of physical distress can also lead to GI-like symptoms, so it’s important to discuss each of these potential causes with a qualified medical practitioner who can then refer the patient to an expert or team of specialists. 

Common Gastrointestinal Disorders That Co-Occur with Autism

Behavioral problems in children, teens, and adults with autism might also be signs and symptoms of GI issues. Autistic individuals are more prone to gastrointestinal distress than neurotypical individuals, but they can be particularly hard to identify and treat because of communication difficulties.

GI disorders can cause mild or severe symptoms, ranging from mild discomfort to serious and persistent vomiting, but there’s no single criteria for identifying or treating all patients with autism and gastrointestinal disorders. 

The most common GI conditions that autistic people are more likely to experience are

• Abdominal pain
• Constipation
• Diarrhea 
• GERD and/or acid reflux

An individual’s capability to absorb nutrients from either food or food supplements actually depends on the GI condition that the individual is suffering from. Gastrointestinal problems are prevalent in autistic children and they include constipation, stomachache, acid reflux, irregular bowel movements, and food malabsorption and revulsions. 

Some GI issues do not have much impact on an individual’s nutrient absorption or their ability to benefit from those nutrients, but other gastrointestinal problems have a profound impact.

Related problems that can have huge impact on an individual’s nutritional status are

• Lactose intolerance
• A casein-free or gluten-free diet
• Feeding difficulties/being a picky eater

Limitations such as these can cause calcium and vitamin deficiencies, but one can still take in supplements to address dietary deficiencies like these. 

Diarrhea is also a common GI issue in kids with autism and occurs when food passes too fast via the intestines; this quick passage of food via the digestive tract hinders nutrient absorption, but a doctor may recommend nutritional supplements to help compensate for the issue. For diarrhea associated with irritable bowel syndrome (abnormal intestinal function) rather than accelerated digestion, inadequate or poor absorption is unlikely.

Other Health Issues in Autism

Kids, teens and adults with autism experience other health issues and some conditions often co-occur/overlap with autism, including ADHD, OCD, depression, anxiety disorder, and executive dysfunction. Plus, the signs and symptoms of certain conditions like depression and anxiety disorder often include feeding difficulties and/or indigestion. 

Less frequently experienced issues include flatulence or excessive gas, reflux, vomiting and severe abdominal pain.

Reducing and treating GI symptoms is often an integral part of addressing a wide range of mental health issues for people on the autism spectrum and may be important for enhancing the quality of life and improving the daily functioning of affected people. 

Seeking Support Services 

While GI issues are not uncommon, they should not be used to identify people as being autistic. It’s critical for GI symptoms to be first tackled by a gastroenterologist or other medical professionals to prevent the occurrence of serious health problems in the future. 

An individual who has been seeking the services of a pediatric gastroenterologist for recurrent GI issues should seek adult care services from an adult gastroenterologist when they come of age. Keeping communication lines open with regard to the signs and symptoms, how they manifest, and how you have been getting treatment—via dietary modifications and/or prescription medications—is incredibly important to ensure good health outcomes in the future.