Autism and GI Issues: Understanding the Connection Between Stress and Chronic GI Symptoms in Autistic Children
by Christopher Lynch, Ph.D., author of, "Totally Chill: My Complete Guide to Staying Cool"
Article originally published on Psychology Today.
Gastrointestinal (GI) distress is common in autistic children with close to one quarter having at least one chronic symptom (Molly and Manning-Courtney, 2003). Some of the symptoms that occur in greater frequency for this group include diarrhea, constipation, and abdominal pain (McElhanon, et al, 2014).
Given that both anxiety and GI problems are high in autism, it’s interesting to ponder whether or not there is a link between the two. Research suggests that there is. Mazurek and colleagues (2013), for example, found that autistic children with GI conditions had higher rates of both anxiety and sensory over-responsivity.
- Increased intestinal permeability
- Altered intestinal microbiota
- Altered Serotonin metabolism
However, it is important to note that the association between emotional distress and GI symptoms also exists for those who are not autistic. There is an increasingly growing body of literature demonstrating a relationship between emotional distress and GI symptoms for the population at large.
In some ways, this is not surprising given the multiple ways in which the GI tract and nervous system interact. The interactions between the GI tract and the nervous system are so close that the gut is sometimes referred to as “the Second Brain”.
- Be aware that GI symptoms are common in autism. For those who are more verbal, be sure to ask about discomfort. For less verbal children, look for behavioral and physical signs of GI distress. Be sure to address any concerns with your healthcare provider.
- Given the link between emotional distress and many GI conditions, providing ways to reduce stress and anxiety can be part of the overall treatment plan for both emotional and physical health. Children on the autism spectrum can learn and benefit from a range of relaxation techniques. Providing supportive and accepting environments can also go a long way toward reducing stress.
- Be aware of the potential impact of behavioral patterns (e.g. stool withholding, restricted eating) on GI health. Seek consultation when these behavioral patterns impact on health and well-being.
McElhanon, B. O., McCracken, C., Karpen, S., & Sharp, W. G. (2014). Gastrointestinal symptoms in autism spectrum disorder: a meta-analysis. Pediatrics, 133(5), 872-883.
Molloy, C. A., & Manning-Courtney, P. (2003). Prevalence of chronic gastrointestinal symptoms in children with autism and autistic spectrum disorders. Autism, 7(2), 165-171.
Mazurek, M. O., Vasa, R. A., Kalb, L. G., Kanne, S. M., Rosenberg, D., Keefer, A., ... & Lowery, L. A. (2013). Anxiety, sensory over-responsivity, and gastrointestinal problems in children with autism spectrum disorders. Journal of abnormal child psychology, 41(1), 165-176.
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About the Author
Christopher Lynch, Ph.D., is a psychologist who specializes in stress and anxiety management for children with autism. He is the Director of the Pediatric Behavioral Medicine Department at Goryeb Children's Hospital.