Autism Spectrum Disorders in Children with Functional Defecation Disorders

Peeters, Babette; Noens, Ilse; Philips, Elise M.; Kuppens, Sofie; Benninga, Marc A.

doi:10.1016/j.jpeds.2013.02.028

Cited by 59 publications

(42 citation statements)

References 25 publications

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“…For example, it is well known that both fussy eating and functional constipation occur more frequently in children with pervasive developmental disorders. 49,50 In the present study, we explored the role of anxiety disorders, pervasive developmental disorder, attention deficit hyperactivity, and obsessive-compulsive symptoms assessed at age 3 years by maternal report with the CBCL, by adding them as confounders to our models (data available on request). Because this did not change any of the effect estimates describing the association between fussy eating and functional constipation at age 4 years, we did not include them in the subsequent analyses.…”

Section: Discussionmentioning

confidence: 99%

Bidirectional Associations between Fussy Eating and Functional Constipation in Preschool Children

Tharner

Jansen

Jong

et al. 2015

The Journal of Pediatrics

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Section: Discussionmentioning

confidence: 99%

Bidirectional Associations between Fussy Eating and Functional Constipation in Preschool Children

Tharner

Jansen

Jong

et al. 2015

The Journal of Pediatrics

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“…48 Fecal retention in ASD may also occur secondary to difficulty with sensory stimuli, sensory processing, and motor problems, leading to altered gastrointestinal motility and defecation physiology. 49 It is also possible that elevated rates of constipation may be related to the ubiquity of food selectivity in this population, as the dietary patterns often associated with ASD involve high intake of processed food and lack fibercontaining fruits and vegetables, which provide a natural laxative effect and …”

Section: Figurementioning

confidence: 99%

Gastrointestinal Symptoms in Autism Spectrum Disorder: A Meta-analysis

et al. 2014

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BACKGROUND:In pediatric settings, parents often raise concerns about possible gastrointestinal (GI) symptoms in autism spectrum disorder (ASD), yet the specificity of these concerns are not well studied. OBJECTIVE:To conduct a meta-analysis of research investigating GI symptoms among children with ASD. METHODS:We searched Medline, PsycINFO, and PubMed databases in peer-reviewed journals. Analysis involved studies with a comparison group presenting quantitative data on GI symptoms using combinations of terms for ASD and GI indicators. The systematic search yielded 15 studies. We calculated effect sizes and 95% confidence intervals (CIs) using a random-effects model. RESULTS:Children with ASD experience significantly more general GI symptoms than comparison groups, with a standardized mean difference of 0.82 (0.24) and a corresponding odds ratio (OR) of 4.42 (95% CI, 1.90-10.28). Analysis also indicated higher rates of diarrhea (OR, 3.63; 95% CI, 1.82-7.23), constipation (OR, 3.86; 95% CI, 2.23-6.71), and abdominal pain (OR, 2.45; 95% CI, 1.19-5.07). CONCLUSIONS:Results indicate greater prevalence of GI symptoms among children with ASD compared with control children. Identified studies involved high methodological variability and lack of comprehensive data prohibited analysis of GI pathophysiologies (eg, gastroesophageal reflux) typically associated with organic etiologies, limiting conclusions about the underpinnings of the observed association. Future research must address critical questions about the causes and long-term impact of GI symptoms in ASD. Such analyses will require more systematic research and clinical activities, including improved diagnostic screening, standardized assessment, and exploration of potential moderators (eg, dietary restrictions).

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“…[11][12][13] Most recently in 2013, Peeters et al 14 reported that a large number of children presenting with defecation disorders also fall into the autism spectrum disorder.…”

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confidence: 99%

Association of Constipation and Fecal Incontinence With Attention-Deficit/Hyperactivity Disorder

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Several studies have shown that behavioral problems can be associated with defecation and voiding disorders, although few studies have looked directly at a link between a diagnosis of attention-deficit/hyperactivity disorder (ADHD) and constipation or fecal incontinence. WHAT THIS STUDY ADDS:We identified an increased risk for both constipation and fecal incontinence in children with ADHD. In patients with concomitant ADHD and defecation disorders, more aggressive medical and behavioral treatment of the constipation or fecal incontinence may be warranted. abstract OBJECTIVE: Functional constipation and fecal incontinence are common childhood gastrointestinal conditions. Both conditions may be associated with behavioral problems. Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder of childhood, characterized by shortened attention span and hyperactivity. We hypothesize that a diagnosis of ADHD increases the risk for functional constipation and fecal incontinence. METHODS:A retrospective cohort study of children was performed by using the military health system database. Children of active-duty military personnel, aged 4 to 12 years, from October 2005 to September 2007, were included. ADHD, constipation, and fecal incontinence were identified by International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. Relative risks and adjusted incidence rate ratios (IRRs) were calculated. A subgroup analysis of subjects receiving medical therapy was performed.RESULTS: There were 742 939 children identified in the study, 32 773 (4.4%) of whom had ADHD. Children with ADHD had an increased prevalence of constipation (4.1% of children with ADHD vs 1.5% children without ADHD; P , .001) and fecal incontinence (0.9% of children with ADHD vs 0.15% of children without ADHD; P , .0001). Children with ADHD had more visits than those without ADHD for both constipation (IRR 3.39; 95% confidence interval 2.59-4.43) and fecal incontinence (IRR 7.74; 95% confidence interval 5.01-11.98). Children with ADHD receiving medicinal therapy did not differ significantly from children with ADHD not receiving medicinal therapy on rates of constipation visits (P = .57) or fecal incontinence visits (P = .32). CONCLUSIONS:Children with ADHD are significantly more likely to have constipation and fecal incontinence. Medical therapy for ADHD does not impact visit rates for defecation disorders.

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Autism Spectrum Disorders in Children with Functional Defecation Disorders

Cited by 59 publications

References 25 publications

Bidirectional Associations between Fussy Eating and Functional Constipation in Preschool Children

Bidirectional Associations between Fussy Eating and Functional Constipation in Preschool Children

Gastrointestinal Symptoms in Autism Spectrum Disorder: A Meta-analysis

Association of Constipation and Fecal Incontinence With Attention-Deficit/Hyperactivity Disorder

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