Evaluation of Chronic Constipation in Children With Autism Spectrum Disorder

Abstract

Objectives: Chronic constipation occurs frequently in children with autism spectrum disorder (ASD). The primary objective was to determine whether chronic constipation is associated with a higher rate of abnormal colonic motor activity in ASD children than in non-ASD children. A secondary goal was to determine if clinical variables could identify children with ASD at risk for possessing abnormal colonic motility. Methods: A retrospective, propensity-matched, case-control study compared colonic manometry (CM) of an ASD cohort and non-ASD controls with chronic constipation. Clinical variables were evaluated as potential predictors for abnormal colonic motility. Results: Fifty-six patients with ASD and 123 controls without the diagnosis of ASD who underwent CM were included. Propensity score resulted in 35 matched cohorts of ASD and controls. The rate of abnormal CM findings between ASD and matched controls (24% vs 20%, P = 0.78) did not differ significantly. A prediction model of abnormal CM that included ASD diagnosis, duration of constipation, and soiling achieved a sensitivity of 0.94 and specificity of 0.65. The risk for abnormal colonic motility increased 11% for every 1-year increase in duration of constipation. Odds for abnormal motility were 30 times higher in ASD children with soiling than controls with soiling (P < 0.0001). Conclusions: Chronic constipation does not appear to be associated with a higher rate of abnormal colonic motility in children with ASD. Clinical information of disease duration and presence of soiling due to constipation show promise in identifying patients with ASD at a greater risk for abnormal colonic motility.

Outcomes of children with constipation and autism spectrum disorder treated with antegrade continence enemas

“…Functional constipation (FC), defined as constipation without an anatomical or physiological cause, is the most common gastrointestinal disorder in children with autism spectrum disorder (ASD) 1,2 . The incidence of FC in children with ASD may be as high as one‐third of patients 3 .…”

“…Functional constipation (FC), defined as constipation without an anatomical or physiological cause, is the most common gastrointestinal disorder in children with autism spectrum disorder (ASD). 1,2 The incidence of FC in children with ASD may be as high as one-third of patients. 3 Emergency department visits for children with ASD are more likely to be related to constipation compared to emergency department visits for children without ASD, and children often present with more significant constipation, including large dilated rectums filled with stool.…”

Role of gastrointestinal health in managing children with autism spectrum disorder

“…A physical examination is necessary to identify signs of constipation and any physical abnormalities that could contribute to it. A bowel movement diary can provide valuable information about bowel patterns, triggers, and dietary habits[ 90 ]. A dietary assessment is also essential to identify potential dietary factors contributing to constipation and assess the intake of fiber-rich foods, fruits, vegetables, and fluids[ 91 ].…”