Abdominal Pain

Abdominal pain can be a frequent concern throughout the lifespan of autistic people. A diagnosis can be challenging, especially for nonverbal adults, or those with limited communication skills who may have difficulty identifying and communicating the source of their pain.

Dr. Tim Buie, a pediatric gastroenterologist at Boston Children’s Hospital, notes that his nonverbal autistic patients communicate digestive discomfort in a number of ways, including:

self-biting and mouthing behaviors

• chewing clothes (often sleeves), paper or other objects

• ingesting nonfood items (pica)

• aggression against others

• twisting of the midsection or rubbing the abdomen against furniture

• rubbing or scratching of the neck and throat areas

• escaping or bolting

• an increase in repetitive behaviors or vocalizations.

Collecting data to help locate the cause of pain

It’s important to note that GI issues are not always the culprit in digestive discomfort situations. Other pain-related behaviors could be caused by dental issues, migraine headaches, or other kinds of physical distress. Collecting data on toileting and food intake behaviors, as well as other GI-related activities, can help the clinician pinpoint what might be causing pain. See our article more information on communicating about pain.

Clinicians have found that when patients who exhibit aggression and/or self-injury are evaluated and found to have underlying GI distress, the treatment of that condition usually results in an improvement in behavior. In this video, Dr. Buie explains some of the behaviors that may indicate digestive upset:

Bowel movements

Tracking bowel movements can be helpful, as abdominal pain may occur at certain times during the digestive process. The Bristol stool chart, which helps document the timing and outcome in bowel movements, is an easy-to-use tracking tool.

Food intake

Sometimes certain foods can cause abdominal pain because they are hard to digest. Fried or spicy foods, dairy products, or vegetables such as spinach, broccoli, and cabbage can all cause discomfort. The Centers for Disease Control has a free, downloadable simple food diary that can help patients record eating habits to identify any potential problem foods or ingredients.

Warning signs of something more serious

The sudden onset of abdominal pain may indicate something more serious than digestive upset. Pain can that appears to be located on the right side of the lower abdomen or the lower back that is accompanied by nausea, loss of appetite, or fever requires immediate medical attention. Such pain could indicate appendicitis, kidney stones, diverticulitis, or another condition that requires prompt specialized care.

Although GI symptoms are common in adults, there is no single set of signs, symptoms, or treatments that applies to all autistic patients. AAHR has articles on the most common GI conditions:

• GERD and acid reflux

• Constipation

• Pica