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digestive issues

Gastroesophageal Reflux Disease (GERD) and Acid Reflux

Gastrointestinal problems occur two to three times more often in autistic people than in the general population.

Gastroesophageal Reflux Disease (GERD) is common in both autistic children and adults, and can affect appetite, sleep, and behavior.

Reflux is the backward flow of acid from the stomach into the esophagus. GERD is when the closure of the lower esophagus becomes weak from recurring acid reflux. Symptoms include heartburn, regurgitation, chest pain, dry cough, shortness of breath, or trouble swallowing. Persistent GERD can lead to more serious health conditions like esophagitis.

Dr. Timothy Buie, a pediatric gastroenterologist at Boston Children’s Hospital whose research and practice focuses largely on autistic patients with digestive issues, notes that non-verbal autistic people sometimes exhibit behaviors that indicate GERD, reflux, or other digestive issues. In this video, Dr. Buie explains some of the behaviors that may indicate digestive upset:

Doctor with hand illustrating how autistic people might touch their throat when suffering from acid reflux
Dr. Tim Buie, Gastroenterologist at Boston Children's Hospital, on signs of gastrointestinal distress in autistic adults

If frequent heartburn or reflux is suspected it should be brought to the attention of a PCP. They may recommend over the counter remedies such as antacids, famotidine, or omeprazole. Regardless, any condition that persists should be referred to a gastroenterologist for proper assessment, diagnosis and treatment.

Autistic adults requiring treatment for GERD may need to have an endoscopy, which is a process in which a gastroenterologist examines the digestive tract by inserting a tube with a tiny light and a camera down the throat. Because medical procedures of this kind can be particularly stressful for autistic people, patients and caregivers should discuss accommodations for making the procedure as tolerable as possible with the gastroenterologist and hospital staff. [link to accommodations article]

Dietary and Lifestyle changes to help ease reflux/GERD

Diet can contribute to the occurrence of increase stomach acid. To reduce the occurrence and uncomfortable symptoms of reflux/GERD, autistic adults will want to limit certain foods, including:

  • mint

  • orange/grapefruit juice

  • tomatoes

  • onions

  • chocolate

  • fried/spicy foods

  • carbonated drinks

Foods and ingredients that can help:

  • banana

  • rice

  • oatmeal

  • melon

  • ginger

  • salmon

  • sweet potatoes

  • carrots

  • beets

Lifestyle changes to consider:

  • avoid eating near bedtime

  • drink plenty of water

  • eat several small meals instead of three large ones

  • placing a bolster under a mattress or using extra pillows to keep the head raised, which lessens the chance of acid rising to irritate the esophagus during sleep

For autistic adults in day programs or who live in residential placements, communication about dietary health can assist in managing GI conditions. Our Dietary Plan Tool is one way of helping caregivers and staff understand and contribute to positive health across the lifespan.


A tool for communicating with schools and providers about dietary needs and interventions.

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