Common Gastrointestinal Conditions

Autistic people are more likely to suffer from gastrointestinal (GI) ailments than the general population. They are especially more difficult to identify and diagnose in adults with communication challenges. GI symptoms can range from mild stomachaches to serious, persistent vomiting. 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:

• abdominal pain

• constipation

• GERD and acid reflux

Seeking care

Although GI symptoms are common, no digestive condition should be accepted as simply part of being autistic. It’s important that GI symptoms are addressed by a PCP or gastroenterologist to avoid serious health consequences during the adult years.

An adult patient who has been under the care of a pediatric gastroenterologist for ongoing digestive issues should transfer their care to an adult gastroenterologist. Communicating about the symptoms, how they present, and how they’ve been treated — through diet and/or medication — is important to assuring good health over the lifespan.

Behavior as communication about pain

Caregivers should note that behaviors of all kinds are a form of communication, and sometimes that communication is speaking about pain. Aggression and self-injury are not core symptoms of autism. When such behaviors do appear, it’s important to consider whether they indicate that an autistic adult is in pain. Gastrointestinal problems often create the kind of discomfort that can lead to behaviors (or an increase in the kinds of behaviors) that are core signs and symptoms of autism. Examples of behaviors that may indicate pain are:

• 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 neck or throat areas

• escaping or bolting

• an increase in repetitive behaviors or vocalizations.

Autistic adults or caregivers should record when, where, and how often these behaviors occur, in preparation for discussing them with a PCP or gastroenterologist so that a full diagnosis can be made. If the underlying cause turns out to be GI distress, treatment of that condition very often results in an improvement in the behavior(s). AAHR has more information on communicating about pain.

Keep in mind that GI issues are not always the culprit. Mental health issues such as anxiety can also trigger GI symptoms, and other pain-related behaviors could be caused by dental issues, migraine headaches, or other kinds of physical distress. Each of these possibilities can be discussed with a PCP, who can then make referrals to one or more specialists.

We recognize that gastrointestinal problems are very common in the population of individuals with autism. And that's true at all ages, from childhood to adulthood. The frequency of GI issues in individuals with autism is greater than the general population. It's perhaps 2 to 3 times more frequent to see gastrointestinal problems in this population than the general population.

Dr. Tim Buie, Pediatric Gastroenterologist, Boston Children's Hospital