A fifth of autistic children experience constipation, which is linked to significantly increased emergency department (ED) visits and hospitalisations for gastrointestinal symptoms, according to a study in the American Journal of Gastroenterology.
The study analysed over 20 million electronic records of children and young people aged 6 to 17 years from 70 Patient-Centred Outcomes Research Network health systems during 2015–2024, identifying diagnoses of autism, constipation, emergency department visits, and hospitalisations.
Approximately 22% of the children with autism had a recorded diagnosis of constipation, a rate that was 2.6 times higher than that observed in children without autism. Children with vs without autism were more likely to have faecal incontinence (4% vs 1%) and have an ED visit (8% vs 5%) or hospitalisation for abdominal pain and/or constipation (4% vs 1%).
Autism and unplanned healthcare for constipation
The children with autism and constipation, compared with those without constipation, were 4.5 times more likely to be diagnosed with abdominal pain (34% vs 8%) and more likely to have an ED visit (26% vs 3%) and hospitalisation (16% vs 1%) for abdominal pain and/or constipation.
Study limitations include the potential for misclassification and lack of specificity when using a single diagnosis code to identify autism or constipation. Other limitations include the inability to evaluate other factors such as comorbidities, geographic variability in constipation diagnosis and management, and concomitant medications.
The researchers concluded: “We observed a much higher prevalence of constipation among autistic youth as compared to nonautistic youth, along with an outsized symptom burden that includes faecal incontinence and unplanned health care utilisation. These data may inform health policy, advocacy, research prioritisation, and clinical care.”
Constipation and gastrointestinal problems are common in people with learning disabilities and/or autistic people, and may have unusual presentations. Constipation may present with behavioural changes, such as stopping eating, and altered sleep patterns, for example.