Autism spectrum disorder and digestive symptoms

Yes, children with autism spectrum disorder (ASD) tend to have more medical issues, including gastrointestinal (GI) symptoms such as abdominal pain, constipation and diarrhea, compared with their peers.

At the same time, many children with ASD eat only a few foods (selective eating), prefer highly processed foods, and eat fewer fruits, vegetables and whole grains.

For these reasons, children with ASD may have nutritionally poor diets and weight-related health issues that can extend into adulthood. Adults with ASD are at increased risk of obesity, high blood pressure (hypertension) and diabetes.

It can be challenging to know how to help a child with ASD and GI symptoms. Communication deficits associated with ASD often make it difficult to sort out whether a child's diet is the cause of the GI symptoms or if the symptoms are the result of an underlying medical problem. In addition, making dietary changes can be difficult when a child has become used to selective eating.

Parents and caregivers may try restrictive or elimination-type diets in an effort to manage symptoms or behaviors. Because restrictive diets increase the risk of nutrient deficiencies, they must be thoughtfully planned.

The goal for a child with ASD is the same as for any child — to provide adequate intake of all nutrients and promote lifelong health. To that end, the Academy of Nutrition and Dietetics has made the following recommendations:

• The child with ASD and the family should work with a dedicated care team that involves a dietitian. The team should assess the nutrient adequacy of the child's diet, keeping in mind that deficiencies may be present even if growth appears appropriate.
• The care team should work to address barriers, such as food selectivity, that may interfere with dietary changes to address allergies, constipation or other GI symptoms.
• Coaching about planning and preparing nutritious meals should involve the whole family.