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1
and individuals with ASD experience varying degrees of impairment.
2
The estimated prevalence of ASD in pediatric populations has climbed dramatically
during the past decade, with approximately 1 in every 68 children currently meeting
diagnostic criteria in the United States.
3
High prevalence occurs against a backdrop of increased health care costs
4
and social burden.
5
Medical comorbidities are significantly overrepresented compared with other pediatric
populations, and children with ASD often present with medical conditions affecting
multiple organ systems.
6
Dysfunction of the gastrointestinal (GI) tract is among the most frequently cited
comorbidities. A recent meta-analysis indicated that children with ASD were four times
more likely to experience general GI complaints, are more than three times more prone
to experience constipation and diarrhea, and complain twice as frequently about abdominal
pain compared with peers.
7
Lack of data prevented analysis of other GI symptoms (eg, gastroesophageal reflux,
celiac disease, lactose intolerance) typically associated with organic etiologies;
however, a 2010 consensus report concluded that, at a minimum, rates of other GI pathophysiology
in ASD should be viewed as occurring at similar levels to those observed in the general
population.
8
This includes consideration of the potential contribution of factors such as GI motility,
altered gut microbiome, immune abnormalities, and food allergy when GI symptoms are
detected.
7
In addition to calling for greater research scrutiny in this area, the expert panel
of pediatric gastroenterologists also emphasized the need to develop evidence-based
standards for the evaluation and treatment of GI symptoms in ASD.To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 09, 2015
Footnotes
This article was written by Rashelle C. Berry, MPH, MS, RD, CSP, lead nutritionist, Pediatric Feeding Disorders Program, Marcus Autism Center, Atlanta, GA; Patricia Novak, MPH, RD, EMPOWER project coordinator, Children’s Hospital of Los Angeles, Los Angeles, CA; Nicole Withrow, PhD, RD, assistant professor and dietetic internship coordinator, University of Northern Colorado, Greeley; Brianne Schmidt, RD, clinical nutrition specialist, Division of Neurodevelopmental and Behavioral Pediatrics, Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, NY; Sheah Rarback, MS, RD, director of nutrition, Mailman Center for Child Development, Miller School of Medicine, University of Miami, Miami, FL; Sharon Feucht, MA, RD, nutritionist, Center on Human Development and Disability, University of Washington, Seattle; Kristen K. Criado, PhD, psychologist, Pediatric Feeding Disorders Program, Marcus Autism Center, Atlanta, GA, and assistant professor, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; and William G. Sharp, PhD, director, Pediatric Feeding Disorders Program, Marcus Autism Center, Atlanta, GA, and assistant professor, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This work was supported by a 2014 Education Grant from Nutricia North America.
Identification
Copyright
© 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
