Many children with autism experience stomach and digestive problems that can make their autism symptoms worse and affect how much they eat. This study looked at 737 autistic children in China to understand how different types of stomach problems affect them differently. Researchers found that children with belly pain problems had more anxiety and sensory issues, while children with bowel problems were pickier eaters and didn’t drink enough water. The findings suggest that treating stomach problems in autistic children should be customized based on which type of problem they have, rather than using a one-size-fits-all approach.

The Quick Take

  • What they studied: How different types of stomach and digestive problems affect autistic children’s behavior, emotions, eating habits, and nutrition
  • Who participated: 737 children with autism in China, average age 7.76 years old (mostly boys). About 20% had some type of digestive problem, while 80% had no digestive issues
  • Key finding: Children with different types of stomach problems showed different patterns: belly pain was linked to more anxiety and sensory sensitivity, while bowel problems were linked to picky eating and not drinking enough water
  • What it means for you: If your autistic child has stomach problems, doctors may need to treat them differently depending on the specific type of problem. This could help improve both their digestion and their overall behavior and mood. However, this research was done in China, so results may differ in other populations

The Research Details

This was a cross-sectional study, which means researchers looked at a large group of children at one point in time and compared those with different types of stomach problems to those without any stomach problems. The researchers used standardized questionnaires and diagnostic criteria (called Rome IV) to identify which children had which types of digestive disorders. They measured autism symptoms, anxiety, sensory sensitivity, eating behaviors, and what foods the children actually ate. They then used statistical analysis to see if children with different stomach problem types had different patterns in these areas.

The study included 737 children with autism from China, with an average age of about 7.8 years old. Most participants were boys (87%), which matches the typical male-to-female ratio in autism. The researchers carefully categorized children into groups: those with no digestive problems, those with belly pain disorders, those with bowel movement disorders, and those with nausea and vomiting disorders.

Understanding that different types of stomach problems affect autistic children in different ways is important because it means doctors can’t treat all digestive problems the same way. By identifying which specific type of problem a child has, doctors can target their treatment more effectively. This approach recognizes that the gut and brain are connected in autism, and that fixing stomach problems might also help with behavioral and emotional symptoms.

This study has several strengths: it included a large sample size (737 children), used standardized diagnostic criteria, and measured multiple outcomes including behavior, emotions, eating, and nutrition. However, the study was conducted only in China, so results may not apply equally to other populations. The study was cross-sectional, meaning it shows associations but cannot prove that one thing causes another. Additionally, one of the stomach problem groups (nausea and vomiting) had only 6 children, making those findings less reliable

What the Results Show

About 20% of the autistic children in the study had some type of functional digestive disorder. The researchers found that children with different types of digestive problems had distinctly different patterns of symptoms and behaviors.

Children with belly pain disorders (the most common type) showed more severe autism-related behaviors, including more repetitive behaviors, higher anxiety levels, and greater sensitivity to sensory input like sounds and textures. These children also showed specific eating patterns: they tended to eat less when upset, ate very slowly, and felt full quickly even after eating small amounts.

Children with bowel movement disorders showed a different pattern. They were much pickier eaters, ate slowly, felt full quickly, and importantly, they drank less water and ate less fiber and protein. These factors likely contributed to their bowel problems, creating a cycle where picky eating makes constipation worse.

The group with nausea and vomiting disorders was very small (only 6 children), but they showed a tendency to eat more when emotionally upset, which is the opposite pattern from the belly pain group.

The study revealed important connections between sensory sensitivity and digestive problems. Children with belly pain disorders were particularly sensitive to sensory input, suggesting that their nervous system’s difficulty processing sensations might be connected to their stomach pain. The study also showed that feeding problems are a key feature of digestive disorders in autistic children—not just a separate issue. Nutritional intake was affected differently depending on the type of digestive problem, with some children not getting enough water, protein, or fiber

Previous research has shown that digestive problems are common in autistic children, but most studies treated all digestive problems as one category. This study is important because it breaks down digestive problems into specific types and shows that each type has its own pattern of associated symptoms. This aligns with growing understanding in autism research that autism is not one condition but involves many different subtypes with different characteristics

The study was conducted only in China, so the findings may not apply equally to children in other countries or cultures with different diets and healthcare systems. The study design was cross-sectional, meaning it shows which symptoms occur together but cannot prove that one causes the other. The group with nausea and vomiting disorders was very small (only 6 children), so those findings are less reliable. The study included mostly boys (87%), so results may not apply as well to autistic girls. Additionally, the study relied on parent reports of symptoms and eating behaviors, which could be subject to bias

The Bottom Line

If your autistic child has digestive problems, work with their doctor to identify which specific type of digestive disorder they have (belly pain, bowel movement, or nausea/vomiting). Once identified, treatment can be tailored to address that specific type. For belly pain disorders, addressing sensory sensitivity and anxiety may help. For bowel movement disorders, increasing water and fiber intake gradually while working with a feeding specialist may help. These recommendations are based on moderate evidence from this study and should be discussed with your child’s healthcare team

Parents and caregivers of autistic children with digestive problems should pay attention to this research. Healthcare providers treating autistic children should also consider these findings when developing treatment plans. Teachers and school staff who work with autistic children may benefit from understanding these connections. This research is less relevant for autistic children without digestive problems, though it may help with early identification

Changes in digestive symptoms typically take several weeks to months to improve, depending on the type of problem and the treatment approach. Dietary changes (like increasing fiber and water) may show benefits within 2-4 weeks. Behavioral and emotional improvements related to reduced digestive discomfort may take longer, typically 2-3 months or more. It’s important to be patient and work closely with healthcare providers to monitor progress

Want to Apply This Research?

  • Track your child’s digestive symptoms daily using a simple scale (none, mild, moderate, severe) and note which meals or times of day symptoms occur. Also track eating patterns: how much they eat, how long meals take, and which foods they accept or refuse. This data helps identify patterns and shows whether treatments are working
  • Start a food and symptom diary in the app where you log: (1) what your child ate and drank, (2) digestive symptoms that occurred, (3) mood and behavior changes, and (4) sensory reactions. Over time, patterns will emerge showing which foods or situations trigger problems. Share this data with your child’s doctor to guide treatment decisions
  • Set up weekly reviews in the app to look for patterns in your child’s symptoms and eating. Create alerts for concerning symptoms (like severe pain or vomiting) that need immediate attention. Track progress on specific goals like increasing water intake or trying new foods. Use the app’s comparison feature to see if symptoms improve after starting a new treatment or dietary change

This research describes associations between digestive problems and autism symptoms but does not prove cause-and-effect relationships. The study was conducted in China and may not apply equally to all populations. If your child has digestive symptoms, consult with their pediatrician or gastroenterologist for proper diagnosis and treatment. Do not use this information to self-diagnose or replace professional medical advice. This summary is for educational purposes only and should not be considered medical advice. Always discuss any concerns about your child’s health with qualified healthcare providers