MEDICAL DEBATE over children with developmental delays and gastrointestinal disorders

By Amy Brown, PhD
The medical debate continues as to whether or not children with autism experience stomach and or intestinal symptoms – bloating, belching, abdominal pain, reflux, constipation, diarrhea, and even vomiting.

University of Hawai`i Associate Professor Amy C. Brown and some of her students in a clinical research methods course at the John A Burns School of Medicine (JABSOM) sought to answer this question. After reviewing the literature, they published a 2010 editorial in Expert Reviews of Gastroenterology and Hepatology.

They uncovered that certain GI problems already exist in some children with developmental delay disorders. The question then became why would not a subset of children with autism also be affected? Buie and others (2010) reported in a landmark Pediatrics review of 11 studies (Buie T, 2010), that the prevalence of stomach and intestinal problems in children with autism averaged 44% (9-91% range). Brown and the others found that constipation and stool impaction are common in children with mental retardation. Approximately 76% of children with Rett syndrome experience gastrointestinal problems, and about 43% of children with cerebral palsy have high blood markers for celiac disease. Celiac disease is specifically observed in approximately 10% of children with Down syndrome, Turner syndrome and Williams syndrome.

How many of these developmentally delayed children are tested for celiac disease or gluten-sensitivity and then treated with a gluten-free diet? Buie’s group also suggested that lactose intolerance and food allergies should be eliminated as potential triggers. The stomach and intestinal symptoms, if they exist, of these conditions can be very painful. Professor Brown wants to spread awareness that celiac disease or gluten sensitivity, and possibly lactose intolerance and food allergies, may exist in a small subset of developmentally delayed children who are compromised in their ability to communicate.

Editorʻs Note: “The hope in publishing the editorial was to speak up for these children unable to have a voice themselves,” said Dr. Brown. Dr. Brown is on the faculty of the Department of Complementary and Alternative Medicine.

See also: Hawaii Autism Foundation Fundraiser April 27.

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