Are there more bowel symptoms in children with autism compared to normal children and children with other developmental and neurological disorders?: A case control study.
GI symptoms in autism are measured so inconsistently that past studies give useless 4–97 % ranges—use a standard tool like the ASD-GIRBI.
01Research in Context
What this study did
The team pulled every paper they could find on tummy trouble in kids with autism. They ended up with 144 studies from around the world.
Each study asked parents or doctors about constipation, diarrhea, or belly pain. The authors lined up the numbers to see how often these problems show up.
What they found
The answers were all over the map. One paper said only 4 % of kids had any GI issue. Another said 97 %.
Constipation rates bounced from 4 % to 46 %. Diarrhea swung from 2 % to 76 %. The wide spread made it clear there is no common way to ask about gut problems.
How this fits with other research
LeBlanc et al. (2003) found chronic GI symptoms in 24 % of 137 Midwest kids with ASD. That single number sits near the low end of the 4–97 % range the review later showed.
Chandler et al. (2013) and Kang et al. (2014) each reported GI issues in about half of their samples. These mid-range points fit inside the same wide span.
Lestarevic et al. (2025) finally fixed the mess. Their new ASD-GIRBI checklist gives everyone the same questions to ask, answering the 2009 call for one standard tool.
Why it matters
If you screen for GI pain, use a fixed set of questions each time. Until your clinic adopts the ASD-GIRBI, write down the exact wording you use so later data stay consistent. Kids can’t work on goals when their stomach hurts.
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02At a glance
03Original abstract
UNLABELLED: There is no standard approach to measuring GI symptoms in individuals with ASD, despite postulated interactions. The objectives of this study were to (a) describe the range of GI symptom ascertainment approaches in studies of ASD, (b) describe the range of prevalence estimates across studies, and (c) assess associations between ascertainment approach and prevalence estimates. Studies published from 1/1/1980 to 1/31/2017 were collected via PubMed. Eligibility included studies with at least ten individuals with ASD that measured GI symptoms or conditions. We excluded review and hypothesis papers. We extracted information on study design, GI symptom ascertainment method, demographics, and ASD diagnostic criteria. From a subset of studies, we extracted GI symptom estimates. Out of a possible 386 titles, 144 were included. The prevalence range for constipation was 4.3-45.5% (median 22%), for diarrhea was 2.3-75.6% (median 13.0%), and for any or more than one symptom was 4.2-96.8% (median 46.8%). GI symptoms differed significantly by age of individuals, primary goal of study, study design, study sample, and who reported symptoms (P < .05). Due to small sample size, we were not able to test for associations between every GI symptom and study characteristic of interest, or examine associations between GI symptoms and intellectual or verbal disability. Studies used a broad range of methods to ascertain GI symptoms in ASD. GI symptoms varied widely across these studies, with significant differences by study characteristics. Our findings highlight the need for a reliable, valid GI assessment tool to be used consistently across studies of ASD. Autism Res 2018, 11: 24-36. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We reviewed studies having to do with autism spectrum disorder and the gastrointestinal system, dating back to 1980. We found that the median prevalence of constipation was 22.2%, diarrhea 13.0%, and any symptom 46.8%. All symptoms had a wide range of estimates across studies. GI symptoms were associated with characteristics of the study, including who measured the GI symptoms. We call for the development of a reliable and valid GI questionnaire for studies of ASD.
Autism : the international journal of research and practice, 2009 · doi:10.1177/1362361309106418