Gastrointestinal abnormalities in children with autistic disorder☆,☆☆,★
Section snippets
PATIENTS AND METHODS
Children diagnosed with autistic disorder or pervasive developmental disorder, not otherwise specified by professionals with expertise in behavioral pediatrics were referred to our gastroenterology clinic for further evaluation.
Thirty-six children with one or more of the following symptoms including abdominal pain (n = 25), chronic diarrhea (n = 21), gaseousness/bloating (n = 21), nighttime awakening (n = 15), and unexplained irritability (n = 18) underwent esophagogastroduodenoscopy. The mean
Histologic Findings
The most frequent histologic finding was the presence of reflux esophagitis in 25 of 36 children (69.4%). Twenty-two of these 25 children (88%) had symptoms such as nighttime awakening with irritability, signs of abdominal discomfort, or pushing on the abdomen, which are typically reported by non-autistic children with esophagitis. Chronic inflammation of the gastric mucosa was present in 15 children. None of the patients had H pylori infection. Chronic nonspecific duodenal inflammation was
DISCUSSION
Few studies have addressed gastrointestinal problems in children with autistic disorder. Goodwin et al7 studied 15 randomly selected children with autism and found that 6 had either bulky, odorous, or loose stools or intermittent diarrhea; one had celiac disease. In a recent study, 43% of the autistic patients without symptoms or evidence of any gastrointestinal disease had altered intestinal permeability.2 Low concentrations of serum α1-antitrypsin were reported in children with typical autism,
Acknowledgements
We thank Lisa Medeiros, BSN, and Tina Sewell, BSN, for their help with patient recruitment and during the procedures; their contribution was important to accomplish this work. We are very grateful to Lois Roeder, PhD, for her contribution in the preparation of the manuscript.
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Supported by an intramural grant by the University of Maryland School of Medicine.
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Reprint requests: Karoly Horvath, MD, PhD, Department of Pediatrics, 22 S Greene St, N5W70, Box 140, Baltimore, MD 21201-1595.
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0022-3476/99/$8.00 + 0 9/21/101636