Role of gastrointestinal health in managing children with autism spectrum disorder

Table 1 Impact of gastrointestinal disorders on children with autism spectrum disorders

Domain	The impact
Patient’s behavior	Abnormal posturing, self-injury, sudden outbursts, social withdrawal or isolation, and changes in eating habits
	Self-stimulatory behaviors
	Toe walking, increased irritability, restlessness, and agitation
	Poor attention, reduced food intake, or avoidance of certain foods
	Poor response to psychotropic medications
Patient’s social interaction	Difficult engagement in social interactions
	Anxiety, irritability, and withdrawal from social situations with social avoidance
	Decrease the ability to engage in social play, follow social cues, or maintain relationships with peers and family members
	Poor development of social skills
Patient’s sleep	Disrupted sleep patterns
	Disruption of sleep-wake cycles regulation
Patient’s epilepsy	Altered brain electrical activity
	Increased risk of epileptic tendencies
	Decrease epilepsy thresholds
	Interactions with anti-epileptic medications
Patient’s education	Increase absenteeism and poor attendance
	Poor academic performance
	Poor participation
	Decreased ability to concentrate
	Poor engagement in learning activities
	Reduced motivation and participation in classroom activities
	Poor participation in group activities
	Poor participation in food-related activities
	Poor cognitive functioning
Patient’s quality of life	Poor eating, sleeping, and social interactions
	Reduced appetite, causing poor nutrition and weight loss

Table 2 The different behavior changes that result from various gastrointestinal disorders

GI disorder	Behavior changes
Gastroesophageal reflux with/without ulcerations	Self-stimulatory behaviors (commonly called stimming)
	Constant eating/drinking/swallowing (grazing behavior)
	Frequent nighttime awakenings, abnormal posturing, pushing out the jaw, straining the neck, and tapping the throat, increased self-injury, and other challenging behaviors
Abdominal pain	Increased anxiety levels and emotional dysregulation, leading to outbursts and meltdowns
	Repetitive rocking and other repetitive behaviors.
	Blinking, sudden screaming, spinning, and fixed look
	Agitation: Pacing, jumping up and down
	Sleep disturbances, exacerbating the behavioral challenges and affecting overall well-being and functioning
Constipation	Tip-toe walking
	Increased irritability, restlessness, and agitation
	Abnormal sleep patterns, such as difficulties falling asleep, frequent awakenings, or restless sleep
	Daytime irritability, poor attention, fatigue, and behavioral challenges
	Reduced food intake, or avoidance of certain foods
	Toilet training problems
Diarrhea	Social withdrawal if the child is experiencing discomfort or embarrassment due to diarrhea
	Increased self-stimulatory behaviors like engagement in repetitive or self-stimulatory behaviors to self-soothe, especially during the time of discomfort
	Toilet training problems
	Change appetite with changing eating patterns or food preferences