Around the time that Sam was diagnosed with autism at age 3, he began to throw hour-long crying fits. When he wasn’t plagued by lengthy spells of constipation, the Michigan toddler endured terrible bouts of diarrhea.
By the time Sam was 4, his parents suspected that it might be something besides autism that made him so miserable. About half an hour before every bowel movement, Sam doubled over, clutching his belly and crying out in pain. He sometimes draped his abdomen over toys or furniture, as if trying to ease his aching gut.
Sam’s parents took him to numerous pediatricians and gastroenterologists, but physical exams and blood tests revealed no obvious problems that would affect his digestive system. His parents reluctantly began to accept that his gut problems might simply be yet another manifestation of his autism. “We kind of gave up,” says Sharon, Sam’s mother. (Their names have been changed to protect their privacy.)
Unfortunately, Sam’s experience is common among children with autism. About 40 to 60 percent of these children cope with gastrointestinal (GI) problems, ranging from frequent abdominal pain and bloating to diarrhea and constipation. But why and how their distress develops—and what to do about it—remain a mystery.
Despite their pain, these children’s abdominal tracts generally appear normal, says Emeran Mayer, the director of the Center for Neurobiology of Stress at the University of California, Los Angeles. In some children, GI problems may result from stress and anxiety, or emerge as a consequence of behavior. If a child’s insistence on sameness spills over into eating habits, for example, she might not consume enough fiber or liquid, and may become constipated as a result.