Autism and Stomach Issues.

This topic is one that I find is discussed in the autism community online a lot. It is an area I am fascinated in and I have read a lot of articles about it. I also have stomach issues myself-in the last seven years, I don’t think there’s been a week where I’m free of stomach pain and nausea for seven consecutive days. I have been diagnosed with Irritable Bowel Syndrome but medication does not do much for me in this regard. I am a lot better than I used to be. I used to be kept awake for nights on end with intense bouts of nausea but now it may only be one night in every fourteen that I actually can’t settle at all because of it. I will come back to this point later when I discuss reasons for these issues.

From my own personal experience and from the experiences of other people on all levels of the autistic spectrum who I know personally, I would estimate that the majority of people on the autistic spectrum suffer with a variety of gastrointestinal issues. Constipation and diarrhoea are the main ones along with reflux, indigestion, stomach cramps, bloating, nausea and vomiting. Some suffer with gastroparesis, a condition which affects the rate at which your stomach digests food, meaning that meals remain undigested for sometimes as long as 24 hours afterwards and inevitably get vomited back up again (although, like any of these symptoms and disorders, it affects people without autism too). I don’t think anyone with close knowledge of autism can deny that stomach issues are a huge part of it but what a lot of people fail to agree on is why these issues occur.

I believe there are several reasons why stomach issues are common in people with autism at all levels on the spectrum. Firstly, it is well known that people with autism can often have limited diets which are often low in fibre and this can often lead to constipation in particular. Some medications for co morbid conditions such as epilepsy can also cause constipation as a side effect. Some autistic people also eat extremely quickly and have a tendency to swallow without first chewing which is not good for the stomach. Another reason is gluten intolerance. A lot of children with autism in particular follow gluten free diets due to gluten intolerance. Gluten intolerance is not specific to autism, of course. There are a lot of people out there who suffer stomach issues when they eat foods which contain gluten and have to follow a gluten free diet-my brother is one of them. Some autistic children are on diets that cut out certain foods because their parents or caregivers have noticed that cutting out these foods helps with decreasing behavioural issues. This may well be related to stomach issues-if you are a person with autism who cannot communicate with words, how are you going to communicate to those around you that you are experiencing intense stomach cramps and feel uncomfortably bloated? As someone who works with children with disabilities who cannot communicate verbally, I know that pain is often expressed through behaviour such as hitting or scratching.

One medical theory which often makes it’s way around autism sites online is that autism is actually a gut based disorder rather than a neurologically based one. If you Google “autism and stomach issues”, some of these articles are bound to appear on the first page of search results. This theory I don’t believe on a personal level but I know there are a lot of people out there who do believe it. I think that the biggest reason for stomach issues in people with autism is anxiety. In fact, I can’t believe how many people have never come forward with this idea in the many discussions I have read about this online.

It is a fact that the majority of people on the autistic spectrum suffer with anxiety. For those people with autism who don’t communicate verbally, it is often expressed in forms of challenging behaviour when the person has to finish an activity or transition to a new environment. It’s not just a dislike of change-it’s a fear of change. For those of us who are lucky enough to be able to communicate verbally, we can sometimes verbally identify to people that we are anxious although some of us have difficulty in labelling emotions and may not be able to pinpoint anxiety as our current emotional state but can feel in our stomachs that something is bothering us. It is also a non disputed fact that anxiety is often expressed physically in the stomach and bowels. Nausea is common in people who are feeling nervous-indeed, some people who experience panic attacks vomit during or immediately after them. A lot of people, autistic or not, have a physical reaction to stress that includes vomiting and diarrhea. This seems to be accepted widely as a reason for stomach issues in the general population but, for some reason, it’s neglected a lot as a reason for stomach issues in autism. Perhaps it is because of the narrow way in which society as a whole views stress and anxiety. If you consider the outward manifestation of anxiety to be something physically obvious such as a panic attack involving hyperventilation (which not all of them do), it’s probably not crossed your mind that the person with autism who is hitting themselves and banging their head against a door or wall is doing so because they are extremely anxious. It simply doesn’t cross most people’s minds to equate challenging behaviour with anxiety unless they are closely involved with someone with autism who expresses their anxiety in such ways. Most people with autism live with high levels of anxiety on a daily basis-the next logical step is that any bowel issues may be associated with this.

Perhaps what is needed the most to help stomach issues in people with autism are measures to decrease anxiety levels first and foremost. Yes, food intolerance of various types may also be behind their stomach problems and special diets will also help in these cases but I genuinely believe that a large number of digestive problems in people with autism are anxiety related. A little understanding can work wonders-please remember that.


7 Responses to Autism and Stomach Issues.

  1. Noah Weiss says:

    I occasionally suffer from stomachaches, but almost always, they are due to anxiety. I think I am hyper-aware of my inner processes, which causes a normal process (e.g. digestion) to sometimes resemble a stomachache, even if the food that I ate would not ordinarily be disagreeable. They almost always subside if I take Tums and/or Pepto Bismol.

  2. Mark says:

    I have Autism Spectrum Disorder and whenever I’m experiencing anxiety that is significant enough, I get extremely bloated. I’m high functioning, very self aware of physical(too much) and mental states. I have been wondering for awhile whether the bloating is food intolerance and leads to anxiety, or that my anxiety leads to bloating. I really appreciate you exploring this online as it’s been a question I haven’t taken the time to research yet but has piqued my interest to do so because I’m trying to get a handle on my anxiety. I just started studying the neuroscience relevant to the autistic brain. This is so I may understand why my view of the socio-cultural normalities of my social system, come halfway or more, from an anthropological perspective. I also, and this is pressing for me, want to know why the medications that doctors are prescribing have not worked the way they should for my anxiety. I’ve experienced paradoxical reactions to fast acting benzodiazepines like lorazepam(it increases my anxiety), or I’m lethargic. Slower acting and longer half-life benzodiazepines work better but not good enough. I’m on a SSRI as well, again if it was working I wouldn’t have find your article. Basically, my medication or dosage is insufficient, and doctors aren’t solving it for me. So I will, like every subject I’ve tackled before, study until I know how to fix my quality of life, because I’m sick of having a choice between anxiety and lethargy. Thank you for your thoughts. -Mark

  3. Tom says:

    There have been some very interesting points made here. I have recently been diagnosed with ASD, I have also had numerous episodes of stomach problems throughout my life. I also agree with the articles conclusions that it is probably based on the anxiety that ASD causes and not with the condition itself. I have also worked alongside another individual who had ASD and significant stomach problems when he was young. The world is percieved to be a more hostile and uncertain environment to people with ASD so it stands to reason that stomach problems would arise from these fears.

  4. Michael says:

    I know very little about Aspergers or ASD, but have just read about Dr Ellen Li’s research on the GI issues of people on the spectrum (Li is at Stony Brook University). As someone who has spent many of my 56 years noticing that when I’m anxious, the first thing that is affected is my GI system, I agree with you that it is odd that no one has connected anxiety with GI issues.

    Brilliant deduction.

    But most importantly, congratulations on the birth of your son!

  5. Natalie says:

    Thanks so much for publishing this article. I recently started working as a teacher’s aide. While I have studied ASD, working with a student who actuallyhas ASD is a huge adjustment. One of my students is on the ASD and complains about bad breath etc. I noticed he often dry wretches and has to keep tissue boxes on hand. I thought it was just a sensory problem, now I have a much deeper insight. Thank you!

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