SchaferAutismReport: Recommendations for Treating GI Tract Symptoms in Children With Autism Issued

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Subject: Recommendations for Treating GI Tract Symptoms in Children With

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Recommendations for Treating GI Tract Symptoms in Children With Autism

Issued

From Medscape Medical News, ine

. is.gd/5Npi9

In the absence of evidence-based guidelines

specific to children with autism spectrum disorder (ASD), clinicians can

use new expert opinion recommendations for the identification and treatment

of gastrointestinal (GI) tract disorders in this patient population.

The recommendations are published in the

January 2010 issue of Pediatrics.

It can be challenging for clinicians to

determine the source of GI tract disorders in children with ASD. These

youngsters may have trouble communicating information about symptoms. They

may also be unable to follow instructions for certain procedures (eg,

drinking barium to determine the source of gastroesophageal reflux

symptoms, or fasting overnight for a lactose breath test).

For this article, 8 pediatric

gastroenterologists reviewed published guidelines for the management of GI

tract symptoms that occur frequently in the general pediatric population.

On the basis of their clinical experience, they then adapted current best

practices to the diagnostic evaluation and treatment of children with ASDs.

The prevalence of GI tract symptoms in

children with ASD is reported to range from 9% to 70% or higher.

Recommendations for Various GI Tract

Disorders The recommendations pertain to chronic abdominal pain

(intermittent or constant abdominal pain that lasts more than 1 or 2

months), chronic constipation (delay or difficulty in defecation for

approximately 2 weeks), chronic diarrhea (loose stool persisting for at

least 2 weeks), and symptoms of gastroesophageal reflux disease (passage of

gastric contents into the esophagus). The study authors provide information

on differential diagnosis, evaluation, and treatment considerations for

these GI tract conditions.

Primary care clinicians can use these

recommendations as a " guide " when evaluating a child with ASD who

presents with symptoms and/or signs that suggest abdominal distress.

Clinicians should be alert to behavioral

manifestations of GI tract disorders in patients with ASDs who may have

impaired language skills, the study authors state. These children might

indicate the presence of GI tract discomfort by, for example, pressing on

their abdomen or exhibiting self-injurious behavior.

Thorough History and Physical Examination,

Tests The diagnostic evaluation of GI tract

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TREATMENT

Recommendations for Treating GI Tract Symptoms in Children With Autism

Issued

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LETTERS

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