As a parent, it is important to make connections with other parents who relate to your stage of life. Realizing someone else truly understands your child’s hardships and triumphs can bring so much encouragement.
For many parents of children with autism spectrum disorders (ASD), these connections are often few and far between. Sharing your child’s struggles can be intimidating, especially when it includes more personal details such as autism and constipation.
In this article I would love to bring some perspective, share some informative research studies, and just offer general encouragement from one parent to another. I can honestly say I have been there.
Watching your child go through gastrointestinal symptoms, such as abdominal pain, severe constipation, or diarrhea can be heart-wrenching. There are solutions that can help, so let’s explore the topic of autism and constipation together.
Potential links between autism and constipation
The links between autism and constipation are easy to see, but difficult to substantiate despite some studies indicating a correlation. Most likely, the higher instance in autistic children’s constipation, compared to neurotypical children, is due to other conditions common to people with autism, rather than autism itself.
The complication lies with the specific autism symptoms that affect how a child functions. Diet, social jitters, fluid intake, aggressive behaviors, medications, and treatment plans may all play a part in constipation becoming an issue for children on the spectrum.
Possible causes of constipation in relation to autism
Many children present with the most common symptoms of constipation during toilet training. This was the first time I questioned my daughter’s bowel movements. Potty training was a complete nightmare.
Many children, autistic or not, suffer from constipation. However, children with autism spectrum disorder may have extenuating factors that are unique.
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Autism Potty Training
Those unique factors could produce common GI symptoms. These symptoms can include abdominal pain, loose stools, bladder incontinence, and constipation. Their overall physical health can be affected.
Many children with autism suffer from food-related sensitivities that could stem from other conditions such as Sensory Processing Disorder (SPD) that often accompany autism. Autistic children may have an aversion to the taste or texture of food, resulting in a limited diet. Dietary limitation, whether for food aversions, food allergies, or even food selectivity, can affect their gastrointestinal tract causing GI symptoms.
Sudden dietary changes can also cause constipation and other gastrointestinal problems.
Fluid intake, or lack thereof, can also contribute to constipation. Lots of water and juice can help keep things moving more smoothly.
Certain medications can have a profound effect on our bodies. It is good to ask a doctor to advise if a medication our child is prescribed may interfere with their bowel function. There is nothing like getting a handle on potty training, only for it to be undone by medication.
Many children with autism experience anxiety for different reasons. Social situations can make them uncomfortable, worries over changes in routine, and feeling insecure about being different can all be factors. Each child feels anxiety in different areas of their body. If your child feels it in their gut, it could produce GI symptoms.
As children who suffer from constipation experience painful or embarrassing symptoms, they can begin to fear them. This can cause them to hold stools, which can cause urinary or bowel incontinence, especially at night when their bodies relax. At that point anxiety itself is causing the symptoms, creating a vicious circle.
Rigid compulsive behaviors
Autistic children often exhibit compulsive and repetitive behaviors. They may be very resistant to changes in their everyday lives. This can be frustrating to parents and caregivers, and can take quite a toll on the children themselves. According to one study, a link was shown between ridgid compulsive behaviors in children with autism and constipation.
Unfortunately, children on the autism spectrum sometimes experience meltdowns. These meltdowns differ from tantrums, and can severely impede their ability to keep themselves safe from harm in the way they normally would. They may injure themselves to the point of needing medical care.
The injury sustained may directly or indirectly cause constipation. A child’s constipation could be indirectly caused by an injury if:
- they are prescribed a medication with side-effects including gastrointestinal symptoms
- they are immobilized for an extended period of time
- changes to the child’s diet: they are unable to eat, or eat their prefered foods
- they are afraid
- changes to their location/routine
This is not an exhaustive list, and I feel it is important to note that not all injuries to an autistic child happen as a result of a meltdown.
Common constipation solutions
Finding viable solutions to your child’s constipation issues can actually begin by talking to your child’s doctor during infancy. I wish I would have known this earlier.
I found out that I could have identified my daughter’s mild (at the time) constipation when she was a tiny baby. Inadequately treated constipation could have contributed to her future GI symptoms.
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For example, I was under the impression that constipation symptoms began with missing bowel movements. However, it was during my third child’s early days that his pediatrician showed me signs of constipation which I remembered from my daughter as well.
You may talk to your child’s doctor about identifying possible symptoms such as “sandy stool” that could indicate constipation. Learn the signs; information is key and education inspires empowerment. What better time to feel empowered than when your child is in pain?
Recently I spoke with Bethany Goddard, founder of Empowered Parent. Her autistic son suffered from chronic constipation for the first seven years of his life. She had some great tips for managing constipation in children. I found them most helpful and will share them here:
“I wish I would have known sooner, that my son’s constipation would interfere so much with potty training,” Bethany said. She then provided the following tips:
- sitting on the toilet for 15 minutes, with a timer, after each meal to help train your child’s body
- saving certain activities for toilet time (such as hand-held video games) to provide distraction and prevent boredom
- Pull ups, even for older children, help prevent accidents by reducing bedtime apprehension and possible embarrassing (to the child) messes
- disposable adhesive pads absorb leak overflow from underwear or pull-ups, to aid in sheet maintenance
- increasing foods in their diet which promote gastrointestinal health or reduce symptoms such as diarrhea (bananas)
- flushable toilet wipes
- a fiber supplement, as well as other natural remedies from the health food store (always check with your doctor to prevent medication interference and failure to adhere to dietary restrictions your child may have)
“We tried a supplement from the health food store that had a combination of aloe and slippery elm that seemed to really help,” Bethany continued.
Changing your child’s diet can be a catch 22. For some, introducing new foods could help. For others, food selectivity, food preferences, and the possible meltdowns associated with them, could complicate things. Each parent knows their child best.
One tip I would share is to have a plan ready in the event that your child objects to the new dietary changes. Being ready in advance to give choices, and rewards, can ease your child’s apprehension and prevent behavior regression. Preparing your child by planning and executing the plan together can go a long way to making them more comfortable.
Reducing anxiety can soothe your child’s bowel problems. Weighted blankets, warmies, predictable schedules, steady diets, knowing they won’t be punished for accidents, and feeling secure are consistent stress reducers.
Warm baths may also help. What parent hasn’t experienced the bowel movement in the bathtub phenomenon? I know I can most definitely relate to that one!
Certain exercises (such as kegels) and sitting forward on the toilet to ensure proper elimination can also be tried, again with guidance from a doctor.
Other constipation solutions
Children with autism often have more professionals in their lives than other children. Why not take advantage of the unique connections with professionals in your child’s life to elicit some opinions?
Your pediatrician may prescribe your child medication or change any medications they are taking already. They may also recommend the afore-mentioned fiber supplement or another over-the-counter remedy.
A visit to the pediatric gastroenterologist may also provide reassurance and guidance. Good medical care is crucial for children who suffer from constipation. Their health can be greatly improved with the relief of each constipation symptom.
My daughter visited her pediatric gastroenterologist and he discovered she had weak bladder tone as a result of her chronic constipation. Bladder and bowel leakage made potty-training exceptionally difficult for her. At five years old, once the bowel movements were under control, her toilet training was finally complete.
An often-untapped resource can be found in schools. If your child is in school, you may be able to enlist the help of your school administration.
An Individualized Education Plan (IEP) or a 504 could provide your child with accommodations at school that could aid in the consistency of toilet training and constipation relief. This could be as simple as staff allowing your child to visit the restroom with their timer after meals.
Every therapist, doctor, and teacher has an opinion on almost every subject. Many of them are also parents. They can be available as a non-judgmental party who is experienced with many children’s issues. They may even have first hand knowledge of autism spectrum disorder and its effects. Confide in them, you may learn something that could greatly improve your child’s health and wellbeing.
As I walked through this process with my daughter, I was encouraged by the accessibility of natural solutions to constipation. I also appreciated the doctors who put my mind at ease by proving her health was intact. The friends around me who reached out to listen and offer whatever help they could meant a great deal to me as well.
These people being at my side, at different times, gave me a sense of being surrounded by a whole team. I hope reading this has given you the same sense of support.
Peters, B., Williams, K. C., Gorrindo, P., Rosenberg, D., Lee, E. B., Levitt, P., & Veenstra-VanderWeele, J. (2014). Rigid-compulsive behaviors are associated with mixed bowel symptoms in autism spectrum disorder. Journal of autism and developmental disorders, 44(6), 1425–1432. https://doi.org/10.1007/s10803-013-2009-2