Fulceri Francesca, Morelli Mariangela, Santocchi Elisa, Cena Hellas, Del Bianco Teresa, Narzisi Antonio, Calderoni Sara, Muratori Filippo
IRCCS Stella Maris Foundation, Pisa, Italy.
Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, University of Pavia, Italy; Speciality School of Nutritional Sciences, University of Milan, Italy.
Dig Liver Dis. 2016 Mar;48(3):248-54. doi: 10.1016/j.dld.2015.11.026. Epub 2015 Dec 11.
Gastrointestinal (GI) symptoms are frequently reported in children with Autism Spectrum Disorder (ASD), and an impact of GI comorbidity on ASD behavioral problems has been hypothesized.
To explore the type and the prevalence of GI symptoms in ASD patients and typical development (TD) controls, and to investigate their possible association with behavioral problems.
A total of 230 preschoolers were included in this study. Specifically, four groups of children were evaluated: ASD individuals suffering from GI symptoms (ASD/GI+), ASD subjects without GI symptoms (ASD/GI-), TD peers with (TD/GI+) and without (TD/GI-) GI symptoms. Parental report of behavioral problems and GI symptoms were assessed through the Child Behavior Check List 1½-5.
A significant higher percentage of ASD (37.4%) versus TD (14.8%) with GI symptoms was observed. 'Constipated' and 'Not-Eat' were the most frequent GI symptoms both in ASD and in TD groups, but they were evaluated as more severe in ASD patients. ASD/GI+ children had more anxiety problems, somatic complaints, externalizing and total problems than ASD/GI- individuals. TD/GI+ did not show more behavioral problems than TD/GI-.
Development of evidence-based guidelines for identification of GI problems in ASD preschoolers is warranted. GI symptomatology should be accurately assessed, especially in ASD children with anxiety and/or externalizing behavioral problems.
自闭症谱系障碍（ASD）患儿经常出现胃肠道（GI）症状，并且有人推测胃肠道合并症会对ASD行为问题产生影响。
探讨ASD患者和典型发育（TD）对照中GI症状的类型和患病率，并研究它们与行为问题的可能关联。
本研究共纳入230名学龄前儿童。具体而言，评估了四组儿童：患有GI症状的ASD个体（ASD/GI+）、无GI症状的ASD受试者（ASD/GI-）、有GI症状的TD同龄人（TD/GI+）和无GI症状的TD同龄人（TD/GI-）。通过儿童行为检查表1½ - 5评估行为问题和GI症状的家长报告情况。
观察到有GI症状的ASD患者（37.4%）比例显著高于TD对照（14.8%）。“便秘”和“不吃东西”是ASD组和TD组中最常见的GI症状，但在ASD患者中被评估为更严重。与ASD/GI-个体相比，ASD/GI+儿童有更多焦虑问题、躯体主诉、外化问题和总体问题。TD/GI+组没有比TD/GI-组表现出更多行为问题。
有必要制定基于证据的指南来识别ASD学龄前儿童的胃肠道问题。应准确评估胃肠道症状，特别是在有焦虑和/或外化行为问题的ASD儿童中。
