Coe Alexander, Ciricillo Jacob, Mansi Sherief, El-Chammas Khalil, Santucci Neha, Bali Neetu, Lu Peter L, Damrongmanee Alisara, Fei Lin, Liu Chunyan, Kaul Ajay, Williams Kent C
From the Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
University of Toledo College of Medicine, Toledo, OH.
J Pediatr Gastroenterol Nutr. 2023 Feb 1;76(2):154-159. doi: 10.1097/MPG.0000000000003662. Epub 2022 Nov 23.
Chronic constipation occurs frequently in children with autism spectrum disorder (ASD). The primary objective was to determine whether chronic constipation is associated with a higher rate of abnormal colonic motor activity in ASD children than in non-ASD children. A secondary goal was to determine if clinical variables could identify children with ASD at risk for possessing abnormal colonic motility.
A retrospective, propensity-matched, case-control study compared colonic manometry (CM) of an ASD cohort and non-ASD controls with chronic constipation. Clinical variables were evaluated as potential predictors for abnormal colonic motility.
Fifty-six patients with ASD and 123 controls without the diagnosis of ASD who underwent CM were included. Propensity score resulted in 35 matched cohorts of ASD and controls. The rate of abnormal CM findings between ASD and matched controls (24% vs 20%, P = 0.78) did not differ significantly. A prediction model of abnormal CM that included ASD diagnosis, duration of constipation, and soiling achieved a sensitivity of 0.94 and specificity of 0.65. The risk for abnormal colonic motility increased 11% for every 1-year increase in duration of constipation. Odds for abnormal motility were 30 times higher in ASD children with soiling than controls with soiling (P < 0.0001).
Chronic constipation does not appear to be associated with a higher rate of abnormal colonic motility in children with ASD. Clinical information of disease duration and presence of soiling due to constipation show promise in identifying patients with ASD at a greater risk for abnormal colonic motility.
慢性便秘在自闭症谱系障碍（ASD）儿童中频繁出现。主要目的是确定慢性便秘在ASD儿童中是否比非ASD儿童具有更高的结肠运动活动异常率。次要目标是确定临床变量能否识别有结肠动力异常风险的ASD儿童。
一项回顾性、倾向匹配、病例对照研究比较了患有慢性便秘的ASD队列和非ASD对照的结肠测压（CM）结果。评估临床变量作为结肠动力异常的潜在预测因素。
纳入了56例接受CM检查的ASD患者和123例未诊断为ASD的对照。倾向评分产生了35对匹配的ASD和对照队列。ASD组和匹配对照组之间CM异常结果的发生率（24%对20%，P = 0.78）无显著差异。一个包含ASD诊断、便秘持续时间和便污情况的CM异常预测模型的敏感性为0.94，特异性为0.65。便秘持续时间每增加1年，结肠动力异常的风险增加11%。有便污情况的ASD儿童出现动力异常的几率比有便污情况的对照组高30倍（P < 0.0001）。
慢性便秘似乎与ASD儿童中更高的结肠动力异常率无关。便秘持续时间和因便秘导致便污的临床信息在识别结肠动力异常风险更高的ASD患者方面显示出前景。
