Feeding disorders and ‘picky’ eating in autism link to medical problems
- Identifying health problems in autism 1 December, London. CPD educational event for parents and professionals.
- Autism Research Should Be Financed Like Venture Capital
- London Support Group Meeting 18 October
- TA Clinical & Research newsletter for professionals – Issue 2 out!
- Century-old drug offers new hope for autism treatment
- October 2017
- September 2017
- June 2017
- May 2017
- April 2017
- March 2017
- February 2017
- January 2017
- December 2016
- May 2016
- April 2016
- March 2016
- October 2015
- June 2015
- November 2014
- September 2014
- June 2014
- January 2014
- June 2013
- March 2013
- March 2012
- January 2012
- November 2011
- October 2011
- September 2011
- June 2011
- May 2011
- March 2011
- September 2010
Feeding disorders and ‘picky’ eating in autism linked to medical problems in some cases
Selective eating, food refusal, irritability and crying during meal times, self-harming behaviours, and sleeping difficulties in children with autism could be due to undiagnosed gastrointestinal conditions. While commonly dismissed as ‘behavioural’ or theorised to be due to sensitivities to food textures, new findings point towards such behaviours in autism being caused by painful gastrointestinal disorders, such as eosinophilic esophagitis (EoE) or esophageal achalasia.
“Feeding disorders in children with ASD should not be assumed to be solely behavioral and an esophagogastroduodenoscopy should be performed to evaluate for EoE.”
Eosinophilic esophagitis is a chronic inflammatory disorder that manifests in reflux-type symptoms that do not respond to standard anti-reflux medication. Achalasia is a primary esophageal motility disorder with similar symptoms, also unresponsive to standard PPI therapy. Its etiology, although not yet fully known, is strongly suspected to be linked to autoimmune and allergy-related mechanisms.
“Difficulties in swallowing (dysphagia) are the cardinal symptom of achalasia. Such a symptom may be difficult to ascertain in autistic children, and other symptoms such as irritability during eating, sudden or unexplained crying during meals, sleep disturbances, sudden aggressive behavior, and even autolesionism (as occurred in one of our patients) may represent the counterpart of chest pain and odynophagia (pain at swallowing). Weight loss and growing retardation should be carefully evaluated in these patients, and the diagnosis suspected and eventually sought for. Regurgitation of indigested food, the other cardinal symptom of achalasia, may be confused with food selectivity or generically related to the behavior disturbance of these patients.”
Heifert TA, Susi A, Hisle-Gorman E, et al. (2016) Feeding Disorders in Children With Autism Spectrum Disorders Are Associated With Eosinophilic Esophagitis. J Pediatr Gastroenterol Nutr. Oct;63(4):e69-73. doi: 10.1097/MPG.0000000000001282.
Betalli P, Carretto E, Cananzi M, et al. (2013) Autism and esophageal achalasia in childhood: a possible correlation? Report on three cases. Dis Esophagus. Apr;26(3):237-40. doi: 10.1111/j.1442-2050.2012.01358.x.
Jarocka-Cyrta E, Wasilewska J, Kaczmarski MG. (2011) Eosinophilic esophagitis as a cause of feeding problems in autistic boy. The first reported case. J Autism Dev Disord. Mar;41(3):372-4. doi: 10.1007/s10803-010-1059-y.
Horvath K, Papadimitriou JC, Rabsztyn, A, et al. (1999) Gastrointestinal abnormalities in children with autistic disorder. The Journal of Pediatrics, 135, 559–563. doi: 10.1016/S0022-3476(99)70052-1.