Children with autism spectrum disorder and alterations in eating behavior: could it be gastroesophageal reflux disease?

This study looked at eating problems in 115 autistic children and found that 60% had eating difficulties. Of those with eating problems, almost 90% showed signs of acid reflux (GERD). When doctors examined some children more closely with a camera test, they found inflammation in the throat and stomach in 3 out of 8 children tested. This suggests that some eating problems in autistic children might be caused by medical issues like acid reflux that cause pain or discomfort when eating.

This descriptive study examined 115 children with autism spectrum disorder (ASD) aged 3-12 years to investigate the relationship between eating behavior alterations and gastroesophageal reflux disease (GERD). Using validated screening instruments, researchers found that 60% of children had eating behavior alterations, and among these, 89.8% showed warning signs of GERD. Upper gastrointestinal endoscopy was performed on 8 children with suspected esophagitis, revealing erosive esophagitis in 2 children and eosinophilic esophagitis in 1 child. The findings suggest a potential connection between eating difficulties commonly seen in autism and underlying gastrointestinal conditions, particularly GERD, highlighting the importance of medical evaluation for persistent eating problems in autistic children.

Clinicians should consider GERD screening in autistic children with eating difficulties. Medical evaluation may be warranted for persistent eating problems, as underlying gastrointestinal conditions could be contributing factors. Upper GI endoscopy should be considered when esophagitis is suspected to guide appropriate treatment.

Small sample size for endoscopy (8 children), descriptive design without control group, selection bias as only symptomatic children received endoscopy, and unclear causation between eating behaviors and GERD. Limited generalizability due to single-center tertiary hospital setting.

Describe the occurrence of warning signs of gastroesophageal reflux disease (GERD) and esophagitis in children with eating behavior (EB) alterations associated with autism spectrum disorder (ASD). Descriptive study of 115 children aged 3 to 12 years, followed at a tertiary hospital and previously diagnosed with ASD. The BRCA-TEA instrument was applied to identify children with EB alterations, and the 17-ATN-GISSI instrument was applied to identify those with warning signs of GERD. The selected children were invited for a medical consultation to identify those with suspected esophagitis and an indication for upper gastrointestinal (GI) endoscopy with biopsies.

Sixty-nine children (60 %) were classified with alterations in the EB and, among these, 62 (89.8 %) presented warning signs of GERD. Eighteen children had suspected esophagitis and an indication for upper GI endoscopy. Among the 8 children who underwent the exam, 1 child had grade A erosive esophagitis, 1 child had grade B erosive esophagitis, and 1 child had eosinophilic esophagitis. A high frequency of EB alterations was found in children with ASD.

The high frequency of GERD warning signs may be related to EB alterations in this group. Cases of esophagitis highlight the possibility of an organic disease. In these cases, performing upper GI endoscopy with biopsies is essential for diagnosis.