Constipation is commonly seen in autistic people, but with treatment and high fiber meals, it can be reduced.

It’s not uncommon for someone to experience constipation from time to time. After all, sometimes all it takes is a slight change in diet, sleep, or even activity level to cause a “backup” in your regular routine.

But for millions of autistic people, constipation may be a common occurrence that can become a chronic issue if left untreated. In fact, 2021 research suggests that one of the most common symptoms among autistic people ― especially autistic children ― is chronic constipation.

Ahead, we’ll explore the relationship between autism and constipation, including how autistic folks with chronic constipation can learn to manage this condition.

Research suggests that there is a significant relationship between autism spectrum disorder (ASD) and gastrointestinal symptoms like constipation.

In a study from 2019, researchers explored the relationship between externalizing problem behaviors, internalizing symptoms, and gastrointestinal symptoms in autistic children and adults.

Results of the study found that more than half of the participants ― roughly 65% ― experienced constipation, with many also experiencing stomach pain, nausea, and diarrhea. In addition, the researchers found that older autistic children who had greater anxiety levels were more likely to report having constipation.

Another 2021 study explored the relationship between ASD and constipation by analyzing research on the gut microbiome of autistic folks. According to the results, stool samples taken from autistic participants showed abnormal levels of different bacteria related to constipation.

Behavioral elements

One of the reasons that autistic people may be at a higher risk of constipation is because of limited food preferences. For example, one recent study found that food selectivity in ASD was indirectly associated with gastrointestinal issues like constipation.

Behavioral difficulties might also play a role in constipation risk ― especially in children who have rigid toilet-related behaviors, like avoiding going to the bathroom. Some autistic children may even have trouble communicating when they need to poop, which can reinforce these types of behaviors.

Chronic constipation can also affect mood and behavior in autistic children, creating a behavioral cycle. For example, constipation may lead to an increase in symptoms like irritability, hyperactivity, and defiance, which in turn can worsen some of the difficulties mentioned above.

Learn about when constipation can become an emergency.

Autistic children can experience difficulties with daily behaviors, like bathing, eating, or using the bathroom. In some children, this can even include having trouble with urination or bowel movements.

Restricted or repetitive behaviors are common in autism and may explain why some autistic children have trouble using the bathroom. For example, when an autistic child is engaged in another behavior that is more comforting or interesting, they might choose to withhold their bowel movements.

A research review in 2016 also shows that autistic people may have a lowered ability to recognize internal cues, making it difficult for children to recognize when they have to use the bathroom.

Frequently withholding bowel movements can also change a child’s ability to recognize when they need to poop.

Researchers suggest that chronic constipation cannot only increase the risk of hospital visits and inpatient admissions for autistic folks, but it can also raise their chances of complications, like bowel obstruction.

But for many autistic folks, treating chronic constipation isn’t necessarily as simple as making a few dietary changes. Instead, the focus should be on a combination of behavior-based changes and nutrition recommendations.

Treating constipation in children

Toilet training can be helpful for autistic children because it can reinforce good toilet habits, like peeing and pooping when the urge arises. Because toilet training can be more difficult for autistic children, it can be beneficial to have the help of an occupational therapist or other pediatric expert.

Food-related behavioral training can also help address behaviors that may increase the risk of constipation. For example, creating mealtime and bathroom routines, trying new fiber-rich foods, and adding supplements can all help reduce constipation risk.

Treating constipation in adults

While autistic adults may not have as much trouble with toilet training, other behaviors can make constipation worse ― like forgetting to eat or use the bathroom. In this case, it can be helpful to create new routines, such as having scheduled mealtimes and bathroom visits.

And for autistic adults, it’s also important to treat the constipation directly. Lifestyle changes like increasing water and fiber intake, getting regular exercise, and even practicing bowel training can all help reduce the risk of constipation in adults.

Learn more about eating well with autism.

Autistic people have a higher risk of gastrointestinal symptoms, especially chronic constipation. Chronic constipation in autistic folks may be due to several factors, like limited food preferences, rigid bathroom behaviors, and trouble recognizing internal cues, to name a few.

However, with the right behavioral and nutritional approaches, autistic folks can learn to manage their bowel habits and reduce their risk of constipation.