Monday, November 26, 2018

Reading the Research: Identifying GI Disorders

Welcome back to Reading the Research, where I trawl the Internet to find noteworthy research on autism and related subjects, then discuss it in brief with bits from my own life, research, and observations.

Today's article deals with gastro-intestinal (GI) disorders, which are so commonly found alongside autism that some parents and professionals insist they're part of autism.  Regardless of whether you believe that (I don't), GI disorders do affect at least 25% of autistic people, and that number may be a great deal higher than our numbers show.

The reasons are manifold.  First, for autistic people who are nonverbal or have limited communication, it can be really difficult to convey that you're in pain, or what kind of pain you're experiencing, or that the pain is a regular problem.  Second, if you've had pain in a certain area for as long as you can remember, or pain in that area is a very commonplace occurrence, it may not occur to you to bring it up.  I suffered constipation for much of my childhood, and had no idea it wasn't normal.  The most that was said on the subject was teaching me how to use a plunger to unblock the toilet pipes after I was done.

Third, even if you're capable of conveying the information and recognize the situation as abnormal or relevant, talking about your bathrooming isn't really a normal or polite subject, so it's not necessarily addressed.  Fourth, assuming all these previous conditions are met, the autistic person may not be able to pinpoint exactly where it hurts when asked.  The article quite rightly points out that sensory processing disabilities exist, and can really get in the way of diagnosing a potential problem.  When asked to locate the pain, a person might point to their stomach rather than their colon, which muddles the issue quite effectively.

The article also makes the very excellent point that GI problems can lead directly to behavior problems.  This is a surprising revelation to some people, but it shouldn't be.  At least, not when you think about people who live with chronic pain.  In my experience, such people (including me) tend to be get frustrated more quickly, have less patience for things overall, and can be both aggressive and angry in the wrong circumstances.  Parents sometimes mistake these poor behaviors for symptoms of autism... but while autism can't be cured, GI problems can be.

With all this in mind, the researchers developed a short questionnaire to try to simplify the process.  At only 17 questions, it's not at all bad, and could be easily used in a doctor's office when a parent has concerns about their child's behavior.  And with an accuracy rate of 84%, it's significant enough to reasonably send a parent off to a GI specialist.

Hopefully their second study will come back with similar results, and this questionnaire can be adopted widely.  A lot of kids and adults could be spared a lot of suffering as a result.  

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