A quarterly publication of the Autism Research Institute

The Autism Research Review International is quarterly publication of the Autism Research Institute

Fall, 2017 | Number 4, Volume 31

Study supports link between ASD, inflammatory bowel disease

A new study adds to evidence that children with autism spectrum disorders (ASD) have a higher prevalence of inflammatory bowel disease (IBD) than children without ASD. 

Maunoo Lee and colleagues conducted a retrospective study using records from the TRICARE MHS database. They identified all children between the ages of 2 and 18 years enrolled in the database between October 2000 and September 2013 who received a diagnosis of ASD. Each child was matched to five controls who were the same age and sex and were enrolled in the same time frame. 

The researchers then identified children in the ASD and control groups who had received a diagnosis of IBD (either Crohn’s disease or ulcerative colitis). They used strict criteria that included both a diagnosis and the outpatient prescription of at least one medication commonly used to treat IBD, excluding treatments such as systemic and enteric steroids that are used less specifically. 

The researchers found that children with ASD had 67% higher odds of having IBD compared to controls. While these odds are lower than those reported in a previous study, they emphasize that their new study used stricter criteria. 

In addition, the researchers found that children with ASD and IBD had higher prescription rates for second-tier biologics than children with IBD but not ASD, possibly indicating greater disease severity. However, they note that this could instead be due to non-compliance with first-tier oral medications, leading to a need for injected drugs. 

They comment, “Children with ASD are often non-verbal and may have difficulties communicating abdominal discomfort. With increased prevalence of IBD in children with ASD with potentially increased severity, it is important for providers to recognize early or possible signs and symptoms of IBD.” These signs, they note, include failure to thrive, down-trending growth charts, and diarrhea.


“Association of autism spectrum disorders and the inflammatory bowel disease,” Maunoo Lee, Jayasree Krishnamurthy, Apryl Susi, Carolyn Sullivan, Gregory H. Gorman, Elizabeth Hisle-Gorman, Christine R. Erdie-Lalena, and Cade M. Nylund, Journal of Autism and Developmental Disorders, November 23, 2017 (online). Address: Maunoo Lee, Dept. of Pediatrics, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, [email protected].