Thursday, 18 September 2014

Anxiety and sensory over-responsivity linked to gut issues in autism

"The name's Lonnegan! Doyle Lonnegan!"
Consider this micropost an extension of some previous discussions on this blog about how gastrointestinal (GI) issues present in cases of autism might show some connection to the presence of anxiety and sensory issues (see here). Today I'm discussing further research by Micah Mazurek and colleagues [1] which follows a previous publication by this author [2] on this topic.

In the latest paper, Dr Mazurek and colleagues describe the course of abdominal pain in 225 children diagnosed with an autism spectrum disorder (ASD). Of the quarter of participants who presented with "chronic abdominal pain at baseline", the majority (over 80%) still had the same GI issue at 1-year follow-up. Indeed, a further 25% of those who did not present with abdominal pain at the start of the study finished the study with such an issue. The authors conclude: "Abdominal pain appears to be common and persistent among children with ASD". Further, anxiety and sensory over-responsivity also seemed to correlate with bowel features which is probably not unexpected.

Yes, you might indeed say that this study was based on "the parent-reported GI Symptom Inventory Questionnaire" among other things and so one has to be slightly cautious about inferring states. But as I've mentioned before on this blog, parents/primary caregivers tend to be pretty good at picking up when such issues are present in their children (see here) if not precise to all the technical details [3].

Perhaps the most important detail about the Mazurek study is their mention of the word 'pain' and how so many of their cohort seemed to be enduring quite a bit of it for such a long period of time. You wouldn't think that there was guidance on identifying and managing these issues [4] would you? And whilst we are on the topic of GI issues and autism, I might as well bring your attention to the potentially important question asked by Heitzer and colleagues [5]: Should clinical trial research of psychotropic medication in autism control for gastrointestinal symptoms? Answers on a postcard please (although I will blogging about this paper in times to come).

So then, how about William Shatner singing Pulp to close. Replacing a Sheffield accent with a Montreal one... mmm, maybe he needs a little Henderson's Relish with that cheese?

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[1] Mazurek MO. et al. One-year course and predictors of abdominal pain in children with autism spectrum disorders: The role of anxiety and sensory over-responsivity. Research in Autism Spectrum Disorders. 2014; 8: 1508-1515.

[2] Mazurek MO. et al. Anxiety, sensory over-responsivity, and gastrointestinal problems in children with autism spectrum disorders. J Abnorm Child Psychol. 2013 Jan;41(1):165-76.

[3] Gorrindo P. et al. Gastrointestinal dysfunction in autism: parental report, clinical evaluation, and associated factors. Autism Res. 2012 Apr;5(2):101-8.

[4] Buie T. et al. Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report. Pediatrics. 2010; 125: S1-S18.

[5] Heitzer AM. et al. Should clinical trial research of psychotropic medication in autism control for gastrointestinal symptoms? J Clinical Pharmacology. 2014. 6 May.

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ResearchBlogging.org Mazurek, M., Keefer, A., Shui, A., & Vasa, R. (2014). One-year course and predictors of abdominal pain in children with autism spectrum disorders: The role of anxiety and sensory over-responsivity Research in Autism Spectrum Disorders, 8 (11), 1508-1515 DOI: 10.1016/j.rasd.2014.07.018