Symptoms of constipation in autistic adults: A systematic literature review on diagnostic methods and presence of actual symptoms
Authors: Smith Wynn , Desprez Charlotte 
Published: October 2024

Autism significantly impacts how individuals interact, communicate and perceive the world. Gastrointestinal disturbances, particularly constipation, are prevalent among autistic people, affecting their overall well-being. However, to the best of our knowledge, no specific guidelines are currently available regarding the diagnosis of constipation among this population. This systematic review investigates various diagnostic methods employed in studies addressing constipation among autistic adults. It aims to identify discrepancies between the symptoms reported based on diagnostic methods and the actual symptoms experienced by this population. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, nine studies conducted between 2012 and 2022 were included, revealing a predominance of non-prospective designs and an emphasis on children and adolescents. Diagnostic tools varied, including standardized criteria, questionnaires and observation. The prevalence of symptoms not outlined in the official criteria, such as sleep disorders and challenging behaviours, emerged as crucial aspects requiring comprehensive assessment in autistic people experiencing constipation. The study highlights the need for age-specific research in order to develop tailored assessment tools to improve diagnostic accuracy and enhance the overall management of constipation in autistic adults. Recognizing the diverse manifestations of constipation in this population is crucial for developing nuanced interventions and advancing healthcare strategies. Lay abstract Autistic people often experience gastrointestinal issues, with constipation being one of the most common concerns. However, there are currently no specific guidelines for diagnosing constipation in autistic adults. This makes it harder for healthcare providers to identify and treat the condition effectively. In this review, we analysed nine studies from 2012 to 2022 to understand the various methods used to diagnose constipation in autistic adults and their symptoms. We found that most studies used different approaches, such as questionnaires, standardized criteria, or observation. In addition, many studies focused on children and adolescents, leaving a gap in understanding symptoms in autistic adults. The studies highlighted symptoms that were not covered by official diagnostic criteria, such as sleep disturbances and challenging behaviours. This indicates a need for healthcare providers to consider a broader range of signs when diagnosing constipation in autistic people. Our review suggests that more research focusing on adults is needed to create tailored tools for diagnosing constipation in autistic adults. This will help improve accuracy and ensure better treatment outcomes. Understanding the unique ways constipation can present in autistic people is crucial for developing effective care strategies. For healthcare providers, this review emphasizes the importance of recognizing a wide range of symptoms when assessing constipation in autistic people. For policymakers, it highlights the need for age-specific guidelines to ensure that autistic adults receive the care and support they need. Further research will help refine these diagnostic tools and ultimately lead to better healthcare practices for autistic people.