Constipation in Children with Autism Spectrum Disorder Associated with Increased Emergency Department Visits and Inpatient Admissions

      Objective

      To evaluate whether constipation in children with autism spectrum disorder (ASD) is associated with increased emergency department (ED) visits and inpatient admissions compared with constipation in children without ASD.

      Study design

      The Nationwide Emergency Department Sample was used to retrospectively examine demographic data, clinical characteristics, and outcomes of children with ASD and children without ASD who visited the ED for constipation between 2006 and 2014.

      Results

      ED visits by children with ASD were more likely to be constipation-related compared with visits by children with other chronic conditions or children with no chronic conditions (1.9% vs 0.6% vs 0.9%; P < .001). Children with ASD were more likely than children with other chronic conditions or no chronic conditions to be admitted to the hospital after an ED visit for constipation (15.0% vs 10.6% vs 1.2%; P < .001). Hospital charges were higher in children with ASD than in those without chronic conditions.

      Conclusions

      Constipation is responsible for a large proportion of ED visits and more inpatient admissions resulting from these ED visits. These findings suggest a need for developing more effective outpatient therapies for constipation in children with ASD.

      Keywords

      Abbreviations:

      ABA ( Applied behavioral analysis), ASD ( Autism spectrum disorder), ED ( Emergency department), GI ( Gastrointestinal), HCUP ( Healthcare Cost and Utilization Project), ICD-9-CM ( International Classification of Diseases, Ninth Revision, Clinical Modification), NEDS ( Nationwide Emergency Department Sample)
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      Linked Article

      • Constipation Burden in Children with Autism Spectrum Disorder: Emergency Department and Healthcare Use
        The Journal of PediatricsVol. 202
        • In Brief
          Autism spectrum disorder (ASD) is associated with high rates of gastrointestinal (GI) disturbances and comorbidities. The reported prevalence of GI symptoms in children with ASD varies greatly, which reflects methodologic limitations; however, constipation is consistently among the most frequently reported GI symptoms, with a prevalence of up to 50% or more, and has a meaningful impact on children with ASD and their families.1-4 Difficulties in acquiring bowel training, behavioral stool withholding, inadequate fluid intake, low fiber consumption, decreased activity, and medications resulting in altered GI and specifically decreased colonic motility have been cited as potential etiologies of constipation of children with ASD.
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