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A New Path to Relief: Gastrostomy Tubes Offer Treatment for Children With Autism and Chronic Constipation

A New Path to Relief: Gastrostomy Tubes Offer Treatment for Children With Autism and Chronic Constipation 1024 680 Pam Georgiana
Close up color photo of little boy holding hands on his belly

A groundbreaking study reveals how a low-risk intervention dramatically improves quality of life.

Children with autism spectrum disorder often struggle with chronic constipation due to behavioral, sensory and dietary challenges. Uncontrolled constipation can cause poor school functioning, eating challenges and sleeping issues. In many cases, due to oral sensory issues, children with autism cannot reliably take oral medications or fluids to manage chronic constipation.

A retrospective study at Nationwide Children’s Hospital evaluated how children with autism and functional constipation who could not tolerate oral therapy responded to a different sort of therapy. Published in JPGN Reports, this is the first study to examine the use of a gastrostomy tube as a therapeutic strategy for this specific patient population.

“Functional constipation is the most common, yet challenging to manage, gastrointestinal issue we see in autistic children,” Kent C. Williams, MD, an attending pediatric gastroenterologist at Nationwide Children’s, explains. “It can be quite severe and profoundly affect a child’s quality of life.”

The study reviewed nine pediatric patients who received tube placement at Nationwide Children’s between 2020 and 2023. The median age was 7.4 years. Most had severe autism with limited verbal ability. Before tube placement, all patients experienced significant bowel dysfunction. Doctors administered stool softeners, laxatives and fluids through the tube. After tube insertion, notable improvements were seen in stool consistency, frequency of bowel movements and reduced straining.

“We saw measurable gains in quality of life. Patients were calmer, sleeping better and eating better,” Dr. Williams noted. “In some cases, this one intervention made a huge impact.”

Importantly, all patients tolerated the tube well. There were no cases of tube dislodgement, infection or removal due to behavioral issues, even among patients with severe sensory or behavioral challenges.

“Parents worried their child might pull the tube out,” Dr. Williams says. “But that has not been the case. Even in the kids with intense behavioral concerns, the tubes have been well tolerated.”

While gastrostomy tubes are typically used for nutritional support, this study demonstrates a novel use in treating severe functional constipation. It also provides an option to delay or prevent more invasive surgical interventions.

“This has given us an easier, lower-risk surgical option,” Dr. Williams explained. “We have done about six more cases beyond this study, and the results remain promising.”

Roughly one-third of the patients in the study have since had their tubes removed. “The long-term goal is always to work toward oral or even no medication. However, for some children, the tube could be a lifelong tool,” says Dr. Williams, who is also an associate professor of Clinical Pediatrics at The Ohio State University College of Medicine.

While more research is needed, this single-institution study provides early evidence that gastrostomy tube placement is a safe, effective and well-tolerated intervention for children with treatment-resistant functional constipation.

“It is not yet standard practice, but it should be considered,” concludes Dr. Williams. “This is a viable treatment option that can dramatically improve a child’s quality of life.”

 

Reference:

Srinivas S, Halaweish I, Griffin KL, Rodriguez C, Pruitt LCC, Stephenson KG, Yossef L, Wood RJ, Williams KC. Gastrostomy tube placement for children with autism spectrum disorders and functional constipation. JPGN Rep. 2024;6(1):5-10.

Image credit: Adobe Stock

About the author

Pam Georgiana is a brand marketing professional and writer located in Bexley, Ohio. She believes that words bind us together as humans and that the best stories remind us of our humanity. She specialized in telling engaging stories for healthcare, B2B services, and nonprofits using classic storytelling techniques. Pam has earned an MBA in Marketing from Capital University in Columbus, Ohio.

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