Evaluation, Diagnosis, and Treatment of Gastrointestinal Disorders in Individuals With ASDs: A Consensus Report

被引：498

作者：

Buie, Timothy ^{[1
,2
,3
]}

Campbell, Daniel B. ^{[6
]}

Fuchs, George J., III ^{[7
]}

Furuta, Glenn T. ^{[8
,9
]}

Levy, Joseph ^{[10
]}

Van de Water, Judy ^{[11
]}

Whitaker, Agnes H. ^{[12
]}

Atkins, Dan ^{[13
,14
]}

Bauman, Margaret L. ^{[2
,4
,5
]}

Beaudet, Arthur L. ^{[15
]}

Carr, Edward G. ^{[16
]}

Gershon, Michael D. ^{[17
]}

Hyman, Susan L. ^{[18
]}

Jirapinyo, Pipop ^{[19
]}

Jyonouchi, Harumi ^{[20
]}

Kooros, Koorosh ^{[21
]}

Kushak, Rafail ^{[1
,4
]}

Levitt, Pat ^{[22
,23
]}

Levy, Susan E. ^{[24
]}

Lewis, Jeffery D. ^{[25
]}

Murray, Katherine F.

Natowicz, Marvin R. ^{[26
,27
,28
,29
]}

Sabra, Aderbal ^{[30
]}

Wershil, Barry K. ^{[31
]}

Weston, Sharon C. ^{[32
]}

Zeltzer, Lonnie ^{[33
]}

Winter, Harland ^{[1
,3
]}

机构：

[1] Harvard Univ, Sch Med, Dept Pediat, Boston, MA 02115 USA

[2] Learning & Dev Disabil Evaluat & Rehabil Serv, Lexington, MA USA

[3] Mass Gen Hosp Children, Pediat Gastrointestinal Unit, Div Pediat Gastroenterol & Nutr, Boston, MA 02114 USA

[4] Mass Gen Hosp Children, Dept Pediat, Boston, MA 02114 USA

[5] Mass Gen Hosp Children, Dept Neurol, Boston, MA 02114 USA

[6] Univ So Calif, Keck Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA 90033 USA

[7] Univ Arkansas Med Sci, Arkansas Childrens Hosp, Div Pediat Gastroenterol Hepatol & Nutr, Little Rock, AR 72205 USA

[8] Childrens Hosp Denver, Sect Pediat Gastroenterol Hepatol & Nutr, Aurora, CO USA

[9] Univ Colorado Denver, Sch Med, Dept Pediat, Aurora, CO USA

[10] NYU, Sch Med, Dept Pediat Adm, NYU Langone LangoneMed Ctr, New York, NY USA

[11] Univ Calif Davis, Dept Internal Med, Div Rheumatol Allergy & Clin Immunol, Davis, CA 95616 USA

[12] Columbia Univ, Dept Psychiat, Div Child & Adolescent Psychiat, New York Presbyterian Hosp, New York, NY USA

[13] Childrens Hosp, Div Ambulatory Pediat, Dept Pediat, Natl Jewish Hlth, Denver, CO USA

[14] Univ Colorado, Sch Med, Dept Pediat, Denver, CO USA

[15] Baylor Coll Med, Dept Mol & Human Genet, Houston, TX 77030 USA

[16] SUNY Stony Brook, Dept Psychol, Stony Brook, NY 11794 USA

[17] Columbia Univ Coll Phys & Surg, Dept Pathol & Cell Biol, New York, NY 10032 USA

[18] Univ Rochester, Med Ctr, Golisano Childrens Hosp Strong, Div Neurodev & Behav Pediat, Rochester, NY 14642 USA

[19] Mahidol Univ, Dept Pediat, Siriraj Hosp, Bangkok 10700, Thailand

[20] Univ Med & Dent New Jersey, New Jersey Med Sch, Div Allergy Immunol & Infect Dis Pediat, Newark, NJ 07103 USA

[21] Univ Rochester, Med Ctr, Golisano Childrens Hosp Strong, Div Pediat Gastroenterol & Nutr, Rochester, NY 14642 USA

[22] Univ So Calif, Keck Sch Med, Zilkha Neurogenet Inst, Los Angeles, CA 90033 USA

[23] Univ So Calif, Keck Sch Med, Dept Cell & Neurobiol, Los Angeles, CA 90033 USA

[24] Univ Penn, Childrens Hosp Philadelphia, Div Child Dev Rehabil & Metab Dis, Dept Pediat, Philadelphia, PA 19104 USA

[25] Childrens Ctr Digest Hlth Care LLC, Atlanta, GA USA

[26] Cleveland Clin, Inst Pathol & Lab Med, Cleveland, OH 44106 USA

[27] Cleveland Clin, Inst Gen Med, Cleveland, OH 44106 USA

[28] Cleveland Clin, Inst Neurol, Cleveland, OH 44106 USA

[29] Cleveland Clin, Inst Pediat, Cleveland, OH 44106 USA

[30] UNIGRANRIO, Brasilian Acad Med, Escola Med, Dept Pediat, Rio De Janeiro, Brazil

[31] Northwestern Univ, Childrens Mem Hosp, Feinberg Sch Med NW, Div Gastroenterol Hepatol & Nutr, Chicago, IL 60614 USA

[32] Childrens Hosp Boston, Dept Gastroenterol & Nutr, Peabody, MA USA

[33] Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Pediat Pain Program, Los Angeles, CA 90095 USA

来源：

PEDIATRICS | 2010年 / 125卷

关键词：

autism spectrum disorder; gastrointestinal; constipation; chronic diarrhea; abdominal discomfort; problem behavior; gluten-free casein-free diet; AUTISM SPECTRUM DISORDERS; INDUCED ENTEROCOLITIS SYNDROME; LYMPHOID-NODULAR HYPERPLASIA; COMMON DIETARY PROTEINS; NORTH-AMERICAN-SOCIETY; PROBLEM BEHAVIOR; PEDIATRIC-GASTROENTEROLOGY; CYTOKINE PRODUCTION; REGRESSIVE AUTISM; ADVERSE-REACTIONS;

D O I：

10.1542/peds.2009-1878C

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Autism spectrum disorders (ASDs) are common and clinically heterogeneous neurodevelopmental disorders. Gastrointestinal disorders and associated symptoms are commonly reported in individuals with ASDs, but key issues such as the prevalence and best treatment of these conditions are incompletely understood. A central difficulty in recognizing and characterizing gastrointestinal dysfunction with ASDs is the communication difficulties experienced by many affected individuals. A multidisciplinary panel reviewed the medical literature with the aim of generating evidence-based recommendations for diagnostic evaluation and management of gastrointestinal problems in this patient population. The panel concluded that evidence-based recommendations are not yet available. The consensus expert opinion of the panel was that individuals with ASDs deserve the same thoroughness and standard of care in the diagnostic workup and treatment of gastrointestinal concerns as should occur for patients without ASDs. Care providers should be aware that problem behavior in patients with ASDs may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders. For these patients, integration of behavioral and medical care may be most beneficial. Priorities for future research are identified to advance our understanding and management of gastrointestinal disorders in persons with ASDs. Pediatrics 2010; 125: S1-S18

引用

页码：S1 / S18

页数：18

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