Food selectivity, gastrointestinal symptoms and urine organic acids in autism spectrum disorder: A pilot study

Background: Autism Spectrum Disorder (ASD) is characterized by numerous comorbidities including eating problems, the most common of which is food selectivity (FS), and gastrointestinal (GI) dysfunction, which often occurs concurrently with eating problems. Aim: To investigate the relationships between food selectivity, GI symptoms and various metabolic pathways in children with ASD using parental report and quantitative urine organic acid testing. Methods: An anonymous review of the clinical charts of 68 children aged 1.6 to 11 with a diagnosis of ASD was performed. Demographic and health information from intake forms and urine organic acid test reports were analyzed; descriptive statistics and Chi square tests were conducted. Results: Parents of 60% of children reported food selectivity in their child and parents of 69% of children reported GI symptoms. 47% of parents reported both food selectivity and GI symptoms in their child. 90% of the participants were found to have at least one elevated GI fungal metabolite, and 30% or more had elevated levels of 5 different GI bacterial metabolites. No significant correlation between food selectivity and GI symptoms was identified. Conclusion: This study highlights important trends among FS, GI symptoms and select organic acid metabolites; further studies of the clinical significance of these metabolites and their effect on the behavior, sensory experiences and physical symptoms among children with ASD are suggested.