Laxatives And Autism: Is There A Link?

can laxatives cause autism

There is no evidence that laxatives cause autism. However, constipation is a common issue for autistic children, affecting 1 in 3 children. This can cause a delay in potty training and achieving reliable bowel and bladder control. Autistic children often have restricted diets, which can make constipation more likely. Laxatives are often used to treat constipation in autistic children, and there are concerns about the safety of some of these treatments. For example, Miralax (also known as PEG or polyethylene glycol) has been linked to neurological or psychiatric problems in children, although there is conflicting evidence about its safety. Overall, while laxatives themselves do not cause autism, they are sometimes used to treat constipation, which is a common issue for autistic children.

Characteristics Values
Laxatives Polyethylene glycol (PEG) 3350, also known as Miralax
Autism A neurodevelopmental disorder characterised by difficulties in social interaction and communication, and restricted and repetitive behaviour
Link between laxatives and autism No evidence of a causal link between the two
Laxative concerns Long-term use of PEG may be unsafe; concerns about the presence of ethylene glycol, a component of antifreeze, in PEG
Alternative treatments Dietary and behavioural changes, other laxatives (e.g. lactulose, mineral oil, magnesium laxatives)


Polyethylene glycol (PEG) 3350, the main ingredient in laxatives like Miralax, is linked to long-term changes in the gut microbiome, contributing to leaky gut

Polyethylene glycol (PEG) 3350 is a common ingredient in laxatives, notably Miralax, used to treat constipation in children. Its widespread use has raised concerns about its potential impact on gut health and neurological development, especially in children with autism who experience chronic constipation.

Several reports to the Food and Drug Administration (FDA) have linked PEG 3350 to increased anxiety, aggression, and obsessive-compulsive behaviours in children. These reports have sparked investigations and scientific studies to assess the safety of this ingredient.

One study, conducted by Dr. Ross Maltz and colleagues, administered PEG3350 to mice to evaluate its effect on anxiety-like behaviours. The results showed no difference in anxiety-like behaviours between mice given high or low doses of PEG3350. However, the study did find that PEG3350 altered the gut microbiome, specifically the relative abundances of several bacterial taxa.

Another study, led by Salman S. Salman, investigated the impact of PEG3350 on stool consistency and the gut microbiome in CD1 mice. This study also found that PEG3350 altered stool consistency and the gut microbiome but did not induce anxiety-like behaviours in the mice.

While these studies provide valuable insights, it is important to note that they were conducted on animal models, specifically mice. Further evaluations in paediatric patients are warranted to definitively determine the safety profile of PEG3350.

In conclusion, while PEG 3350 has been linked to changes in the gut microbiome, the current evidence does not support a direct link between this ingredient and the development of autism. However, the impact of PEG3350 on gut health and its potential long-term effects are areas that require further investigation, especially considering the widespread use of this laxative ingredient.

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Constipation is common in autistic children due to restricted diets, sensory issues, and communication challenges

Constipation is a common issue for children with autism, and it can be challenging to treat due to the symptoms of autism. Autistic children often experience gastrointestinal issues, including constipation, which can cause pain and anxiety for the child and their parents.

One reason constipation is common in autistic children is restricted diets. Autistic children often have limited diets that may not include enough fibre or fluids, leading to constipation. Milk consumption, for example, has been found to be the strongest predictor of constipation in autistic children. This may be because autistic individuals' gastrointestinal systems handle milk products differently. However, it's important to note that milk doesn't necessarily cause constipation but could be a contributing factor for some.

Sensory issues also play a role in constipation for autistic children. They may find it challenging to try new foods or drinks, making it difficult to introduce more fibre and fluids into their diet. Additionally, they might have sensory issues related to the toilet, such as anxiety about being in the bathroom, especially away from home, or difficulty with the sensation of sitting on the toilet. These sensory challenges can lead to withholding behaviours, where children hold in their bowel movements to avoid discomfort or unfamiliar sensations.

Communication challenges in autistic children can further compound the issue of constipation. They may not be able to verbally express that they are experiencing pain or difficulty with bowel movements. This can lead to aggressive or self-injurious behaviours as their only means of communicating their discomfort. Additionally, parents may have to rely on external clues and behaviours to recognise that their child is constipated.

To address constipation in autistic children, a combined approach is recommended, including medication and behavioural strategies, along with regular support and follow-up. Dietary changes, such as increasing fibre and fluid intake, are often the first line of treatment. However, it's important to note that behavioural changes, such as regular exercise and establishing good daily bowel habits, are also crucial. Working with a behavioural therapist can be beneficial when implementing these dietary and behavioural modifications. In some cases, medication may be necessary, especially if the constipation is severe.

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Laxatives can cause behavioural side effects, such as aggression and self-injurious behaviour, in autistic children

Constipation is a common issue for autistic children, who often experience dietary restrictions that make them more likely to become constipated. Laxatives are frequently used to treat constipation, but they can have behavioural side effects such as aggression and self-injurious behaviour.

Constipation can be extremely painful, and autistic children who struggle with communication may not be able to express this pain verbally. Instead, they may resort to using their behaviour as a form of communication, leading to aggressive and self-injurious behaviours. This is often the only way they can express their misery, and it can be challenging to identify the root cause of their distress.

The pain associated with constipation can also disrupt sleep patterns, causing children to wake up in the middle of the night and have difficulty falling back asleep. This can further contribute to behavioural issues and impact their overall well-being.

It is important for parents and caregivers to be aware of the potential side effects of laxatives and to monitor their children closely for any changes in behaviour. In some cases, alternative treatments or a combination of approaches may be more suitable for managing constipation in autistic children.

The safe and effective management of constipation in autistic children is a complex issue. While laxatives can be effective, they should be used with caution and under the guidance of a healthcare professional. Behavioural and dietary changes, such as increasing fluid intake and dietary fibre, can also play a crucial role in treating constipation. Working with a behavioural therapist can be beneficial when implementing these changes.

Additionally, it is important to address the underlying causes of constipation in autistic children. This may include dietary restrictions, sensory issues, or other factors related to their autism. A comprehensive approach that considers the unique needs of each child is essential for effective management of constipation and its associated behavioural side effects.

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Constipation can delay potty training and affect bladder control in autistic children

Constipation is a common problem for children, affecting one in three. It is even more prevalent in children with autism, who may have nutritional and sensory issues that make them predisposed to problems with defecation.

How constipation affects autistic children

Constipation can cause pain and anxiety for autistic children and their parents, on top of the other issues they face in their daily lives. It can also cause a delay in potty training and the child achieving reliable bowel and bladder control.

Why autistic children become constipated

Autistic children often have restricted diets, which can make constipation more likely. They may also have a poor fluid intake, as most young children do not have a good awareness of thirst.

How to spot constipation

There is often a delay in recognising when a child is constipated, and there are few definite signs. It's important to look carefully at the child's bowel pattern. The normal bowel pattern is to have a soft sausage-shaped poo at least three times a week, but some people have a more frequent pattern, sometimes several times a day.

One alert sign is an alteration in the bowel pattern, which may happen when routines change, such as when going on holiday, a new baby arriving, or starting playgroup. When children are unwell, this may be associated with a change in the bowel pattern, linked to different fluid intake and food.

Large, irregular, painful bowel actions are usually associated with constipation. The abdomen may be distended at times. Children can sometimes have abdominal pain and become irritable, with poor eating and sleeping patterns.

How to relieve constipation

The NICE guidelines recommend that children with constipation have a physical examination by a medical professional. Usually, further investigations are not needed.

For children on the autism spectrum, there should always be a combined approach with medication and behavioural strategies, as well as regular support and follow-up.

How to prevent constipation

Prevention is key, so discussing diet and bowel habits should be a standard part of well-child visits. Parents can ensure their infant's diet includes adequate fibre and water as they start solid food at around six months of age.

How to treat constipation

When constipation has developed, it needs to be treated effectively. The NICE guidelines state that to do this, appropriate medication is needed. This is a two-stage process: disimpaction to empty the bowels, followed by regular maintenance treatment. This often needs to be continued for several months, or sometimes longer.

How to support autistic children with constipation

When working with an autistic child, it is important to explore their difficulties from both an autistic and a medical perspective. For example, a child may be in pain (from a medical perspective), but they may not be aware of it or may not communicate it (from an autistic perspective).

Tips for supporting toilet training

  • Start early and help your child get used to being in the bathroom. Learning skills such as sitting on a potty and washing their hands will help later.
  • Reward your child's effort as much as their success.
  • Break down the task into easy steps.
  • Include toileting in your child's regular daily routines, for example, by going to the toilet 20 minutes after meals, before bedtime, and after waking up.
  • Teach words and signs for toilets, wee and poo, using pictures too.
  • Make going to the toilet fun – and not scary!

Strategies to help autistic children go from nappies to the potty or toilet

  • Encouragement and rewards.
  • Descriptive praise, for example, 'Charlie, well done for sitting on the toilet'.
  • Non-verbal praise, gestures (clapping) or signs (thumbs up).
  • A favourite activity, for example, playtime with trains.
  • A star on a reward chart.
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Mitochondrial dysfunction

Mitochondrial dysfunction is highly associated with gastrointestinal symptoms such as constipation. Gastrointestinal symptoms are prevalent in autism spectrum disorder (ASD), and imbalances in the enteric microbiome have been associated with ASD. The connection between gastrointestinal symptoms and ASD through mitochondrial dysfunction is compelling since ASD is strongly associated with both gastrointestinal symptoms and mitochondrial dysfunction.

Thyroid dysfunction

Thyroid testing is frequently ordered to evaluate constipation in children. However, the contribution of occult hypothyroidism to isolated constipation in children may have been previously overestimated. In a study of 873 patients on whom thyroid testing was performed, only one child had constipation as their sole presenting symptom.

Food allergies

Various studies have suggested that food allergies play a role in causing or worsening autism. Specifically, gluten and casein have been blamed for worsening symptoms in children with autism. However, authors of alternative medicine literature on the subject of autism and food allergies admit that allergy tests to these foods are usually negative, and that most of these children do not seem to experience typical symptoms of food allergies.

Gut dysbiosis

In recent years, we have been learning that the bacteria we harbor in our intestines may affect everything from the diseases we develop to our moods. This science is still in its infancy, and it is uncertain what, if any, role gut bacteria play in autism.

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