This retrospective study compared chronic constipation outcomes, medication adherence, and management needs at 1 year and most recent follow-up between 74 children with ASD and 122 without ASD seen at a tertiary motility service, and explored whether ASD severity level influenced prognosis.
Children with ASD had significantly lower medication adherence (56.8% vs. 76.2%, p=0.006) and lower constipation resolution at last follow-up (11% vs. 25%, p=0.036) compared to non-ASD peers; ADHD co-occurred in 50% of the ASD group vs. 13.9% of controls (p=0.0001). Outcomes were broadly similar across ASD severity levels, though toileting compliance trended lowest in Level 3.
Retrospective single-centre design limits generalisability; "resolution" and adherence were not defined by validated instruments; ASD severity subgroups may have been underpowered to detect differences.
Children with ASD managed for chronic constipation at specialist centres show markedly lower adherence and resolution rates—clinicians should proactively implement multidisciplinary, tailored strategies (e.g., occupational therapy, behavioural support) regardless of ASD severity level. Screen routinely for ADHD as a common co-occurring barrier to treatment engagement in this group.
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