BMJ 2002;325:419-421 ( 24 August )

Primary care

Relation of childhood gastrointestinal disorders to autism: nested case-control study using data from the UK General Practice Research Database

Corri Black, research associate,  James A Kaye, senior epidemiologist,  Hershel Jick, associate professor of medicine. 

Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, MA 02421, USA

Correspondence to: C Black cxb2{at}ph.abdn.ac.uk

Objectives: To assess whether children with autism are more likely to have a history of gastrointestinal disorders than children without autism.
Design: Nested case-control study.
Setting: UK General Practice Research Database.
Subjects: Children born after 1 January 1988 and registered with the General Practice Research Database within 6 months of birth.
Outcome measures: Chronic inflammation of the gastrointestinal tract, coeliac disease, food intolerance, and recurrent gastrointestinal symptoms recorded by the general practitioner.
Results: 9 of 96 (9%) children with a diagnosis of autism (cases) and 41 of 449 (9%) children without autism (matched controls) had a history of gastrointestinal disorders before the index date (the date of first recorded diagnosis of autism in the cases and the same date for controls). The estimated odds ratio for a history of gastrointestinal disorders among children with autism compared with children without autism was 1.0 (95% confidence interval 0.5 to 2.2).
Conclusions: No evidence was found that children with autism were more likely than children without autism to have had defined gastrointestinal disorders at any time before their diagnosis of autism.

What is already known on this topic Gastrointestinal disease with a characteristic endoscopic and pathological appearance has been reported among a case series of children with autism and hypothesised to be related to measles, mumps, and rubella vaccination The incidence of autism has been rising over the past decade despite a stable rate for measles, mumps, and rubella vaccination among the same population What this study adds Children with autism are no more likely than children without autism to have had gastrointestinal disorders at any time before the diagnosis of autism Less than 10% of children diagnosed with autism have a history of gastrointestinal disorders, and for most the symptoms are mild No temporal association was found between measles, mumps, and rubella vaccination and the onset of gastrointestinal symptoms in children with autism

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