Constipation on the Autism Spectrum


By Dr. Janet Lintala

gandalfYou might be an autism parent if you think Gandalf the Grey’s famous line, “You shall not pass!” is referring to your child’s bowel movements.

 But seriously, You might be an autism parent if:

  • Your child has four or less bowel movements a week
  • You wonder how your child passed something that enormous
  • Your toilet is frequently clogged
  • Your child whines and cries, and is afraid to poop
  • Constipation is making your child anxious, grumpy and irritable

What you see isn’t always what you get on the Autism Spectrum, and although the struggles with social communication and behaviors that children and adults may have are well known, very little is devoted to associated conditions such as constipation.

Constipation is a monumental fact of daily life for up to 70% of folks on the autism spectrum 1,2 and doesn’t always respond to the time-tested advice of increasing fiber, fluids and exercise.  With most of us on a tight budget, it gets awfully expensive to go to the pediatrician, get an x-ray or even have our child admitted to the hospital for painful bouts of constipation.

 Vicious Cycles in Constipation:

 Today’s Special: Constipation with a Side of Reflux!

As an autism mother, I know our children are vulnerable to some pretty vicious cycles.  Constipation can contribute to and cause acid reflux, which can create discomfort and pain, irritability and difficulty falling asleep. (Sound familiar?)  They often take medications to help with these problems, which ends up in a predictable cycle:constipation cycle

And here’s another cycle they get caught in:  Does your child hold in his bowel movements, or have messy smears in his underpants?  Constipation cause hard dry stools that may be painful to pass, and many children hold off going to the bathroom as long as possible out of fear.  This is called encopresis and sets up another vicious cycle of constipation as illustrated below:constipation cycle2

What’s an autism parent on a budget to do?

Here are 15 Ways to Help ASD Constipation (And avoid expensive trips to the doctor!):

Laxatives are cheap and easy to use, but don’t actually cure constipation and are only for short-term use.  In fact, long term use of stimulant laxatives can have serious side effects 39,30,41,42, decrease bowel function and lead to…constipation!  Ouch, not fair! They can also reduce the effect of medications if taken too closely together, and cause inflammation of the lining of the intestine. Of course, be sure to tell your doctor if abdominal pain is severe, or you notice bloody stools and unexplained weight loss.

Let’s explore some other options:

gluten free#1.  Gluten-free, Casein-free DietIt’s a myth that the GFCF Diet is very expensive, but it can be a budget buster if you purchase lots of prepackaged specialty items.  I love making simple delicious meals for my children, and the GFCF Diet is budget-friendly for the thrifty home cook.  Click here for some great tips to serve up yummy gluten-free, casein-free meals that won’t break the bank.

When pennies really count, check out this link for how to do the diet on public assistance:  I have seen hundreds of cases of constipation clear up within a few weeks of introducing either the GFCF Diet, enzymes with DPP-IV or both.

Tip for Success:  The diet and enzymes must be introduced gradually, as the children will actually experience a withdrawal from these opiate peptides. Note:  Some blends contain cellulase, and this ingredient should not be used if your child is on time-release medications.

#2.  Enzymes with DPP-IVfor best results, choose a broad-spectrum blend with DPP-IV.  Dipeptidyl peptidase IV is the key to breaking the cycle of constipation and it attacks the opioids creating the problem.  You will not see success if your blend doesn’t have any DPP-IV enzyme. Be sure to introduce both the GFCF Diet and the digestive enzymes with DPP-IV gradually, as your child may experience an opiate withdrawal with these methods. Houston Enzymes makes a great tasting chewable if your child has trouble swallowing pills.

Vitamin-C#3.  High Dose Vitamin CIf you’re like me, you prefer a natural healthy approach, rather than harsh chemical choices.  The laxative effect of higher amounts of Vitamin C is well known 34,35. By gradually increasing the amount, you can find a dose that gets your child’s bowels moving without causing any blowouts.  This gradual increase is called “titrating to bowel tolerance”.  Vitamin C is safe, natural and has many health benefits 33.  It’s a fact that children on the autism spectrum are often low in antioxidants 38, so this is a supplement they need anyway!

aloe#4.  Aloe Juice – Wouldn’t it be great if there was some remedy you had to give your child tasted, smelled and looks like spring water?  Well, look no further – aloe vera to the rescue!  Aloe Vera and Aloe Barbadensis not only have a laxative effect on the bowels 34, but calm down inflammation 37 and have healing properties for the intestinal tract 35.  It’s easy to grow Aloe even if you don’t have a green thumb, and you can really save some money by making your own:

If you don’t want to make your own, Premier Research Labs Aloe Pro is a great organic, preservative free option.

Falling in love with Aloe?  Here’s a review of the health benefits of this amazing plant.

#5.  MagnesiumThis cheap home remedy has a bonus – magnesium is very calming!

#6.  Fermented foods We don’t eat as many fermented foods like foods like yogurt, kefir, kimchee or sauerkraut these days, and it’s a shame because they help keep bowels moving thanks to their load of beneficial organisms.  Making fermented foods at home is surprisingly easy, but kids may not appreciate the new flavors at first. Hang in there!

chia seeds#7.  Chia Seeds – Soak 2 tablespoons of Chia seeds in water, hemp milk, coconut milk, or rice milk overnight in the fridge. In the morning they will have formed a “Chia Gel“. Eat and drink this first thing in the morning. This Chia gel or Chia drink (depending on how thick or runny you prefer it) works as a broom for your intestines! To make a delicious breakfast, add fresh chopped peaches, pears, apples or berries and nuts and seeds in the morning.

#8.  Fiber – If you have tried fiber, and it only increased the constipation, perhaps your child wasn’t drinking enough water.  Fiber absorbs water and will absorb fluids from the bowels if not taken with enough water.   better if from the diet: fruits, vegetables, flax and sesame seeds, beans.

#9.  Choose a multivitamin that doesn’t contain iron.

#10.  Castor Oil – This one is cheap, but is for short term use only, and might cause stomach pain and cramping.

#11.  Check out the side effects of your child’s medications:  Many of the meds used for ASD have constipation as a potential side effect! Discuss medication-related constipation with your pediatrician.

#12.  If you use antacids, give ones that contain magnesium, not aluminum or calcium.

#13.  Fish oil Be sure to get a purified form. Fish oil is rich in Omega 3 which is beneficial for language and brain function and is a natural anti-inflammatory. If your kids struggle with the taste or smell of fish oil, you have to try Barlean’s Omega Swirls. They are delicious with a smooth creamy texture and not a hint of fishiness.

#14.  Probiotics – entire books are written about the health benefits of probiotics. Choose a  high potency blend of colonizing and transient strains. This combination will provide broad coverage to support a healthy balance of microflora across the entire gastrointestinal tract.

#15.  Senna – Fasten  Your Seat Belt! – This one is not for young children and is strictly for short-term use.  It can be explosive and you may even need a seatbelt for the toilet!  Check out the side effects before using 39,40,41,42.

Although cost and ease of use are always important to an autism mom, safety is my number one concern in the long-term management of ASD constipation.   My top picks are the GFCF Diet and the enzymes with DPP-IV – they actually address the root cause of the problem.

I can’t resist one last “crack”…Did you hear about the new movie, “Constipation”?   It hasn’t come out yet!



Children and adults with frequent or chronic constipation often benefit from digestive enzymes with DPP-IV. Digestive enzymes are a safe and effective way to help break down the tough to digest protein, such as gluten, casein, and soy; as well as starches, carbohydrates, sugars (including lactose) and fats. Take advantage of this special offer from Practitioner Select!


Houston Enzymes are extremely high quality and meet with the Practitioner Select Quality Standards:

  • Independent laboratory tested (for quality/impurities)
  • No fillers
  • Vegan
  • Gluten-free
  • Non-GMO
  • No yeasts
  • No sugars or sugar alternatives
  • Soy protein-free
  • Known origin of ingredients
  • No egg
  • No nuts
  • No hydrogenated oils
  • Allergen screening for cross-contamination
  • No added coatings, shellacs, binders, excipients, artificial flavors, artificial sweeteners or colors

About the author:

Dr. Janet Lintala is the mother of three boys with a variety of issues such as Asperger syndrome, Tourette disorder, OCD, anxiety and ADHD. She holds a B.S. in Genetics, and graduated as a Doctor of Chiropractic Salutatorian, summa cum laude, from The National University of Health Sciences, a postgraduate program near Chicago, IL.




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