constipation, behaviour and postures due to INDIGESTION in autism kids
It's not uncommon to have constipation in kids with autism. It's seen in around 70% cases.
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It is hypothesised to be due to lack of sensing the gut distention for evacuation and child starts reatining motions /stools inside.
In most kids it's not per se constipation to hard stools. But if the child has 5o strain, it's better to call it constipation and manage as early as possible.
A child refusingt I sit for potty or doingw eird gestures at potty time or making legs curved or not sitting properly or had pain or discomfort is likely to have indigestion which eventually causes constipation.
The gut is 18 feet long and if the child passes less than 4 inches motion block at a time, it's likely 5o be constipation.
It's again constipation if the child passes very smal pellet like stool balls or smelly or gassy stools mean the child is retaining a lot and most potty is getting fermented and smelly.
DISCLAIMER: NO MEDICINES TO BE ADMINISTERED OR TAKEN OR STOPPED WITHOUT CONSULTATION WITH A DR.
Why do we need to know about constipation in autism kids?
It's mainly because it adds to restless irritability crankiness indigestion reduced appetite poor weight gain and reduced water intake. Remember crankiness of constipated Amitabh Bacchan in movie Piku.
Eating less and drinking less is not a reason for constipation but it happens due to constipation.
Commonest constipation diet is hard food like high protein diet, dry fruits, milk, hard daals and pomegranate .
Soft foods like rice and potato being easy to digest cannot cause constipation.
Constipation is also possible due to some nutrients like fish omega or calcium or phosphate containing tablets.
Best way to treat constipation is not by giving extra water or adding fibre or dry fruits or fruits vegetables .
Best way to treat constipation is by using stool softeners, non absorbable sugar syrups and avoiding constipationg 4d diet as mentioned above. Google for *4d minus diet* for same.
It's common to have indigestion or not passing motions or reduced intake or crankyness with constipation.
There are some probiotic and enzyme supplements that help in constipation.
Constipation with blood ina tools and constipation with daily vomiting will need tests to rule out medical serious emergencies like intussusception, intestinal obstruction or pseudoobstruction or tuberculosis
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Standard sampleof advice given by a dr in a case of hard stools:in a 2 year old kid
In such situations
Syr gutclear / dofotil 10 ml 3 times a day for 3 days
If no relief double the dose for next 3 days
If no relief
Maintain 10ml 3 times a day and
Add rectal suppository hallens glycerine 2gmsuppository or dulcolax suppository or babie less than 2 year age u can use neotonic enema.
Above medicines donot get absorbed in blood but just pull the potty out of body, meaning usually simple extra dose is harmless.
If loose motions, stop all of them.
Aristozyme drops 1 ml daily for 1 month, can be increased.
Can be continued long term. It doesn't cause habit.
Dofotil/gutclear/duphalac/laxolite/peg clear/evaq /move out etc all are same and dose is no limit when it's blocked gut.
For vomiting give domstal baby drops 1ml 3 times a day as needed
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For constipation/indigestion:
Stop milk,dry fruits, toor daals , daanewale fruits like pomegranate and guava.
Add syr laxolite or gutclear or dofotil 10 ml 2 times a day till stools are not regular. Can givetill next consultation or meeting
1. Some medicines like fish oil and tablets can at times cause constipation when water intake is not enough to wash it off. Stopping them is not a solution because it will halt development.
2. No constipation medicines are habit forming or addictive and most of them donot get into blood or body and stay in pipe and are extremely safe even in over doses. Doses need to change as per needs and can be easily doubled, they rarely cause loose motions and if they do u can just skip them for one day or reduce to 1ml
3. Syrups like laxolite, laxopeg, peg clear in doses 10 ml 1 to 3 times a day is preferred. Powder forms need more water which kids don't drink easily.
4. Other levels of syrups that work are, syr dofotil, gutclear, lax or duphalac etc again dose needs to be doubled for results.
5. Not treating it fully makes the kid cranky irritable and crying. So much so that commonest cause of crying in autism kid is indigestion.
6. In autism kids, rarely a kid may need syr albendazole 400 mg single dose for deworming or antifungal like tab flucon 50 mg single dose
7. Adding digestive enzymes like tummysoft, aristozyme drops , pro CN drops in doses 1ml to 3ml daily helps like breaking the hard stools motions in gut.
8. A child going to washroom many times doesn't mean he has loose motions. It can be constipation.
9. Read more about constipation at https://kondekar.weebly.com/constipation-in-children.html
Whatspp 9869405747
Behaviors and Postures Seen in Autism Children During Constipation or Difficulty Passing Stool
Many children with Autism Spectrum Disorder cannot clearly express internal discomfort using words. When they experience constipation, rectal pressure, bloating, painful stool passage, or incomplete evacuation, their body often “speaks” through behavior, posture, movement, facial expression, and emotional changes.
Parents and therapists may mistakenly think:
- the child is becoming “more autistic,”
- stubborn,
- hyperactive,
- aggressive,
or sensory-seeking,
when in reality the child may simply be struggling to pass stool comfortably.
Understanding these body signals is extremely important because chronic constipation can silently affect:
- attention,
- sleep,
- mood,
- learning,
- social participation,
- and emotional regulation.
Why Autism Children Show Unusual Stool-Holding Behaviors
Passing stool requires:
- body awareness,
- recognition of rectal fullness,
- relaxation,
- coordination,
- posture adjustment,
- and communication.
Many autism children struggle with:
- interoception (internal body awareness),
- sensory processing,
- anxiety,
- rigidity,
- fear of discomfort,
- toilet-related sensory aversion.
As a result, they may try to suppress or avoid stool passage using repetitive body postures and unusual movements.
Common Stool-Holding Postures and Behaviors
1. Standing Rigidly in One Place
Some children suddenly:
- stop activity,
- become stiff,
- stand motionless,
- tighten legs,
- clench buttocks.
Parents may think the child is “staring” or “zoning out,” but the child may actually be trying to hold stool inside because passing it feels painful or frightening.
2. Crossing Legs Tightly
A very common sign.
The child may:
- tightly cross legs,
- squeeze thighs together,
- press heels inward,
- twist lower body.
This posture helps temporarily suppress rectal urge.
3. Squatting in Corners
Some children:
- hide behind furniture,
- go to corners,
- squat repeatedly,
- rock while squatting.
Parents often think:
«“He is trying to pass stool.”»
But many times the child is actually trying to HOLD stool due to fear of painful passage.
4. Pressing Abdomen Against Furniture
The child may:
- lean stomach against sofa,
- press abdomen on table edge,
- lie over pillows,
- push belly against parent.
This may help relieve:
- abdominal pressure,
- bloating,
- rectal discomfort.
5. Toe Walking Increases
Some children show:
- increased toe walking,
- body stiffening,
- unusual gait during constipation episodes.
Tightening pelvic and lower limb muscles may help stool retention.
6. Repetitive Rocking or Body Movements
Rocking may increase during bowel discomfort.
The child may:
- rock back and forth,
- bounce,
- move pelvis repeatedly,
- shift weight continuously.
Sometimes these movements help the child cope with internal discomfort.
7. Sudden Aggression or Irritability
A child unable to express:
- pain,
- pressure,
- fullness,
may suddenly:
- hit,
- bite,
- scream,
- throw objects,
- push others away.
The aggression may actually reflect physical distress rather than intentional behavior problems.
8. Crying During or Before Stool Passage
The child may:
- cry before entering toilet,
- resist bathroom,
- scream while passing stool,
- become fearful after painful experiences.
Once painful stooling occurs repeatedly, the child may develop:
- anticipatory anxiety,
- stool withholding cycle,
- chronic constipation.
9. Hiding During Urge
Some children disappear behind curtains, beds, doors, or furniture when they feel stool urge.
This may reflect:
- desire for privacy,
- sensory regulation,
- fear,
- internal concentration,
- or conditioned stool-holding behavior.
10. Facial Expressions of Silent Distress
Parents may notice:
- grimacing,
- sudden sweating,
- facial flushing,
- tightening jaw,
- unusual eye widening,
- silent discomfort.
The child may not verbally complain despite significant constipation.
11. Refusal to Sit on Toilet
Some autism children strongly resist:
- toilet seat texture,
- cold surface,
- flushing sound,
- smell,
- echo,
- bathroom lighting.
The child may:
- arch body away,
- stiffen,
- scream,
- escape bathroom.
This can create severe stool retention over time.
12. Repeated Sitting and Standing
Some children repeatedly:
- sit briefly,
- get up immediately,
- pace,
- return again.
This reflects difficulty coordinating:
- relaxation,
- fear,
- sensory discomfort,
- and urge suppression.
13. Self-Injurious Behaviors
In severe discomfort some children may:
- hit abdomen,
- bang head,
- bite hand,
- scratch skin,
- press body strongly against surfaces.
This may worsen during severe constipation episodes.
Important Clinical Misinterpretation
Constipation-related behaviors are often mistaken for:
- hyperactivity,
- sensory-seeking,
- “stimming,”
- oppositional behavior,
- worsening autism.
In reality:
«the child may be communicating through posture because verbal communication is limited.»
The body becomes the language.
The Stool Withholding Cycle
Painful stool leads to:
1. fear of passing stool,
2. stool holding,
3. larger harder stool,
4. more pain,
5. more fear,
6. worsening constipation.
This cycle may continue for months unless recognized early.
Effects on Brain and Learning
A chronically constipated child may show:
- poor attention,
- reduced eye contact,
- irritability,
- poor sleep,
- emotional dysregulation,
- increased repetitive behaviors,
- reduced participation in therapy.
Sometimes behavioral improvement occurs dramatically after constipation treatment.
Important Message for Parents and Therapists
Whenever an autism child suddenly develops:
- aggression,
- crying,
- sleep worsening,
- unusual postures,
- hiding behaviors,
- abdominal pressing,
- increased hyperactivity,
always evaluate:
- bowel habits,
- hydration,
- stool consistency,
- pain,
- toilet routine,
before assuming “behavioral deterioration.”
Final message
An autism child may not say:
«“I am constipated.”»
Instead the child may:
- squat,
- cross legs,
- stiffen body,
- scream,
- hide,
- rock,
- press abdomen,
- become aggressive,
or withdraw silently.
The child’s posture may be the child’s communication.
Understanding these body signals with sensitivity can reduce suffering, improve behavior, and support better emotional and developmental regulation.
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