# Children with autism spectrum disorder and alterations in eating behavior: could it be gastroesophageal reflux disease?

## TL;DR

This study explores the link between eating behavior changes in children with autism and possible gastroesophageal reflux disease.

## Contribution

It highlights a potential connection between GERD warning signs and eating behavior alterations in children with autism.

## Key findings

- 60% of children with autism showed eating behavior alterations.
- 89.8% of those with eating behavior issues showed GERD warning signs.
- Some children had esophagitis confirmed through endoscopy.

## Abstract

Describe the occurrence of warning signs of gastroesophageal reflux disease (GERD) and esophagitis in children with eating behavior (EB) alterations associated with autism spectrum disorder (ASD).

Descriptive study of 115 children aged 3 to 12 years, followed at a tertiary hospital and previously diagnosed with ASD. The BRCA-TEA instrument was applied to identify children with EB alterations, and the 17-ATN-GISSI instrument was applied to identify those with warning signs of GERD. The selected children were invited for a medical consultation to identify those with suspected esophagitis and an indication for upper gastrointestinal (GI) endoscopy with biopsies.

Sixty-nine children (60 %) were classified with alterations in the EB and, among these, 62 (89.8 %) presented warning signs of GERD. Eighteen children had suspected esophagitis and an indication for upper GI endoscopy. Among the 8 children who underwent the exam, 1 child had grade A erosive esophagitis, 1 child had grade B erosive esophagitis, and 1 child had eosinophilic esophagitis.

A high frequency of EB alterations was found in children with ASD. The high frequency of GERD warning signs may be related to EB alterations in this group. Cases of esophagitis highlight the possibility of an organic disease. In these cases, performing upper GI endoscopy with biopsies is essential for diagnosis.