Rome Iv Functional Gastrointestinal Disorders In Children Aged 1–7 Years With Autism Spectrum Disorder: A Cross-Sectional Comparative Study

Background. Gastrointestinal (GI) symptoms are commonly described in children with autism spectrum disorder (ASD), and these symptoms can be accompanied by behavioral changes and changes in sleep quality, as well as added caregiver burden. There exist few state of the art data about Rome IV FGIDs in young children with ASD in Uzbekistan. [1,2,3,4,5,9]. Aim. To determine the prevalence of and the spectrum of Rome IV FGIDs among the child 1–7 year of age with ASD in Tashkent, Uzbekistan. Methods. A cross-sectional comparative study was performed in Evimedkids Clinic (pediatric gastroenterology) and Republican Children’s Psychoneurological Hospital (Tashkent) from March to April 2025. The ASD group consisted of 22 - 1–7 year-old children with DSM-5 diagnosed with ASD; Childhood Autism Rating Scale-2 (CARS-2) scores ≥30 were used. A control group of 25 age- and sex-matched children non-developing ASD was obtained from outpatient pediatric services; controls had non-GI complaints and demonstrated no clinical abnormalities. Clinical evaluation excluded children with suspected or confirmed organic GI disease. Parents filled age-appropriate versions of the Rome IV Pediatric Diagnostic Questionnaire (R4PDQ) in Uzbek or Russian. During between group comparisons, Fisher’s exact test or χ² testing was used as appropriate. [12,13,14,15]. Results. Sex distribution was not significantly different between groups (female: 52.0% in controls; 40.9% in ASD; p=0.640) or age (1–3 year olds: 44.0% versus 45.5%, respectively; p=1.000). At least one FGID was detected in 86.4% of children with ASD (19/22) compared with 52.0% of controls (13/25; p=0.015). Functional constipation was higher in ASD (27.3%, 6/22) than controls (4.0%, 1/25; p=0.040). Fecal incontinence was present in 63.6% of ASD children (14/22) as compared to 4.0% of controls (1/25; p=0.00002). Abdominal pain, irritable bowel syndrome, and dyspepsia have been more frequent among ASD children; however, there was no statistical significance in these three conditions (p=0.079, p=0.228, and p=0.446, respectively). Conclusions. Rome IV FGIDs were extremely common in young children with ASD in this Tashkent sample, and the differences were greatest and most clinically actionable for functional constipation and fecal incontinence. The inclusion of routine GI symptom screening in the ASD care pathways may enhance earlier identification and management of under-documented comorbidity.

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