Gut mobilization improves behavioral symptoms and modulates urinary p-cresol in chronically constipated autistic children: A prospective study.
Laura Turriziani, Arianna Ricciardello, Francesca Cucinotta and 7 others
PMID 34813183WHAT IT FOUND
Treating chronic constipation with daily PEG lowered hyperactivity, anxiety, and social deficits in autistic children.
Gut mobilization improved behavior across all participants, though the study lacked a control group and blinding.
Key findings
01Oral polyethylene glycol (PEG) consistently improved constipation in all 21 children, raising Bristol stool scale scores to normal or diarrhea range in 90.5% at 1 month and 100% at 6 months.
02Hyperactivity, anxiety, social interaction deficits, and stereotypic behaviors showed significant decreases over the 6-month period following gut mobilization.
03Urinary p-cresol levels did not correlate with behavioral improvements, suggesting the benefit was not primarily driven by changes in this specific neuroactive metabolite.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was open-label with no control group and no blinding, which likely inflated the observed effect sizes due to placebo effects or expectation bias. The sample size was small (21 at baseline, 17 at follow-up), and dropouts occurred due to the pandemic. The study could not determine if behavioral improvements were due to specific neurochemical changes or simply the relief of abdominal discomfort. Baseline urinary p-cresol levels were not as elevated as expected, limiting the ability to detect changes in this specific biomarker.
Declared interests
The authors declare no conflict of interest. The study was funded by the Italian Ministry of Health.
The easy way to misread this
Do not assume this proves PEG treats autism symptoms. The study lacked a control group and blinding, so the improvements could reflect natural variation, placebo effects, or the simple relief of constipation rather than a specific therapeutic mechanism.