Article Text

Download PDFPDF
Recognition and management of bladder bowel dysfunction in children with autism spectrum disorder
  1. Shilpee Raturi1,
  2. Fay Xiangzhen Li2 and
  3. Chui Mae Wong1
  1. 1Child Development, KK Women's and Children's Hospital, Singapore
  2. 2Paediatric Surgery, KK Women's and Children's Hospital, Singapore
  1. Correspondence to Dr Shilpee Raturi; shilpeeraturi{at}


Children with autism spectrum disorder (ASD) with rigidities, anxiety or sensory preferences may establish a pattern of holding urine and stool, which places them at high risk of developing bladder bowel dysfunction (BBD). BBD, despite being common, is often unrecognised in children with ASD. With this case report of a 7-year-old girl with ASD presenting with acute retention of urine, we attempt to understand the underlying factors which may contribute to the association between BBD and ASD. Literature review indicates a complex interplay of factors such as brain connectivity changes, maturational delay of bladder function, cognitive rigidities and psychosocial stressors in children with ASD may possibly trigger events which predispose some of them to develop BBD. Simple strategies such as parental education, maintaining a bladder bowel diary and treatment of constipation may result in resolution of symptoms.

  • paediatrics
  • developmental paediatrics

Statistics from


  • Contributors SR served as the primary author. She reviewed the case in detail, interviewed the mother and read all available reports on clinical progress and reports by the allied health professionals. She also performed a comprehensive literature review with regard to analysing the clinical findings and supporting the discussion. FXL played a key role in the discussion of the diagnosis and management of the patient and editing the case report. CMW revised multiple drafts of the case report and organised the information. She was also involved in the clinical discussion pertaining to the diagnostic challenges faced with the patient in question.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.