Gastrointestinal manifestations and eating behavior in autism spectrum disorder: the role of sensory dysfunction and intestinal microbiota

Eating disorders and gastrointestinal manifestations are widespread in children with autism spectrum disorders (ASD), but they remain heterogeneous in clinical manifestations and mechanisms of formation. This review summarizes current data on the role of sensory dysfunction and intestinal microbiota in the formation of eating behavior and gastrointestinal symptoms in ASD. It has been shown that sensory phenotypes, primarily sensory avoidance and sensory search for stimuli, are key determinants of nutritional selectivity, dietary structure, and the nature of gastrointestinal complaints. The pathophysiological foundations of the brain-gut-microbiota axis are considered, including changes in the microbiota profile, impaired intestinal barrier function, and signs of chronic low-level inflammation, which may enhance innate sensory features and contribute to the consolidation of pathological eating patterns in certain subgroups of children with ASD. Special attention is paid to the genetic and epigenetic mechanisms affecting sensory processing, receptor sensitivity, and appetite regulation, which partially explains the high interindividual variability of clinical manifestations and the heterogeneous effectiveness of standard dietary interventions. The need for a phenotypically oriented approach to the assessment of nutritional and gastrointestinal disorders in ASD is emphasized, based on a comprehensive analysis of sensory characteristics, eating behavior and the state of the gastrointestinal tract.

autism spectrum disorders, eating behavior, sensory phenotypes, gastrointestinal manifestations, intestinal microbiota, nutritional selectivity

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