Healthcare providers’ practices in identifying and managing constipation in autistic adults: A qualitative study of facilities across France

Constipation is a common comorbidity among autistic adults, yet diagnosing and managing it poses unique challenges, notably due to communication barriers and a lack of specific guidelines. The study explores the professional practices of healthcare providers (HCPs) in managing constipation among autistic adults, the symptoms they identify, their management strategies, and the sources of knowledge guiding their practices. A qualitative approach was used, involving semi-structured interviews with ten HCPs, supplemented by twelve online questionnaires. Thematic analysis revealed three overarching themes: (1) HCPs acknowledged challenges in identifying constipation in autistic patients, relying on clinical markers and behavioral cues; (2) HCPs described assessment tools and preventive strategies in managing constipation; and (3) HCPs identified challenges and strategies in managing constipation in autistic adults, adopting a collaborative approach, while exposing a lack of specific training. Findings indicate that HCPs depend on non-verbal cues and behavioral changes, such as increased agitation, irritability, and altered motor patterns, to detect constipation. Variability in treatment protocols and limited formal training underscores the need for more structured training and standardized approaches. The study suggests that improved collaboration among HCPs and with families could lead to more consistent and effective care.Lay abstractConstipation is common among autistic adults, but it can be difficult to diagnose and treat notably because of difficulties in communicating and a lack of clear guidelines. This study considered how healthcare providers (HCPs) in France handle constipation in autistic adults. The research involved interviews with ten HCPs from various medical-social facilities and 12 online questionnaires. The study found three main points: Identifying Constipation: HCPs often struggle to recognize constipation in autistic adults. They rely on physical signs and changes in behavior, such as increased agitation, irritability, and singular ways of acting. Managing Constipation: HCPs use various strategies to manage constipation, focusing on prevention, yet lack clear guidelines for assessment. Challenges and Strategies: HCPs face many challenges, including a lack of specific training. They emphasize working in multidisciplinary teams and with families to manage constipation effectively. The study highlights that better training and standardized guidelines are needed to help HCPs provide consistent and effective care. Improving teamwork among HCPs and with families can lead to better outcomes for autistic adults with constipation.