Gastrointestinal problems in people with Down syndrome

Congenital anomalies of the gastrointestinal tract are common in people with Down syndrome, and include oesophageal, duodenal and anal atresias. Hirschsprung disease is more common in people with Down syndrome than in the general population. These gastrointestinal anomalies and other dysfunctions (eg hypotonia) may contribute to:

• chewing or swallowing difficulties—see dysphagia
• gastro-oesophageal reflux
• coeliac disease—more common in people with Down syndrome than in the general population; screen children and adults; human leukocyte antigen (HLA) testing may be useful to exclude coeliac disease
• constipation.

Constipation is also common in people with Down syndrome who do not have any congenital gastrointestinal abnormalities. Hypotonia, weight, diet, exercise, fluid intake, medication and hypothyroidism are all factors that contribute to constipation. A continence nurse may be helpful in development, implementation and monitoring of strategies for constipation management.