{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T19:03:57Z","timestamp":1789326237066,"version":"build-2803163510"},"reference-count":57,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Atten Disord"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Attention-Deficit\/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition with rising prevalence worldwide. Although alterations in the gut\u2013brain axis have been implicated in its pathophysiology, underlying mechanisms remain unclear. An increase of gastrointestinal (GI) symptoms is well documented in autism spectrum disorder, but the extent of GI involvement in ADHD has not yet been systematically evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To determine whether individuals with ADHD exhibit a higher prevalence of GI symptoms compared with neurotypical controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Following PRISMA 2020 guidelines (PROSPERO: CRD42024602363) (Blake et al., 2024), we searched MEDLINE, Embase and APA PsycInfo (all via Ovid) up to 12 May 2026. We included primary studies involving participants of any age with a DSM- or ICD-defined ADHD diagnosis and reporting GI symptoms. Studies involving formally diagnosed organic GI disease (e.g., IBD) were excluded. Two independent reviewers conducted screening and quality appraisal using Joanna Briggs Institute (JBI) tools. Where appropriate, random-effects meta-analyses were performed for individual and composite GI symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      From 9,613 records, 23 studies met inclusion criteria, representing over 1.9\u2009million participants. ADHD was associated with increased odds of every GI symptom investigated, including total GI symptoms (\n                      <jats:italic toggle=\"yes\">OR<\/jats:italic>\n                      1.48, 95% CI [1.35, 1.62]), irritable bowel syndrome (\n                      <jats:italic toggle=\"yes\">OR<\/jats:italic>\n                      1.58, 95% CI [1.39, 1.78]), constipation (\n                      <jats:italic toggle=\"yes\">OR<\/jats:italic>\n                      1.97, 95% CI [1.49, 2.61]) and encopresis (\n                      <jats:italic toggle=\"yes\">OR<\/jats:italic>\n                      4.32, 95% CI [2.50, 7.47]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ADHD is associated with a substantial increase in functional GI symptoms, distinct from organic gastrointestinal disease. Possible mechanisms include gut microbiome dysbiosis, vagal dysregulation and behavioural contributors. Future research should differentiate intrinsic biological pathways from medication-related effects to improve clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10870547261469626","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T23:01:05Z","timestamp":1789081265000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association Between Attention-Deficit Hyperactivity Disorder and Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1361-1771","authenticated-orcid":false,"given":"Sarah","family":"Blake","sequence":"first","affiliation":[{"name":"Warwick Medical School, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5711-4305","authenticated-orcid":false,"given":"Hugo","family":"Cannon","sequence":"additional","affiliation":[{"name":"Warwick Medical School, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8565-5385","authenticated-orcid":false,"given":"Saran","family":"Shantikumar","sequence":"additional","affiliation":[{"name":"Warwick Medical School, Coventry, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-018-3758-8"},{"key":"e_1_3_5_3_1","doi-asserted-by":"publisher","DOI":"10.46658\/JBIMES-24-01"},{"key":"e_1_3_5_4_1","unstructured":"Blake S. Shantikumar S. Cannon H. (2024). Gastrointestinal symptoms in patients with attention deficit hyperactivity disorder: A systematic review. https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024602363"},{"key":"e_1_3_5_5_1","volume-title":"Obsessive-compulsive disorder","author":"Brock H.","year":"2024","unstructured":"Brock H., Rizvi A., Hany M. (2024). Obsessive-compulsive disorder. StatPearls Publishing. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK553162\/"},{"key":"e_1_3_5_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/aur.70016"},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13010249"},{"key":"e_1_3_5_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1087054712474686"},{"key":"e_1_3_5_9_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2015.15020266"},{"key":"e_1_3_5_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ijo.2008.272"},{"key":"e_1_3_5_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000091219.46560.7b"},{"key":"e_1_3_5_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-199907000-00015"},{"key":"e_1_3_5_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-021-00950-8"},{"key":"e_1_3_5_14_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1026004505764"},{"key":"e_1_3_5_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci14060539"},{"key":"e_1_3_5_16_1","doi-asserted-by":"publisher","DOI":"10.37506\/ijfmt.v14i3.10488"},{"issue":"1","key":"e_1_3_5_17_1","article-title":"Sensory sensitivity in ARFID: Symptoms, causes, and treatment","volume":"12","author":"Harris H. A.","year":"2024","unstructured":"Harris H. A. (2024). Sensory sensitivity in ARFID: Symptoms, causes, and treatment. Journal of Eating Disorders, 12(1), Article 5757. https:\/\/doi.org\/10.1186\/s40337-024-00947-2","journal-title":"Journal of Eating Disorders"},{"issue":"2","key":"e_1_3_5_18_1","article-title":"Cost of illness and comorbidities in adults diagnosed with attention-deficit\/hyperactivity disorder: A retrospective analysis.","volume":"13","author":"Hodgkins P.","year":"2011","unstructured":"Hodgkins P., Montejano L., Sasan\u00e9 R., Huse D. (2011). Cost of illness and comorbidities in adults diagnosed with attention-deficit\/hyperactivity disorder: A retrospective analysis. The Primary Care Companion for CNS Disorders, 13(2), Article 2616026160. https:\/\/doi.org\/10.4088\/pcc.10m01030","journal-title":"The Primary Care Companion for CNS Disorders"},{"issue":"6","key":"e_1_3_5_19_1","first-page":"664","article-title":"Health complaints in children with attention-deficit\/hyperactivity disorder","volume":"95","author":"Holmberg K.","year":"2006","unstructured":"Holmberg K., Hjern A. (2006). Health complaints in children with attention-deficit\/hyperactivity disorder. Acta Paediatrica, 95(6), 664\u2013670. https:\/\/doi.org\/10.1080\/08035250600717121","journal-title":"Acta Paediatrica"},{"key":"e_1_3_5_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0178187"},{"key":"e_1_3_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2013.11.024"},{"key":"e_1_3_5_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1087054716669589"},{"key":"e_1_3_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2024.07.004"},{"key":"e_1_3_5_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073816653782"},{"key":"e_1_3_5_25_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v26.i42.6626"},{"issue":"12","key":"e_1_3_5_26_1","first-page":"817","article-title":"Sleep dysfunction and gastrointestinal diseases","volume":"11","author":"Khanijow V.","year":"2015","unstructured":"Khanijow V., Prakash P., Emsellem H. A., Borum M. L., Doman D. B. (2015). Sleep dysfunction and gastrointestinal diseases. Gastroenterology & Hepatology, 11(12), 817\u2013825.","journal-title":"Gastroenterology & Hepatology"},{"key":"e_1_3_5_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2016.02.008"},{"key":"e_1_3_5_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-025-03483-4"},{"key":"e_1_3_5_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/aur.2549"},{"key":"e_1_3_5_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu14071471"},{"issue":"2","key":"e_1_3_5_31_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss7202a1","article-title":"Prevalence and characteristics of autism spectrum disorder among children aged 8 years\u2014Autism and Developmental Disabilities Monitoring Network, 16 sites, United States, 2022","volume":"74","author":"Maenner M. J.","year":"2025","unstructured":"Maenner M. J. (2025). Prevalence and characteristics of autism spectrum disorder among children aged 8 years\u2014Autism and Developmental Disabilities Monitoring Network, 16 sites, United States, 2022. MMWR Surveillance Summaries, 74(SS-2), 1\u201325. https:\/\/doi.org\/10.15585\/mmwr.ss7402a1","journal-title":"MMWR Surveillance Summaries"},{"key":"e_1_3_5_32_1","doi-asserted-by":"publisher","DOI":"10.1080\/20473869.2024.2318529"},{"key":"e_1_3_5_33_1","doi-asserted-by":"publisher","DOI":"10.4137\/JCNSD.S9058"},{"key":"e_1_3_5_34_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1580"},{"key":"e_1_3_5_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2013.02.008"},{"key":"e_1_3_5_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/children11111388"},{"key":"e_1_3_5_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/2329048X18786799"},{"key":"e_1_3_5_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadr.2023.100607"},{"key":"e_1_3_5_39_1","unstructured":"National Institute of Mental Health. (2024). Attention-Deficit\/Hyperactivity Disorder (ADHD). Retrieved October 15 2024 from https:\/\/www.nimh.nih.gov\/health\/statistics\/attention-deficit-hyperactivity-disorder-adhd"},{"key":"e_1_3_5_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-04303-x"},{"key":"e_1_3_5_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2015.02.009"},{"key":"e_1_3_5_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2025.112512"},{"key":"e_1_3_5_43_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2010.4"},{"key":"e_1_3_5_44_1","unstructured":"Oxford English Dictionary. (2013). Neurodivergence. Retrieved October 15 2024 from https:\/\/www.oed.com"},{"key":"e_1_3_5_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13229-023-00548-3"},{"key":"e_1_3_5_46_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu16101538"},{"issue":"6","key":"e_1_3_5_47_1","first-page":"535","article-title":"Association of race\/ethnicity and social disadvantage with autism prevalence in 7 million school children in England","volume":"8","author":"Roman-Urrestarazu A.","year":"2021","unstructured":"Roman-Urrestarazu A., van Kessel R., Allison C., Matthews F. E., Brayne C., Baron-Cohen S. (2021). Association of race\/ethnicity and social disadvantage with autism prevalence in 7 million school children in England. Lancet Psychiatry, 8(6), 535\u2013542. https:\/\/doi.org\/10.1016\/S2215-0366(21)00055-7","journal-title":"Lancet Psychiatry"},{"key":"e_1_3_5_48_1","doi-asserted-by":"publisher","DOI":"10.5152\/NeuropsychiatricInvest.2025.25031"},{"key":"e_1_3_5_49_1","doi-asserted-by":"publisher","DOI":"10.1177\/1087054706286698"},{"key":"e_1_3_5_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2011.10.008"},{"key":"e_1_3_5_51_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200523010-00008"},{"key":"e_1_3_5_52_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-023-02307-7"},{"key":"e_1_3_5_53_1","doi-asserted-by":"publisher","DOI":"10.2147\/PHMT.S85717"},{"key":"e_1_3_5_54_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm21146"},{"key":"e_1_3_5_55_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.10.015"},{"key":"e_1_3_5_56_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2013.28.7.974"},{"issue":"3","key":"e_1_3_5_57_1","first-page":"179","article-title":"The relationship between attention deficit hyperactivity disorder and functional constipation in patients referred to pediatric Gastrointestinal clinic of the hospitals of Khorramabad City, Iran","volume":"8","author":"Zafari Z.","year":"2021","unstructured":"Zafari Z., Shokri S., Hasanvand A., Ahmadipour S., Anbari K. (2021). The relationship between attention deficit hyperactivity disorder and functional constipation in patients referred to pediatric Gastrointestinal clinic of the hospitals of Khorramabad City, Iran. Crescent Journal of Medical and Biological Sciences, 8(3), 179\u2013184. https:\/\/www.cjmb.org\/uploads\/pdf\/pdf_CJMB_499.pdf","journal-title":"Crescent Journal of Medical and Biological Sciences"},{"key":"e_1_3_5_58_1","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/5993628"}],"container-title":["Journal of Attention Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10870547261469626","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10870547261469626","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10870547261469626","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T18:22:48Z","timestamp":1789323768000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10870547261469626"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":57,"alternative-id":["10.1177\/10870547261469626"],"URL":"https:\/\/doi.org\/10.1177\/10870547261469626","relation":{},"ISSN":["1087-0547","1557-1246"],"issn-type":[{"value":"1087-0547","type":"print"},{"value":"1557-1246","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"article-number":"10870547261469626"}}