Gastrointestinal and Toileting Symptoms Across Pediatric OCD and Tic Disorders: A Retrospective Chart Review

Chronic tic disorders, obsessive–compulsive disorder (OCD), as well as an intriguing intermediary group with comorbid tics and OCD (Tics & OCD) share a striking overlap in neurocircuitry and genetic risk factors, with environmental and epigenetic influences contributing to different clinical presentations. A retrospective chart review of gastrointestinal complaints in patients with Tics (n = 189), OCD (n = 165), and co-occurring Tics & OCD (n = 106) aged 6–22 years seen at Boston Children’s Hospital (2019–2025) was conducted. After adjusting for age and sex, significant group differences in constipation and abdominal pain were observed. Compared to the Tics group, patients with OCD had higher odds of constipation (OR = 2.33, 95% CI = 1.38–3.99, p = 0.002) and abdominal pain (OR = 2.07, 95% CI = 1.16–3.71, p = 0.015). The association with the abdominal pain was attenuated after adjustment for comorbid depression and SSRI use; however constipation remained significant (OR = 1.90, 95% CI = 1.06–3.38, p = 0.030). These findings support routine GI and toileting screening in the clinical evaluation of pediatric patients with OCD. Future prospective studies are needed to clarify the contribution of psychiatric comorbidity to GI and toileting symptoms in pediatric patients with OCD.