How many digits of Pi do you know? Many people stop after a few. A former chief engineer at NASA revealed that advanced calculations used for space exploration use 16.
9-year-old Nova Horton from Raleigh knows even more.
Other WRAL Top Stories
Standing in a Wake Forest playground, Horton proudly recited 51 digits: 3.14159265358979323846264338327950288419716939937510.
It makes sense why the fourth grader responded, “Math,” when asked what her favorite subject was.
“I like numbers. Addition, subtraction, multiplying and dividing, just the standard multiplication algorithm and stuff,” she said. “Solving problems; it’s easy for me.”
As Nova Horton shared more about learning geometry in her advanced math class, her mother, Amber Horton, said her daughter faces challenges that people can’t see.
Nova Horton was diagnosed with autism in 2024. Amber Horton said there were signs earlier in childhood, but they were not initially connected to autism.
When Nova Horton was 3, she began experiencing serious gastrointestinal issues that led to repeated emergency room and doctor visits, as her family searched for answers.
“She got sick, and I didn’t know why, and she was sick for a few nights. There were some GI issues going on and that led to a long road,” Amber Horton explained. “It took five years to actually get a diagnosis.”
Nova Horton now takes multiple medications daily to help manage her symptoms.
“It has been challenging. It's been difficult,” Amber Horton said. “It takes a lot of advocating, a lot of researching. It has been a challenging process to put all the pieces together and find the right support.”
Dr. Bruno Chumpitazi, a pediatric gastroenterologist with Duke Children’s Hospital, is part of Nova Horton’s medical team. He shared that the GI challenges Nova Horton faces are extremely common among children with autism.
“Unfortunately, children with autism have a lot more constipation than other children,” Chumpitazi said. “They are often seen in the emergency department with this problem, they're often hospitalized with this problem, and unfortunately it affects their quality of life.”
Researchers estimate up to 65% of children with autism experience constipation — roughly three times higher than the general population.
The physician explained that children with autism and untreated GI issues can sometimes have increased behavioral challenges, including aggression, which can be difficult for parents and families.
Chumpitazi shared that communication can be another barrier to providing the best care possible for pediatric patients.
“Just realizing what’s happening within their own bodies can be really difficult for children with autism to actually perceive and understand,” he said. “Even having some behaviors that aren’t helpful, sometimes called withholding, where if they feel like they need to go to the bathroom and they’ve had a bad experience where it's hurt before, for example, they'll actually try to hold the stool in. That just makes the constipation worse.”
A new $12.9 million joint study between Duke Health and UNC Health aims to improve treatment options for children with autism struggling with gastrointestinal issues. Researchers plan to enroll 320 children from 30 sites across the country.
“We are doing a very large national trial comparing two different treatments for constipation in children with autism,” Chumpitazi explained. “The first treatment is linaclotide, which is a recently approved FDA medication for children with constipation. The other treatment is polyethylene glycol 3350, which is commonly known as Miralax.”
The standard of care for children with autism experiencing GI issues usually involves three main things, according to the physician: requiring the patient to change their behavior to include more time sitting on the toilet, increasing fiber in their diet, and taking medication.
“Miralax, that's a powder that's mixed in fluid that the children are asked to take,” Chumpitazi said. “That can be really challenging for some children with autism. Sometimes they are very sensitive to different tastes and textures when they're trying to take things like foods or liquids, and they can also have a very sensitive GI tract. Even after they take that medication, they can have some GI issues with that.”
Chumpitazi said the researchers involved with the study hypothesize that the results will find linaclotide is a better option because the capsule can be opened, and the medication more easily dissolves in food or water.
“We’re going to find out whether or not it actually works better than polyethylene glycol 3350,” he said.
The study design was developed after conversations with pediatricians, gastroenterologists, patients with autism, their families, and adults with autism who experienced issues as children.
“They will tell you that this problem, constipation, really affects their lives,” Chumpitazi said. “Some of them say it's the most important medical problem that their child has. A lot of them will tell you about having to go to the emergency department, or even be hospitalized for this problem.”
Amber Horton agrees that a better treatment solution would be a game-changer for her family.
“It excites me. It makes me really happy, because I think the more research that we have and the more answers that we have, it may be easier to put these things together,” Amber Horton said. She continued, “I would tell other families to keep advocating, do your best to navigate the systems because they are complex, they really are. Find somebody who will listen to you and find a provider that follows up.”
Researchers believe the findings could eventually help improve treatment not only for children with autism, but potentially for other pediatric patients struggling with chronic constipation as well.
The study is also one of the first major collaborations tied to NC Children’s, the future standalone children’s hospital being developed jointly by Duke Health and UNC Health in Apex.