Concurrent medical problems affect many with autism, new research suggests, and may be responsible for troubles at home and school.

In a study of nearly 3,000 children and adolescents with autism from across the country, researchers found that nearly a quarter have gastrointestinal issues. What’s more, the study found that those facing the stomach problems in addition to autism were more likely to experience anxiety and sensory problems.

The findings are significant, researchers say, because collectively these struggles can affect quality of life, particularly if they go unrecognized.

“These problems can have a very real impact on daily life,” said Micah Mazurek of the University of Missouri who led the study, which was published recently in the Journal of Abnormal Child Psychology. “Parents need to be aware that these problems may underlie some of their children’s difficulties, so if they notice any symptoms, they should talk to their doctors or therapists about treatment options.”

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