ADHD and toileting

[Crytna610]

My daughter is 8 and was diagnosed with ADHD this year. She has always struggled with pooping consistently and holding. She will go for 2 weeks without any issues then start having smears and sometimes more like an accident. She goes everyday so we never thought she was constipated. The doctors usually blow us off as just immaturity except for her 8 year old check up they finally listened to us and recommended testing. We have done behavior charts and earning large rewards for no accidents. Anyone else struggle with this with their ADHD kid and have suggestions. We are currently seeing a counselor but it does not seem to want to talk about it and gets very defensive. Thanks for the support.

[Aspen797]

It sounds like encopresis. It starts with a prolonged period of constipation where the child develops a hard ball of poo that they cannot expel. Softer poo moves around the hard ball causing leakage. The nerves in the colon that normally detect and help move poo become less sensitive because of the constant pressure. Even when the ball is finally expelled, it can take time for normal movements to resume. If it is encopresis, it is completely unintentional. A pediatric GI doctor can help set up a regimen to get her back on track. So sorry for both your struggles. It can be so hard for the whole family. There are books online to help explain it to your child so they don’t feel to blame. A free one you can google is “Beating Sneaky Poo”

[Crytna610 in reply to Aspen797]

Thank you soo much for your response, I have never heard of this and the pediatrician thought it was just her attention problems. I will definitely get her in to see a pediatric gastro.

[EBNN1 in reply to Crytna610]

I would change pediatricians!

[Krll]

us! We have encopresis in our 6yo that we are just starting to treat after a long stretch of smearing daily.

Have you asked your daughter why she holds it or if there are triggers that cause more holding? Our kid has anxiety and a lot of anxiety about pooping at school. We learned from him that if a teacher tells him to wait until later to go to the bathroom it is too much and he just holds the rest of the day which just causes the whole thing to get worse. We worked with the teacher to get an allowance where she won’t say no, and it immediately got better.

We haven’t yet done scheduled pooping - we are currently in a long weekend of miralax to try to get him moving. We did have an x-ray through our ped which found he was majorly backed up.

100% echo getting medical support for this one. I’m right there with you!!

[Mamamichl in reply to Krll]

We have a 504 for my daughter that says she can just walk out of class if need be (with a hand gesture), and has access to a private one stall bathroom. She doesn’t use it because of her RSD, but it may help you in your situation.

[Crytna610 in reply to Krll]

Thanks for the reply. We have been struggling for awhile but hearing how many people have struggled and went to see the gastro we will definitely be going that route. She does have more issues at school and during playdates, vacations etc. She refuses to talk about it and says it isn't a big deal but she does not like when I set a timer because she says it is embarrassing. Glad to hear others have had similar issues and there is an end to this

[GenXMomma]

I suspect encopresis, too. The key with this is having your daughter try a bowel movement everyday at the same time to establish a routine. And eating enough fiber to produce a bowel movement. Not easy with kids diets. Google Constipation Gurus and do their boot camp or check out their resources.

[GenXMomma]

Also, I never knew this, but it's possible to have a daily bowel movement and still be constipated. Hugs to you and your family. You got this.

[Crytna610 in reply to GenXMomma]

Thanks for the support I will check this out. It is such a relief to hear that we are not the only ones

[MountainBeach]

Us too! Please know that you are not alone, and yes, encopresis is related to ADHD. We struggled with this for YEARS and it finally resolved on its own around middle school. I hate to tell you that my family never got a handle on it, but it did eventually go away. My kiddo is now 16 and I don't have to worry about laundry anymore. 😌

[Mamamichl in reply to MountainBeach]

We didn’t get the smearing. What consistency is the poo if it’s encopresis? Is it usually watery? My kid get giant big poos, so the miralax helps (I slip it into her ramen, lol). When we did the barium enema (xray/ ultrasound of the intestines), she didn’t have a backup, so we know she’s just holding it.

[Mamamichl in reply to MountainBeach]

What does it look like when it’s “going away”?my kid is asking for a suppository and putting them in herself, finally wiping independently and using Vaseline more. I personally still don’t go as often as I should, so it’s not really gone, but it’s better managed. Been thinking about online learning so she doesn’t have to worry about holding it at school.

[Crytna610 in reply to MountainBeach]

Thank you!! This is soo reassuring I would love to not have to worry about extra laundry and extra underwear everywhere we go

[Jillianlynn]

we have a 7 year old boy with combined type ADHD that is going through this. A year ago we did a cleanse as his pediatrician said he was significantly constipated. Then we had him on half cap of Miralax for a year to help the bowel return - which had its ups and downs. We just stopped the Mira and are fingers crossed that he can manage but he also is lactose intolerant which doesn’t help the whole situation. Pediatric Gastro we took him to wasn’t helpful.

He has really big freak outs about it - especially if others catch it (via smell) before him. We just remain hopeful he figures it out.

[Mamamichl in reply to Jillianlynn]

Day miralax didn’t help us. She was doing a cap of that and a square of ex lax every day for 4 years! Having them go every time they complain about their tummy or try after breakfast or dinner has been helping our kiddo. Puberty is maturing her too now she’s 10 and is becoming more independent about it. She and I were so embarrassed having to wipe a 9 year old because she couldn’t do it.

I’ve tried $200 worth of different products over the years. She’s also a picky eater so most of the magnesium supplements didn’t help because she wouldn’t use them. Recently she was prescribed senna, and I just found here is senna tea. She likes peppermint tea so I’m going to try to mix them soon.

[Crytna610 in reply to Jillianlynn]

It is such a tough issue as they get older and kids start to notice. I have not done the gastro yet but that is my next step. Soo nice to hear we are not alone with this issue

[Lillianmcmcl]

yes, my 9 year old daughter has always struggled with constipation, holding it in, and had similar issues to what you described. It is called encropesis. When she was a toddler we managed it with Miralax but now we try to encourage drinking liquids, eating enough fruits and vegetables, and only use Miralax or Smooth Move tea when she starts having accidents or smears. Doctors and the school nurse has told me it is more common than you think. Honestly, I think it just takes time and maturity. It has been very helpful for us to try to just give her the tools, extra clothes in her backpack at all times, a fiber and Probiotic gummy supplement, and encourage drinking water with water flavor drops. I have also suggested my daughter go to the bathroom before the playground at school, because she can't immediately go back in when nature calls. They will grow out of it eventually.

[Crytna610 in reply to Lillianmcmcl]

Glad we are not alone in this struggle, my daughter is also not a fan of water but we do water down her apple juice and she eats lots of fruits and takes a probiotic. The struggle is real but hopefully things will get easier over time.

[Mamamichl]

I totally could have written your post. My daughter was diagnosed at 8; 2 years ago because of her chronic constipation. Apparently people with adhd ignore their body’s signals. She started even at 3 months old going two weeks without a poop. It was weird. She was on daily dose of miralax and expat for 4 years from 3-7 years old. Didn’t change anything. Barium enema showed nothing. She complains of an upset stomach a lot.

We recently got senna as a prescription, and though her stomach hurts a bit more, she has been going more often. They do have this natural laxative in tea form btw. I want to mix it with peppermint.

I have my kid sit on the toilet daily, especially when she complains of her stomach pains. It helps to hyper focus on it and allow something special to do to help relax while on the toilet.

It’s so annoying when docs say “have you tried more produce, more water,etc” because when she was 3, she ate almost nothing BUT produce and water, and we have tried dairy free, and even gluten free for a week. She would only drink from my breast for the first year, so we know it’s not diet related. In the past year we had to take her to ER twice to have an enema done. She’s also finally asking for suppositories and using Vaseline independently as well. No one should have to deal with this regularly.

Now that my kid is starting puberty, she is able to wipe more independently. It’s embarrassing to talk about it, and she will hold all day if a friend is over or she’s at school. Yay for RSD on top of inattentiveness. We are thinking of trying online next year for school so we can possibly get this under better control.

Sorry for the long post. Hope this helps. Zen hugs 🫂

[Crytna610]

This is such a relief that we are not alone. I cannot even discuss with doctors without getting emotional because it is such a big deal for kids this age and the risk of being bullied or labeled by peers. It is stressful being told to try things that have already been tried like making her go regularly or timers which we already do! Thanks for your response.

[MomOfSuperheroes]

It sounds like you already have a lot of helpful responses, but I thought I'd just add that this has been a challenge for our son, too.He was diagnosed with enuresis/encopresis and ADHD in Kindergarten, and it took a lot of work to come up with a plan that even began to help get things under control. We are so lucky that we had a whole pediatric GI team including a therapist to help. Our son's plan included miralax (and laxative cleanses whenever he *still* got blocked up), a stimulant med to help him recognize his body cues (attentiveness), regular 15 minute bathroom sit times (after meals, even at school), a 504, therapy, routines, charts, etc.

He is now in 5th grade, and to some extent he really just needed to grow to overcome the issue. The meds and habits have helped, though. He's not quite all the way there, but he is close! It is absolutely worth going down that road, OP. You're not alone, and you've got this!

[InspiredMom]

My son has had Encopresis since he was about 2 or 3 years old. He’s now 9 and we still struggle.

We’ve tried miralax for years with some success. We put him on a really good probiotic about a year ago which has helped a lot. We use Nordic naturals zero sugar gummies. That combined with double caps or miralax on the weekends has helped. We also added a stimulant just 3 weeks ago and that has seemed to allow him to recognize the signs. The stimulant has really seemed to calm him and almost mature him in some ways.

The pediatrician told us we would probably struggle with his gut until about 5th grade or so when kids seem to “grow out of it”. Which really I think may be more of peer pressure or the fear of peers discovering the issue and traumatizing them.

A few kids at school have already known he has the issue because he’s had accidents at school and not told anyone. But he seems to handle himself well and doesn’t internalize it. Hoping we’re seeing the light and will see a long term improvement from here on out.

Good luck!

Other things we tried were magnesium and fiber. Lots of water. The probiotic seems to help the most. Along with the stimulant.