Why Your Child With ADHD May Poop Their Pants

Most children have a poop accident from time to time. Sometimes, it's linked to a child's age - if a child isn't fully potty trained, for example, some accidents are to be expected. Other times, symptoms are abnormal, and kids struggle with severe toileting issues that detrimentally affect quality of life. When children suffer from an out-of-the-ordinary number of accidents, what can you do as a parent?

In this article, we'll go over various reasons why children with ADHD might face issues related to this topic, what parents can do to address the problem, and why seeking medical help may be necessary.

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Why Is My Child With ADHD Pooping Their Pants?

"My ADHD child poops pants regularly, but I don't know why." This is a frustrating situation for parents to be in, and it can be worrisome, too. There are many reasons why poop accidents may be happening more frequently than they used to or past the typical age a child would experience these problems.

Possible reasons why children with neurodevelopmental disorders like ADHD may poop their pants include but aren't limited to the following:

Delays in potty training

ADHD children may experience delays in potty training for several reasons. Difficulties with focus and other symptoms of ADHD affect all areas of life, in addition to self-care, learning, and body awareness. It makes sense that if a child struggles with potty training, they may have accidents.

Potty training charts and being aware of signs that your child is ready for potty training can be helpful for parents in this situation. Since potty training charts act as somewhat of a reward system, they can be beneficial for kids with ADHD. If you're concerned that your child's behind schedule in terms of potty training, talk with their pediatrician. 

In the case that a child is toilet trained, there are other possible explanations.

Chronic constipation or fecal incontinence

As much as it may seem strange that constipation might lead to a child having an accident, it is possible. Chronically large and hard bowel movements can stretch the rectum where stool is stored and cause the muscles and nerves there to be less sensitive to when it is time to go. Your child may not even be aware they need to have a bowel movement until it is too late. This condition is called encopresis. If you notice concerns like these in your child, there are things you can do. It's been long hypothesized that disorders like ADHD are connected to a higher prevalence of defecation disorders. However, it's no longer a mere hypothesis.

Research shows that children with ADHD are significantly more likely to experience both constipation and fecal incontinence. In fact, a study involving 742, 939 kids found that:

• 4.1% of children with ADHD vs. 1.5% children without ADHD had an increased prevalence of constipation problems.
• 0.9% of children with ADHD vs. 0.15% of children without ADHD had an increased prevalence of fecal incontinence.

Medication for ADHD did not impact the rate of visits for defecation disorders. Note that if your child uses ex-lax or similar medications for constipation, it might lead to the involuntary passage of bowel movements later on. Sometimes, medications used for constipation are too harsh for kids. Ask your child's doctor how much they should take.

They're holding bowel movements for too long

Children with ADHD have trouble controlling their attention. Though this can mean getting distracted easily or difficulty paying attention, you may also find your child particularly fixated on desirable tasks or activities they enjoy. For example, playing a game. This level of hyperfocus can lead children with ADHD to either ignore or sincerely not notice their need to use the restroom.

Extra discussion about how to know when to use the restroom and how important it is to listen to their body may be beneficial for some children with ADHD and related disorders.

They're seeking attention

Similar to urinating on the floor caused by mood state, some children may say they have to go more often than usual as a mode of seeking attention. Other problems should be ruled out first. Before you assume, gently ask a child why their accident happened. If they don't know, that's okay - it is simply important to rule out other possible causes first (such as abdominal pain or painful defecation) so that you don't miss anything serious.

They're upset or bothered

The concomitant ADHD scale displays a connection between ADHD and a range of other medical problems, including those that are behavioral or emotional in nature. Notice whether your child's issues with bowel movements are related to their mood state. When your child is upset, bothered, or anxious, is it more likely that they'll have an accident? For many kids, emotions are overwhelming and might make it hard to think about other things, including physical cues.

Sometimes, retentive fecal soiling (a condition diagnosed in kids aged 4+ who have bowel movements in inappropriate places and times at least once monthly for two months or more) is connected to behavioral or emotional concerns.

If retentive fecal soiling is to blame, it doesn't mean that a child is doing it "on purpose." What actually happens is that they can't tell the difference between gas and the urge to go after withholding bowel movements.

Medication effects

At times, medication treatment for other health problems can be the cause of problems with bowel movements. Some medications cause diarrhea, which may make it hard for a child to control bowel movements. Other medications list constipation as a possible side effect. Some medication treatments even have the potential to cause both. These can include medications used to treat ADHD. For example, an ADHD medication like Adderall can cause a variety of GI effects.

Look at the side effect list on any medications and supplements your child takes to determine whether medication could be a factor. If you're concerned about your child's medication or want to make changes to their behavioral treatment plan, consult with their doctor for guidance.

Other medical problems

A wide variety of medical problems can cause issues with pooping. Some medical conditions can cause urgent or uncontrollable bowel movements. Medical testing can help determine whether this could be what's going on for your child. If your child experiences symptoms at specific times of day (e.g., night time only), or if they experience other additional symptoms that are a cause for concern, make sure that you tell your child's doctor.

Promoting Healthy Digestion In Kids

Usually, finding the reason why your child has bowel issues is the first step to fixing them. There are some general tips that can be advantageous for parents who hope to promote healthy digestion and regular bowel movements in their kids. Here are some things to consider.

Dietary changes

More visits to the bathroom may actually make accidents less likely if constipation is the issue. If a child experiences functional constipation followed by accidents, pay attention to your child's diet.

To decrease constipation, serve fresh fruits, whole wheat crackers, high-fiber cereal, bran waffles or whole wheat pancakes, high-fiber bread, pureed fruits and veggies (like pureed apples), and add other high-fiber foods to their diet. Magnesium supplements may also help.

If kids struggle with picky eating, you might need to find creative ways to boost the amount of fiber they consume. You can make tasty treats and other foods that match their common form but have added fiber (e.g., pureed prunes, pureed zucchini, or shredded carrots hidden or mixed in with foods the child already likes).

Some parents even bake cookies, muffins, and other goods to aid constipation. There are free, child-friendly recipes online created uniquely for this purpose. If dietary changes don't help constipation, make sure to seek medical advice.

For kids with certain medical problems, it may be more effective to reduce fiber. Talk with a healthcare provider before making significant changes to your ADHD child's diet.

Water consumption

Water consumption can help with regular bowel movements. Adequate fluid intake plays a big role in keeping stools soft and avoiding constipation.

To help your child drink plenty of water, make sure that it's available throughout the day. Consider flavored water and similar products for children who have a hard time consuming plain water.

Lack of fluids can have a significant impact on overall well-being, including gastrointestinal health. If your child wets the bed, ensure adequate fluids are provided throughout the day, but limit consumption reasonably in the hours before they fall asleep.

A bathroom schedule

Again, it is also critical to tell children not to ignore bowel movements. Discuss how to know when it's time to use the restroom. Consider setting a bathroom schedule, especially for young children with ADHD. A bathroom schedule can be very valuable for kids who get distracted or do not want to stop engaging with desirable activities once invested.

In the case that a child has persistent or severe constipation, seek medical attention. If any other bathroom issues are ongoing, it is important to seek medical guidance just in case. You want to make sure that you're fully aware of what's going on and don't miss another health problem.

Seeking Medical Guidance

If your child experiences challenges such as frequent accidents, constipation, or fecal incontinence, speak with a medical professional. Depending on the potential cause(s) a doctor finds, associated symptoms may be addressed differently. These could include diet changes, age-appropriate medication treatments, or a referral to another provider, such as a gastroenterologist.

Takeaway 

Children with ADHD are at an increased risk of various gastrointestinal and related problems. These can include but aren't limited to constipation, fecal incontinence, and difficulty with potty training. There are a number of different reasons why a child might have an uptick in accidents, such as taking medication with GI-related side effects.

Finding out why accidents happen is often the first step to mitigating the problem. Some parents add shredded carrots, use whole grain pancake mix, or make other dietary changes to help children have regular bowel movements. Others find that reduction of fiber is necessary, especially for kids with specific medical issues.

Ultimately, it is vital that families who have kids with any ongoing GI issues seek medical advice.