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January 2014

ADHD and Constipation/Encopresis

Over the years many parents have asked me if their child’s encopresis might be due to ADHD.  They assume that perhaps their child is not able to pay attention to their need to poop or pee. Up until now, in the absence of any good scientific evidence, all I could say was that children who do have ADHD are no more likely to be constipated and soil their underwear than children who do not have ADHD.  

However, a study published in October of last year in “Pediatrics”, the official journal of the American Academy of Pediatrics, sheds new light on the relationship between encopresis and ADHD.

In a retrospective study of almost 743,000 children between the ages of 4 and 12 years of age, 33,000 of whom had ADHD, the researchers found that children with ADHD are significantly more likely to have constipation and soiling. It was also found that medication for ADHD neither increased nor decreased the incidence of soiling.

These findings do not tell us that ADHD is the cause of encopresis. Most children with ADHD do not have encopresis.

What these findings do tell us is that there is a relationship of some kind between ADHD and encopresis. The researchers speculate that there may be an “altered communication between the central nervous system and the enteric nervous system” or  that ADHD children may be less attentive to or slower to respond to bodily cues of poop or pee urgency.

One implication of these findings is that screening for ADHD may be helpful in determining the best treatment plan for some children with encopresis.