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Stool issues
Hello Dr ,
My son has adhd and is 6 years old. He has some constipation from long time. From few months he has doing stool multiple times a day but in small quantity. He has urge but doesn't clears. He is not potty trained.
Doctor gave laxatives which also seems to not work properly.
Plz suggest what to do
Answers (8)
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Hello, I understand your concern
Children with ADHD are at higher risk of constipation due to:
Poor awareness of bowel urges
Inattention or distraction during toileting
Withholding behavior
Poor diet and fluid intake
Passing small frequent stools may indicate overflow soiling (encopresis) due to fecal impaction.
Laxatives may not work unless behavioral and dietary factors are also addressed.
Constipation is common and treatable, but requires long-term, consistent management. Toilet training may be delayed in neurodevelopmental disorders like ADHD — patience is key. Soiling is not intentional or behavioral — it’s a medical issue related to stool retention.
Next Steps
1. Disimpaction (if needed): If stools are hard and impacted, consider a high-dose polyethylene glycol (PEG) regimen for disimpaction. May require enema if oral disimpaction fails — under medical supervision.
2. Maintenance Therapy: Continue osmotic laxatives like PEG or lactulose daily at appropriate doses. Treatment should continue for several months, not stopped suddenly.
3. Scheduled Toilet Time: Encourage sitting on the toilet twice daily, especially after meals (gastrocolic reflex). Use visual timers or reward charts to help a child with ADHD stay on track.
4. Proper Toilet Posture: Use footrest or step stool to support legs and maintain squatting posture.
5. Diet and Fluids: High-fiber diet: fruits, vegetables, whole grains. Adequate water intake throughout the day
6. Behavioral Support: Use positive reinforcement (not punishment) for sitting on the toilet or any success. Occupational therapy may help with sensory issues if present. Coordinate with a child psychologist or developmental pediatrician if needed.
Health Tips
Red flags:
Weight loss
Blood in stools
Severe abdominal pain
Suspected Hirschsprung disease (if never passed normal stools)
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Constipation can be severe in autism child and if laxatives are not working then we might need to use combination laxatives with different mechanism. At the same time he needs potty trained
Next Steps
To consider adequate vegetable and fruits rich in fibre
Health Tips
Constipation here more of functional and with appropriate laxatives it can be effectively treated
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Increase fiber content of the food
Drink plenty of water
Avoid sugary drink
Toilet training is needed
Do not threaten the child for soiling pants or force him
Still no progress
Then consult Pediatrician for medical management
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Increase fiber: fruits (banana, papaya, pear), vegetables, whole grains
Increase water intake
Avoid too much milk or processed snacks
If needed, stool softeners like lactulose can be given (dosage based on weight).
If constipation persists or there's blood in stool, consult a pediatrician for evaluation.
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Dr. Prathibha Reddy
Pediatrician
12 yrs exp
Hyderabad
Maintain hydration and give fibre rich diet like green leafy vegetables, apple puree and banana , oats , Kichidi with carrot beans dal . Diet shld b more of fruits and vegetables.
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Dr. Sachin Pariskar
Pediatrician
8 yrs exp
Pune
Give plenty of fiber diet and plenty of water
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Dr. Bhatt Vivek Prafulchandra
Pediatrician
5 yrs exp
Rajkot
Consult with Pediatrician physically for further evaluation and treatment
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Dr. Ajith Narayanankutty
Pediatrician
14 yrs exp
Ahmedabad
Hi.
I understand your concern.
Add fibre to the diet in form of fruits and vegetables. Give plenty of fluids. Avoid refined flour intake.
Consult me online for medical management.
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