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New Study Shows Children with ADHD Have Increased Risk for Constipation

An October 2013 report from Pediatrics has shown a surprising association between ADHD and constipation. Read on to discover the hidden link to attention problems.
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Over 8 percent of children in the United States suffer from ADHD or another form of attention-deficit disorder.

The precise cause of ADHD is unknown, although Focus Adolescent Services offers several potential causes, including allergies, exposure to toxins, fluoride, hearing and vision problems, learning style differences, fetal alcohol syndrome, yeast infections, low blood sugar, and some medications.

Although the exact causes are unknown, the effects of the disorder are far-reaching. Children with ADHD may have trouble in school, be labeled as “troublemakers,” and show other health problems, including chronic constipation and fecal incontinence, according to a new study published in the October 2013 issue of “Pediatrics.”

Study Details

The 2013 study from the Uniformed Services University of the Health Sciences looked at the medical records from over 700,000 children aged between 4 and 12 years. Of that group, 4.4 percent were diagnosed with ADHD. The researchers examined the instances of diagnosis with chronic constipation or fecal incontinence among children with ADHD versus that of children without ADHD.

4.1 percent of children with ADHD suffered from chronic constipation. Only 1.5 percent of children without ADHD had chronic constipation. Nearly 1 percent of children diagnosed with ADHD were also diagnosed with fecal incontinence. Among children without ADHD, only 0.15 percent were diagnosed with fecal incontinence. Children with ADHD visited the doctor more often for constipation than children without ADHD. Whether or not children were on medication for ADHD had no relevance to their likelihood of suffering from fecal incontinence and constipation.

The researchers concluded that children with ADHD are significantly likely to have constipation and fecal incontinence issues over children without ADHD. Children with ADHD are six times more likely to have fecal incontinence and three times more likely to become constipated than children without ADHD.

Similar Study Results

A 2003 study conducted by the University of California showed similar results. In this study, 28 children diagnosed with ADHD and 22 children without ADHD were asked to fill out the Dysfunctional Voiding Symptom Survey each day. Questioned covered topics such as daytime incontinence, nocturnal enuresis, constipation, urgency, voiding frequency and dysuria. Children who had ADHD scored consistently higher on the test than children without ADHD.

The Link Between Bowel Health and ADHD

According to the researchers from the Health Sciences study, the link between bowel health and ADHD could have several causes. Most children with ADHD have trouble controlling behavior, staying focused, paying attention, and staying focused. These issues can lead to failure to pay attention to bodily cues. Rather than use the bathroom when the urge occurs, children may continue in their current activity. This causes the children to suppress the urge to use the bathroom, which can lead to chronic constipation. When children finally do try to eliminate, the build-up of stool in the colon causes pain while having a bowel movement. This may cause children to be even less likely to want to have a bowel movement.

According to Dr. Cade Nylund, a professor of pediatrics at the Uniformed Services University of the Health Sciences and head of the 2013 study, chronic constipation will lead to fecal incontinence. The colon stretches to accommodate the build-up of stool. Eventually, small pieces of stool leak from the stretched colon. This is the body’s last-ditch effort to get rid of the stool. Eventually, a child can train his or her brain to ignore all elimination cues. A stretched colon may also prevent a child from feeling the urge to eliminate. Because of these compounding factors, constipation and fecal incontinence in children with ADHD is more common than in children without attention disorders.

Stopping ADHD-Related Fecal Incontinence

Bowel problems are a troublesome health condition that is not only damaging to the body, but it is also embarrassing. Children older than 4 years of age are expected to be able to schedule and control their own elimination times. Children that still have trouble with “accidents” past kindergarten are often scolded and shamed by both peers and authority figures. However, most children suffering from ADHD-related constipation or fecal incontinence truly cannot feel the urge to use the bathroom.

In order to stop ADHD-related constipation and fecal incontinence, it is necessary to help a child with ADHD restore sensitivity to the bowels and help them focus attention on bodily functions to prevent further constipation and bowel stretching.

Treatment Methods for ADHD-Related Constipation

Parents can implement a variety of methods to help reduce ADHD side-effects and reduce the chances of their child getting chronic constipation. If your child with ADHD already has constipation or fecal incontinence, the following methods will also help heal the bowels and prevent further complications.

Speak With a Health Professional

If your child is suffering from ADHD-related constipation, you should speak with a health professional as soon as possible. In extreme cases, constipation can lead to a build-up of stool in the colon, leading to an impacted bowel, which requires a medical procedure to remove. Your doctor may prescribe more aggressive methods to treat chronic constipation if impaction is an issue. In addition to speaking with a qualified health professional, you can take the following additional measures to prevent chronic constipation in your child.

Improve Focus with Supplements

Attention problems may not have a known cause, but there are known aids for increasing a child’s focus and restoring normal brain function. Two of the best supplements for children with ADHD include fish oil and probiotics.

Fish oil: Several studies have shown that fish oil supplements reduce symptoms of ADHD in children. One study from the University of Adelaide in Australia looked at 109 children with ADHD between the ages of 7 and 12. The children were given a dose of 400 mg of fish oil per day combined with 100 mg of evening primrose oil. After a period of 30 weeks, 40 percent of the children improved in both attention span and concentration. Even after the study ended, children continued to show positive results from the supplements. This indicates that the right balance of Omega-3 fatty acids can have long-term benefits in children with attention problems.

A 2005 study conducted by the University Laboratory of Physiology in the UK showed similar results. This study looked at 117 children between the ages of 5 and 12 suffering from developmental coordination disorder. The children were given fish oil supplements for three months. After a period of 6 months, the children showed improvements in spelling, behavior, and reading. A third study conducted by the Inflammation Research Foundation showed that giving fish oil supplements to children with ADHD improved their behavior after 8 weeks. This study gave children a supplement of EPA and DHA to raise the natural fatty acid level of the children to that normally found in Japanese children.

Probiotics: Probiotics have been linked to a reduction in attention and behavior problems in mice according to several recent studies. A 2011 study conducted by McMaster University compared the behavior of two different groups of mice (one exposed to bacteria and the other kept bacteria-free). The bacteria-free mice showed additional stress levels and BDNF levels (which can contribute to anxiety and depression). Surprisingly enough, in a follow-up study, when the researchers switched the bacteria of the two mice groups, the mice took on the behavior of the opposite group.

A Japanese study from 2004 indicated that there is a narrow window for controlling behavior issues through bacteria. In the study, researchers were able to change the behavior of mice until they reached sexual maturity. This offers the possibility that addressing attention problems in children with probiotics will have the biggest effect before children hit puberty.

Improve Diet

Diet may be one contributing factor to attention problems in children. Chemicals in dyes, processed foods, and an imbalance of nutrients could lead to ADHD symptoms in children. In fact, a 2011 study from the Psychiatric Hospital of Rodewisch in Germany showed that among 67 participants with ADHD, 15 percent had celiac disease (gluten intolerance). In individuals without ADHD, the chances of having celiac disease are around 1 percent. Changing a child’s diet could help improve ADHD symptoms along with any associated bowel disorders.

Dr. Ben Kim, natural food expert, recommends the following dietary changes for children with ADHD:

Improve ADHD through Diet
  • Avoid gluten
  • Avoid processed foods
  • Eat fruits and vegetables
  • Increase healthy fat intake (nuts, eggs, fish, dairy)
  • Drink plenty of non-sugary fluids
  • Avoid sugar
  • Eat 3 square meals a day
  • Reduce consumption of Omega-6 fatty acids (found in vegetable oils)

Fiber, commonly prescribed for constipation may actually make constipation worse for children with chronic constipation. Fiber is responsible for creating bulk in stool, which could make constipation symptoms worse. A low-fiber diet can help prevent unwanted bulk, making it easier for children to regain bowel sensitivity.

A study conducted by the American College of Gastroenterology Functional Gastrointestinal Disorders Task Force in 2012 showed that over a period of 6 months, all 41 participants on a low-fiber diet saw complete recovery from their constipation. Individuals on a reduced fiber diet saw the most constipation problems. This indicates that a low fiber diet is best for curing constipation, followed by a high fiber diet. Parents may want to consider placing their child on a low-fiber diet at first, then switching to a high-fiber diet after constipation issues have healed.

Set a Bathroom Routine

One of the issues that many children with ADHD have is that they do not want to stop what they are doing to go to the bathroom. This leads to chronic stool suppression, which can also lead to chronic constipation and fecal incontinence. One way to help a child with ADHD avoid constipation is by assigning specific times for bathroom breaks throughout the day.

Restore Colon Sensitivity

Children with ADHD-related constipation may no longer have bowel sensitivity. A child will not be able to avoid accidents if he or she can no longer feel the urge to “go.” A 2011 study published in “Nutrition Journal” looked at 20 children with functional constipation. The children were given a probiotic supplement once per day for 4 weeks. During the course of the study, stool frequency increased, pain during elimination decreased, and stool consistency showed a better stool consistency rating. Over time, extended use of probiotics can help restore colon sensitivity by making elimination easier, more frequent, and by healing the damage from previous bouts of constipation.

Healing ADHD-Related Constipation for Good

Children with attention problems have a naturally higher chance of also facing constipation and fecal incontinence problems. If your child suffers from both issues, he or she is perfectly normal. Your child does not have to face the embarrassing problem of chronic constipation or deal with invasive procedures to heal the bowel. A simple combination regimen of improved diet, scheduled bathroom breaks, and a daily supplement of probiotics and fish oil should help your child heal naturally and recover completely from any ADHD bowel-related side effects. Within 6 months to a year, your child should see restored colon function using the above methods along with any prescribed treatments from your doctor.

Sources


http://pediatrics.aappublications.org/content/early/2013/10/16/peds.2013-1580.abstract

http://www.nlm.nih.gov/medlineplus/news/fullstory_141736.html

http://www.ncbi.nlm.nih.gov/pubmed/14501650

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