4 yr. old having potty accidents

My son is 4 1/2. He has been potty trained for about 9 months. Over the past 2 months he has begun to have frequent bowel movements in his pants, just small amounts. I have given him suppositories and finally an enema which did work. I started him on 1/2 tsp. Metamucil daily, which worked for a few days.  However, he has started having small accidents again in his underwear and when I try to get him to sit on the potty he crys and says he doesn't need to go.  I know he is afraid it is going to hurt also. He has also wet his pants several times over the past week.  He is a very active little boys is has recently been diagnosed with ADHD and put on 5mg Ritalin 3 times a day.  I don't believe this is a side effect of the medication, although it all began around the same time he started taking it. He has never had a problem with constipation before and his eating habits have not changed very much.  Any suggestions?

[Kevin Kennedy, Ph.D.]

From the sound of it, your son is avoiding using the toilet due to an expectation that he will experience pain. When children do this, they often become constipated and then leak small amounts of stool in the way you describe. Generally, none of the symptoms you describe are associated with Ritalin use, but it wouldn't hurt to discontinue the medication and see if the dayitme enuresis stops. Occasionally this is a side effect.