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ADHD & Bowel Habits?
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ADHD & Bowel Habits?

My nephew is about to turn 12 years old.  He recently came to live with us after several problems in his own household.  He is in 5th grade.

Ever since he was little he has had a problem with "accidental" bowel movements in his pants.  It is something that we have always had to try and help him with.  He has also been diagnosed with ADHD and is not on any medications.  While medications were tried for the ADHD, his mother opted to take him off of them.  Since he has come to live with us, behaviorally he has been fine, except that he continues to have bowel movements in his pants.  We asked him about this and he says he doesn't actually "feel" when he needs to go.  I also think that the embarassment of the fact that he does it is preventing him from saying anything while we can all tell by his regular "odor."  We aren't sure as what to do about this.  We know that the issue was once addressed with his pediatrician who said he was just "lazy" but at the age of 12 we aren't sure if this is laziness or could be linked to his ADHD or if it could be a medical problem.  However, we know if something isn't done it could become a medical problem if it continues.  We aren't sure weather to try another doctor, a therapist or what.  He is doing fine now that he is in a new more "functional" and "stable" home environment when it comes to behavior.  He enjoys his new school, his teacher, and is making friends.  However, the bowel movements in the pants continue.  We are going through underwear like mad!  Any help would be greatly appreciated as we are at a loss as to what to do!  We don't want to embarass him but we do want to fix the problem that was obviously not corrected before he came to live with us.  Thanks!
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You might consider two things. First, obtain a referral to a pediatric gastroenterologist for a specialized workup. Don't assume that he is well medically. The process can begim with a routine examination by a peditrcian; you'll want to rule out that he is chronically constipated and has impacted bowel syndrome. This can be treated. Second, schedule an evaluation with a pediatric neurologist or child/adolescent psychiatrist for the purpose of re-evaluating and probably treating the ADHD.
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