Introduction

Many studies have shown that behavioral problems are associated with defecation and voiding disorders, nevertheless few studies have looked directly at a link between a diagnosis of attention-deficit/hyperactivity disorder (ADHD) and constipation or fecal incontinence.¹

Keywords: ADHD, Encorporesis

Case Presentation

11 year old boy presented to our health Centre on October 2021 with mother who gave the details of his history as he was born in his home country via normal vaginal delivery with unremarkable perinatal history Up To Date vaccine record the mother raised a concern of recurrent balanitis.

Periodic balanitis was treated successfully with every visit which was as frequent as 3 times a year

Further digging into details of the history was the patient never achieved toilet training for the stool patient physical examination was unremarkable.

A journey of full investigation of his blood/stool/hormonal profile with unremarkable results

Further imaging revealed totally normal structure with no neurological insult or disorders.

1. Rasquin A, Di Lorenzo C, Forbes D, et al.. Childhood functional gastrointestinal disorders: child/adolescent. 2006;130(5):1527–1537.
2. Loening-Baucke V. Prevalence rates for constipation and faecal and urinary incontinence. Arch Dis Child 2007; 92:486.
3. Liem O, Harman J, Benninga M, Kelleher K, Mousa H, Di Lorenzo C. Health utilization and cost impact of childhood constipation in the United States. J Pediatr. 2009;154(2):258–262 [PubMed] [Google Scholar]
4. Wald A, Sigurdsson L. Quality of life in children and adults with constipation. Best Pract Res Clin Gastroenterol. 2011;25 (1):19–27 [PubMed] [Google Scholar]
5. Rajindrajith S, Devanarayana NM, Benninga MA. Review article: faecal incontinence in children: epidemiology, pathophysiology, clinical evaluation and management. Aliment Pharmacol Ther. 2013;37(1):37–48
6. Rajindrajith S, Devanarayana NM. Constipation in children: novel insight into epidemiology, pathophysiology and management. J Neurogastroenterol Motil. 2011;17(1):35–47.
7. Di Lorenzo C. Childhood constipation: finally some hard data about hard stools! J Pediatr. 2000;136(1):4–7
8. Bellman M. Studies on encopresis. Acta Paediatr Scand. 1966;(suppl 170):1. [PubMed] [Google Scholar]
9. Abrahamian FP, Lloyd-Still JD. Chronic constipation in childhood: a longitudinal study of 186 patients. J Pediatr Gastroenterol Nutr. 1984;3(3):460–467 [PubMed] [Google Scholar]
10. Benninga MA, Voskuijl WP, Akkerhuis GW, Taminiau JA, Büller HA. Colonic transit times and behaviour profiles in children with defecation disorders. Arch Dis Child. 2004;89(1):13–16 [PMC free article] [PubMed] [Google Scholar]
11. Duel BP, Steinberg-Epstein R, Hill M, Lerner M. A survey of voiding dysfunction in children with attention deficit-hyperactivity disorder. J Urol. 2003;170(4 pt 2):1521–1523, discussion 1523–1524 [PubMed] [Google Scholar]
12. Becker A, Rubly M, El Khatib D, Becker N, von Gontard A. Central nervous system processing of emotions in children with faecal incontinence. Acta Paediatr. 2011;100(12):e267–e274 [PubMed] [Google Scholar]
13. Peeters B, Noens I, Philips EM, Kuppens S, Benninga MA. Autism spectrum disorders in children with functional defecation disorders. J Pediatr. 2013; 163(3):873–878 [PubMed] [Google Scholar]
14. Wolraich M, Brown L, Brown RT, et al. Subcommittee on Attention-Deficit/Hyperactivity Disorder. Steering Committee on Quality Improvement and Management . ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011;128(5):1007–1022 [PMC free article] [PubMed] [Google Scholar]
15. Mellon MW, Natchev BE, Katusic SK, et al. Incidence of enuresis and encopresis among children with attention-deficit/hyperactivity disorder in a population-based birth cohort. Acad Pediatr 2013;13:322–327.
16. Hergüner S, Hergüer A. Atomoxetine for encopresis in 2 children with attention-deficit/hyperactivity disorder. J Clin Psychopharmacol 2012;32:302–303.
17. Yücel A, Yücel N, Oral E. The Role of Atomoxetine and Sympathetic Pathways in Encopresis with ADHD. Bulletin of Clinical Psychopharmacology 2015; 25(1):93–94
18. Yücel A, Yücel N, Oral E. The Role of Atomoxetine and Sympathetic Pathways in Encopresis with ADHD. Bulletin of Clinical Psychopharmacology 2015;25(1):93–94
19. Çiğdem Yektaş, MD,* Mehmet Akif Cansız, MD,† and Ali Evren Tufan, MD†

Dr Teeba Salwan Abbood

MBBS /Family Medicine Specialist

Primary Health Care, Doha, Qatar