Episode 10: A Gut Feeling - Constipation, Anxiety and ADHD in Children

Episode 10: A Gut Feeling—Constipation, Anxiety, and ADHD in Children Guest: Dr. Gretchen HoyleIn this enlightening episode of Nimble Youth, pediatrician Dr. Gretchen Hoyle returns to tackle a topic that’s both common and frequently misunderstood: chronic constipation and stool withholding in children. What may seem like a simple digestive issue is often a complex interplay between physical discomfort, behavioral habits, and underlying mental health challenges such as anxiety and ADHD.Dr. Hoyle unpacks how children can fall into a cycle of withholding stool—often due to discomfort, embarrassment, or fear—which leads to abdominal pain, functional constipation, and in some cases, encopresis (involuntary stool leakage). She explains how these physical symptoms are not always isolated but can be part of a broader mind-body connection, especially in children with diagnosed or emerging anxiety or ADHD.Key Topics Covered:Why children may begin withholding stool and how it becomes a chronic issueThe connection between constipation and mental health conditions like ADHD and anxietyUnderstanding the feedback loop between physical symptoms and emotional distressDr. Hoyle’s step-by-step approach to treatment, including clean-outs, maintenance with MiraLAX, and behavioral retrainingPractical toileting routines and environmental supports to prevent recurrenceHow parents, schools, and pediatricians can work as a team to support a childScreening for anxiety and ADHD when GI symptoms don’t resolveWhy summer is the perfect time to build healthy bathroom habits before school resumesResources:Mind-Body Cycle of Constipation (Downloadable Graphic)SCAS (Spence Children’s Anxiety Scale) and other screening toolsSample letter for school to support flexible bathroom accessQuote of the Episode:"For kids with anxiety or ADHD, constipation is rarely just about the gut—it’s about how the brain processes pain, embarrassment, urgency, and control. The good news? It’s highly treatable with a team approach." —Dr. Gretchen HoyleNext Episode Teaser:Join us next time as we explore eating disorders in adolescents, debunking myths and examining the serious impact these conditions can have—regardless of gender.Subscribe & Share: If this episode resonated with you or you know a family facing these challenges, please share it. You can find all past episodes, full transcripts, and helpful resources at www.nimbleyouthpodcast.com.