Episode 10: A Gut Feeling—Constipation, Anxiety, and ADHD in Children
 Guest: Dr. Gretchen Hoyle

In 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 issue

  
  

• The connection between constipation and mental health conditions like ADHD and anxiety

  
  

• Understanding the feedback loop between physical symptoms and emotional distress

  
  

• Dr. Hoyle’s step-by-step approach to treatment, including clean-outs, maintenance with MiraLAX, and behavioral retraining

  
  

• Practical toileting routines and environmental supports to prevent recurrence

  
  

• How parents, schools, and pediatricians can work as a team to support a child

  
  

• Screening for anxiety and ADHD when GI symptoms don’t resolve

  
  

• Why summer is the perfect time to build healthy bathroom habits before school resumes

  
  

Resources:

• Mind-Body Cycle of Constipation (Downloadable Graphic)

  
  

• SCAS (Spence Children’s Anxiety Scale) and other screening tools

  
  

• Sample letter for school to support flexible bathroom access

  
  

Quote 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 Hoyle

Next 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.

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