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  • By Steve Hodges, M.D.

The M.O.P. Book: The Only Proven Way to STOP Bedwetting and Accidents

Back in 2011, when It’s No Accident was published, I was still advocating MiraLAX as a reasonable alternative to enemas for fixing bedwetting and accidents. I have since changed my mind.

Enemas work so much better that I no longer recommend the laxative clean-out route. In fact, in recent years I’ve changed my mind or refined my thinking on many issues related to the treatment of enuresis (wetting) and encopresis (poop accidents).

Having treated thousands more patients, I know so much more than I used to!

You’ll find my updated recommendations in The M.O.P. Book: Anthology Edition, which replaces the first edition of The M.O.P. Book (which, itself, replaced It's No Accident). I’m so excited about this book. Now, instead of sending folks to a dozen different blog posts and guides, I can send a single link. Essentially everything I know on the topic is summarized in one place.

The M.O.P. Book: Anthology Edition spells out the rationale and instructions for following the Modified O’Regan Protocol (M.O.P.), an enema-based regimen that resolves bedwetting and accidents far more effectively than drugs, alarms, oral laxatives, or other traditional therapies.

M.O.P. is based on the premise that bedwetting and accidents are caused by chronic constipation; problems resolve when you aggressively clear out the stretched rectum, allowing it to shrink back to size and stop aggravating the bladder. M.O.P. is named for Dr. Sean O’Regan, the pediatric kidney specialist who discovered and tested the regimen back in the 1980s and whose fascinating story I recount in the anthology. I have adjusted Dr. O’Regan’s regimen slightly — hence the name “Modified” O’Regan Protocol.

The M.O.P. Book: Anthology Edition covers both M.O.P., the standard protocol using pediatric enemas, and M.O.P.+, the more aggressive regimen necessary to resolve the toughest cases. M.O.P.+ is more of a process than a protocol, involving high-volume enemas and a variety of possible solution ingredients — saline, glycerin, castile soap, Johnson’s No More Tears Baby Shampoo. (Yes, baby shampoo!)

You’ll also find other tricks in the bag, such as injecting olive oil in the child’s bottom and letting it sit overnight (aka Double M.O.P.). If that sounds a bit nuts, well, it’s safe and it is working for some of the most stubborn cases I’ve encountered.

In The M.O.P. Book: Anthology Edition I answer questions such as:

•What if my child is afraid of enemas? What if I am?

•When do you give up on M.O.P. and switch to M.O.P.+?

•What if my doctor says enemas are “traumatic” or “dangerous”?

•Can I do M.O.P. without my doctor’s blessing or supervision?

•Do I need to have my child X-rayed before starting M.O.P.?

•Should we do pelvic-floor physical therapy in addition to M.O.P.?

•On M.O.P., why do wetting symptoms sometimes worsen before they improve?

Oh, there’s lots more in the book! (You can download the table of contents and introduction here.) The updated recommendations are based on my recent research, my experience treating several thousand more patients since It’s No Accident was published, and the parents who are members of our private Facebook group.

I believe I’ve learned the most from the Facebook parents. Many of these families struggle with particularly challenging cases, and they are willing to push the envelope in terms of treatment. If you want to be on the cutting edge of therapy for bedwetting and accidents, join the group!

I am grateful to all families who have tried M.O.P. and shared their feedback with me. I’m also thankful to the medical professionals who, despite the skepticism and hostility of many in our field, have embraced enema therapy and endorsed our book.

This includes Dr. James Sander, MD, director of pediatric urology at Doctors Hospital at Renaissance in Edinburg, Texas, who wrote: “M.O.P. works radically better than anything else.” And thank you to Mayo Clinic physical therapist Erin Wetjen, PT, an expert in pediatric incontinence, who has much experience with M.O.P. Erin wrote: “It is my mission to get the word out about how incredibly effective M.O.P. is.”

The M.O.P. Book: Anthology Edition is available for purchase in paperback at amazon or as a PDF at

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Must-read books for kids by Steve Hodges, M.D.

• Bedwetting and Accidents Aren't Your Fault

• Jane and the Giant Poop