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  • By Steve Hodges, M.D.,

No, Enemas for Childhood Constipation Are Not Abusive — They Can Give Kids Their Lives Back


I can’t count the number of parents who’ve told me, “Our doctor says enemas are abusive and we should stop immediately.”

In fact, several parents have told me they worry their doctor, or even other parents, will report them to child protective services for following an enema regimen.

One mom in our private Facebook support group posted that she was “scared to death in the pediatrician's office that they are going to call CPS.” This mom was successfully following the Modified O’Regan Protocol (M.O.P.) with her son, against the wishes of her son’s physician.

Another mom had sung the praises of enemas in a post to a different Facebook support group, only to delete that post after a parent warned her, “I have known several families within the autism community who were reported to CPS for posting in public forums that they had given their child an enema.”

Yet another mom, also finding success with enemas, said she was told by a counselor that it would be best to “keep it a secret” because enemas just “are not done today. It’s almost child abuse.”

This makes no sense.

In my blog post “Daily Enemas Are Really, Truly Safe for Constipated Children,” I dispense, at length, with the notion that enemas are unsafe. Doctors frequently caution parents that enemas cause electrolyte imbalance or dependence or that they damage the sphincter. All these objections are demonstrably false.

In addition, I know from well over a decade of experience that enemas are not traumatic or abusive. Quite the opposite: For countless children dealing with bedwetting, daytime accidents, and encopresis (poop accidents), enemas and liquid glycerin suppositories (a smaller type of enema) are the only treatment that resolved their child’s chronic, severe constipation and gave these kids their lives back.

As one mom in our group recently posted: “I have had my child on your program for over a year, currently doing M.O.P.+ [large volume enemas] and Double M.O.P. [overnight oil-retention enemas]. My daughter's gastroenterologist and pediatrician just tell me to up the dose of Miralax and give more Ex-LAX and stop the enemas. The enemas are the only thing keeping my child accident free, and we have made a lot of progress on a very tough case."

Another mom, whose son has been dealing with both daytime and nighttime accidents, posted: “We are on day 80 with liquid glycerin suppositories and the daytime accidents have pretty much disappeared. SO AMAZING! This is truly life changing for our family! Night-time dryness has started to pick up, too, and he has been dry three out of the last four nights, so we are getting closer!”

The vast majority of parents in our support group have been discouraged by doctors from giving their children enemas. Their physicians all have the same advice: more Miralax. And when that fails? Even more!

It boggles my mind that physicians keep pushing treatments that fail — and, worse, that many doctors belittle, scold, or scare parents for taking a different approach.

I applaud parents who have the fortitude to trust their instincts and go against their physicians’ advice. In hopes of encouraging more parents to follow suit, I’m posting a few recent stories from parents who have emailed us or posted in our support group.

You can find seven additional stories in our blog post “Early intervention is everything”: Don’t Wait to Treat Your Child for Enuresis or Encopresis.”

For the scientific arguments and evidence in support of enema safety and effectiveness, read The M.O.P. Book: Anthology Edition or download, for free, The Physician's Guide to M.O.P. The different variations of M.O.P. do include osmotic laxatives (such as PEG 3350 (Miralax), magneisum citrate, and magnesium hyroxide and, for some kids, stimulant laxatives such as Ex-Lax. But I believe daily enemas are the critical treatment for cleaning out the rectum and keeping it clear long enough for it to shrink back to size, regain tone and sensation and stop aggravating the bladder.

Mom #1: “I had NO CLUE how constipated she was”

Her story: We are on day 26 of M.O.P. with my 3-year-old daughter, and oh my word. We have seen such an improvement on so many levels!

Over the last year, my daughter had been pooping in her diaper in the middle of the night. She rarely, if ever, woke up when she pooped, so in the morning, she’d be covered in a diaper rash.

I’m embarrassed to say that I got on to her several times for not waking us up to change her because I just couldn’t figure out why anyone would choose to lay in their own feces for hours at a time.

Now I know that she was so full of poop, she likely never even felt it come out of her.

My daughter had been peeing in the potty during the day for almost a full year, but refused to poop in the potty. Once beginning M.O.P., the middle-of-the-night poop accidents stopped immediately, and after 26 days of M.O.P., she has woken up COMPLETELY DRY (no poop or pee) for 6 days in a row.

I am shocked. I was never expecting her to stop peeing in the middle of the night during this process. Before starting M.O.P., not only was she pooping in the night, but she was also peeing so much at night that her nighttime diaper would leak.

She was pooping every day, so I had no clue how constipated she was. The first few days of suppositories resulted in her passing really hard, firm stool and she even had several “rabbit poops” 10-12 days after beginning, which I think was old, impacted stool that finally came out.

I hate that I got on to her for something she couldn’t control. This program has been such a blessing for our daughter and our family. Her teacher has even noticed a difference in her concentration and attitude while she’s at school. I’m just floored!

I’m sharing this here because I don’t have any other safe space to celebrate, but I honestly want to start talking about this to my friends and family to help spread the word. I really think this information should be posted at every pediatrician’s office.

When your child is pooping every day, constipation seems so unlikely, but the signs of constipation are so inconspicuous and so discreet and parents really need to be educated on what the signs even are.

We are planning to move on to Phase 2 of M.O.P. within the next week or so. My daughter doesn’t mind getting her “bottom medicine,” so I’m thinking I may continue for a few days past the 30-day window to try to avoid any relapse. I’m thankful that we seem to be over the worst of it.

Mom #2: “I am glad I trusted myself.”

Her story: We originally started enemas when my son was 7 because of his encopresis, though he was a constant bed-wetter too. The encopresis was life consuming.

We are guessing that he started getting backed up at 1 to 2 years old, and it worsened during potty training at age 3. We spent years 4 to 6 doing Miralax and magnesium citrate, which really did nothing for him.

It was when we started M.O.P. that we really saw progress. We did daily enemas for over a year and Double M.O.P. a few times. That really helped in the beginning to get the old stuff out.

After a year a half on M.O.P., we started adding in Ex-Lax to our son's regimen. He now takes one square a day and is pretty much accident free. He has been diagnosed with IBS and certain foods and travel throw him off for a few days.

It has taken a really long time for him to regain sensation and for his rectum to heal.

This program has changed our lives. I have actually been relaxed and no longer need to worry about my son having an accident or being embarrassed.

We took the kids skiing over spring break, and we were able to put our kids in ski school ALL DAY and not worry about a thing. If I could go back and do anything different, it would have been to start this program earlier.

I finally started M.O.P. after my research and against the pediatrician’s recommendation. He is a good doctor but was not on board with enemas. In fact, none of the doctors we came in contact with were able to help us. I almost want to go back and tell them all our story so other kids don't have to go through the same thing. However, trying M.O.P. was the best decision I made and I am glad I trusted myself.

Mom #3: “I see her confidence returning.”

Her story: My daughter was fully potty trained at 2.5 and was dry for an entire year before having accidents at night and leaking during the day. This was really hard for her, especially when she became school-aged. Kids would comment on her "smell" and she withdrew from physical contact, which broke my heart.

We went to a number of doctors who all either called it a "brain" thing or a control issue. I knew it was neither of those things because I could see how devastated she was about it. Turns out she was hella constipated.

At age 9, she is now accident-free and I see her confidence returning. I am so thankful for this protocol. It was very easy to follow. Enemas can be a scary thought, but it really wasn't a big deal. Patience is necessary. We did 4+ rounds of M.O.P. She was really constipated and impacted. It takes a while for the colon to shrink back to normal too.

We’ve had our ups and downs, especially in the beginning when she began to regress. We've had lots of talks about this and I've always told her we were on the same team, and we'd figure it out together.

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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

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Feel free to contact Dr. Hodges or Suzanne directly:
shodges@wakehealth.edu
suzanne@bedwettingandaccidents.com

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