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Better Bedwetting Treatment — and How to Stop Encopresis and Pee Accidents, Too

By Steve Hodges, M.D.

As I often tell families, I take the term “medical practice” literally. I’m always looking for ways to improve treatment for bedwetting and daytime pee or poop accidents, and when I hit upon a useful approach or adjustment, I’m eager to share it.

To be accurate, the 5th Edition isn’t entirely new. It’s an updated version of the Anthology 4th Edition. However, version 5.0 contains substantial new guidance that I’m confident will help resolve bedwetting and daytime accidents more quickly, effectively, and permanently.

As with many upgrades — in technology, in medicine, and in life — the new version renders some of the previous version obsolete. (If you own an old version, email a receipt or a photo to to receive a discount coupon code for the new PDF.)

To be sure, my fundamental opinions still hold. I continue to believe that enuresis and

encopresis are woefully misunderstood and vastly under-treated. I’m dismayed these conditions are considered by our society, including some health professionals, to be “normal” or to have psychological and/or behavioral roots.

Heck, just this week a new member of our private Facebook support group for teens and tweens posted that her 14-year-old daughter had struggled with bedwetting, daytime wetting, and urinary tract infections (UTIs) for over a decade — and not a single pediatrician or specialist connected the child’s history of constipation with her persistent wetting. “I was often told that it was normal and she'd grow out of it,” this mom posted. That’s what most parents in our support group have been told!

As always, I shake my head that bladder drugs and bedwetting alarms are the go-to treatments for enuresis and that doctors routinely push Miralax (PEG 3350) in cases where enemas are clearly superior.

I still marvel at the brilliance of Dr. Sean O’Regan, whose studies in the 1980s changed the way I practice medicine and form the basis of the Modified O’Regan Protocol (M.O.P.). When it comes to treating enuresis, encopresis, and recurrent urinary tract infections (UTIs), Dr. O'Regan understood far more back in the Bon Jovi era than the medical community at large recognizes today! I wish his research was required reading in medical school.

However, I also believe treating these conditions sometimes requires more nuance

and a more aggressive approach than is reflected in Dr. O’Regan’s original protocol.

Children with the exact same symptoms may need entirely different variations of M.O.P. — different enema solutions and volumes, different laxative types and doses, different tapering plans. For some children, chronic constipation is a far more stubborn condition than even I realized, and I’ve always taken constipation more seriously than most doctors.

The standard M.O.P. regimen, described as “overly aggressive” by many physicians, simply does not suffice for some kids, and even the variations introduced in previous editions of the M.O.P. Anthology can be improved upon. Overall, in recent years, I've taken a more hard-hitting stance on treating enuresis and encopresis.

At the same time, I’ve taken more notice of ways to make M.O.P. easier on families — logistically, financially, and emotionally.

The 5th Edition of the Anthology includes valuable new advice on all these fronts.

Following are some highlights from the 5th Edition, available in paperback on amazon (in black-and-white and premium color) and as an instant download via our website.

Multi-M.O.P.: A new protocol for the toughest cases, especially teens and tweens, highly motivated kids, kids who feel nauseous on Ex-Lax, and children who've experienced a recurrence of accidents.

•DIY enemas. How to save boatloads of money (and cover the cost of this book!) by making your own liquid glycerin suppositories.

•New M.O.P. Cheat Sheets and Guidance. Which of the five M.O.P. variations is best for your child: Standard M.O.P., M.O.P.+, M.O.P.x, Double M.O.P. or Multi-M.O.P.? Each variation involves a different combination of enemas and osmotic and/or stimulant laxatives. We break it all down.

•The Slow Taper. A more gradual approach to weaning a child off M.O.P., with the goal of reducing the risk that accidents will recur.

•Pre-M.O.P. for Accident-Free Kids. A regimen for kid who never have accidents yet struggle with rectal bleeding, painful pooping, rectal prolapse, or persistent stomachache.

•Bladder Botox. Injecting Botox into the bladder is the quickest, most effective way to halt accidents. But, it’s surgery, and it’s expensive. I discuss which kids are the best candidates.

•Four Essential Guides. In these guides, you’ll find information unavailable anywhere else in the universe!

The Enema Rescue Guide includes 12 strategies to help apprehensive children feel comfortable with enemas.

In the totally revised Physician’s Guide to M.O.P., I speak directly to my colleagues, urging them to keep an open mind about enemas and to read the science in support of M.O.P. Hand the guide to any doctor who considers enemas “overly aggressive” for children.

The M.O.P. Maestro Guide helps parents orchestrate the family’s M.O.P. regimen without going bonkers. It’s especially useful for parents with multiple children on M.O.P. and was inspired by a mom who managed M.O.P. with 5-year-old triplets!

The M.O.P. Parent’s Guide to Advocating for Your Child at School will help you gain the support of your child’s educators and ease your child’s stress in the classroom.

• Q&A With a Psychologist. Amanda Arthur-Stanley, Ph.D., a terrific psychologist who specializes in helping children with enuresis and encopresis, offers guidance on diffusing the frustration, guilty, and family friction that can arise from accidents and treatment.

• Updated Tracking Calendars. Based on parent feedback, we've updated our all-purpose 30-day M.O.P. tracker and added calendars for Multi-M.O.P. and for teens.

There’s a lot more in the Anthology 5th Edition, too!


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