By Steve Hodges, M.D.
A few years back, a mom in our private Facebook support group posted a short video of her 8-year-old daughter, Eden, who had struggled for years with poop accidents, a.k.a. encopresis, and had been hospitalized for severe constipation.
“I’ve had encopresis since I was 3, and it’s been really hard,” Eden says in the video. “When I was 5, I had to go to the hospital, and it was scary. I had to get a tube down my nose. They also gave me an enema, and I felt much better.”
At age 7, Eden started a daily enema regimen, and that's when her accidents stopped.
“Enemas just have really helped me, and they really work,” Eden says in the video. “So, I just recommend using enemas.”
Eden, initially fearful of enemas, made the video to encourage other kids with encopresis to try the treatment, and she succeeded on that front. Many parents in our support group have shown the clip to their kids and reported a positive response.
But Eden’s 2-minute video also had an outsize influence, inspiring Suzanne Schlosberg, who co-founded the support group with me, to write an entire middle-grade novel for older kids with encopresis and enuresis (bedwetting and daytime wetting accidents).
I'm excited to announce that the book, titled Emma and the E Club: An Epic Episode About Eliminating Enuresis and Encopresis, is now available on amazon in hardcover, paperback, and Kindle versions. (Download Chapter 1 for free here.)
“I was really taken by Eden’s honesty and confidence and her eagerness to help other kids,” says Suzanne, a long-time health journalist with over 20 books to her credit. “Her video gave me an idea for a story and a main character, and somehow I found myself writing a novel. It was so much fun.”
The book’s narrator is Emma, an intrepid 5th-grader and word-game enthusiast who has collected 1,038 words that start with the letter E. Emma also happens to have encopresis and enuresis (and a mom obsessed with crime investigations).
For years, Emma’s accidents were a mystery to her and her parents. “I mean, I know how to use the toilet,” Emma writes. “I learned when I was two. By third grade, I could chop an onion, flip an omelet, and peel an eggplant. I could wash and dry my laundry, too. So, why couldn’t I do something as simple as keep my pants dry?”
One epic day, an eccentric doctor enlightens Emma, and suddenly, everything makes sense: her bedwetting, her stomachaches, her entire life.
When Emma discovers that Charlotte, a girl at school, also has enuresis, together they establish the E Club, for kids with enuresis and/or encopresis. The even entice a 5th-grade boy, Lucas, to join — no easy task. The club’s mission is to eradicate enuresis and encopresis so that no kid ever has to wear pull-ups to a sleepover or stress about having an accident. But how will the E Club accomplish that?
Read the book and find out!
Oh, and Emma and Charlotte have a second mission, too: to persuade a very reluctant Lucas to try an enema.
You and your child might be surprised to find Emma is pretty darned funny. I have to admit that when Suzanne first told me her idea for the book, the comic possibilities did not jump out at me.
After all, I’ve treated thousands upon thousands of children with enuresis and encopresis, and I know how much distress and embarrassment these conditions cause. This is especially true for kids age 8+, who’ve been assured they would “outgrow” their accidents.
But this book has a lot of laughs! There’s a grandma, a.k.a. The Purse Lady, who lands in jail for selling fake designer handbags. There’s a plumber who calls herself Dr. Drain and drives an ambulance. And then there’s Emma’s kooky urologist, nicknamed Dr. Pooper, who, FYI, is not based on me.
“Dr. Pooper is far wittier and more fun than you are,” Suzanne told me. “You two basically have nothing in common other than your medical degree.”
Well, that’s not entirely true. Dr. Pooper and I both advocate enema-based treatment for enuresis and encopresis. But unlike Dr. Pooper, I have never referred to pooping as “launching a torpedo,” “squeezing the cheese,” or “taking the Browns to the Super Bowl.”
Nor have I ever nicknamed a patient “the Exalted Empress of the Enema Empire.”
I should add that the book’s humor is amplified by the illustrations of Mark Beech, a renown children’s book illustrator who lives in England. The guy is a genius!
Suzanne says that boosting kids’ self-esteem was her primary goal in writing Emma and the E Club.
“Encopresis and enuresis take such an emotional toll on kids, more than most parents realize,” Suzanne says. “Elementary and middle school students often feel they’re the only kids their age who have accidents, and they internalize the blame that society has placed on them.”
Many of these kids, like Emma and her E Club friends, did not realize at first that accidents are caused by chronic constipation. “It’s so important for kids to know that, in fact, accidents are common, never a child’s fault, and totally fixable,” says Suzanne.
On the subject of enemas, well, Dr. Pooper has a lot to say, some of it pertaining to ancient Egypt and some of it pertaining to the Eisenhower Expressway in Chicago. But I particularly like how he explains their value to Emma: "Some kids need an inhaler to help them breathe. Some kids need tutoring to help them read. And some kids need enemas to help them poop. No one in life is exempt from needing a bit of assistance, Emma!”
That includes Dr. Pooper himself, as he goes on to explain.
Suzanne says it was important to her to portray Emma as a girl who is not defined by her medical condition. Emma is an upbeat, bold personality with eclectic interests.
“Chronic constipation can be all-consuming for families,” Suzanne says. “The most conscientious, well-intentioned parents can spend an inordinate amount of time monitoring their kids’ pooping habits and treatment regimens. Sometimes kids feel like all their parents care about is whether they’ve pooped that day.”
In Emma and the E Club, parents don’t play a big role. The kids drive the story. It’s their ideas, observations, and feelings that predominate.
I’m pleased to report the book has received the stamp of approval from many parents in our private support group who, along with their kids, critiqued various drafts of the manuscript.
One dad said his 10-year-old “devoured this book in one gulp,” and one mom called the book "delightful and clever," saying it "tackles a challenging topic with humor and intelligence.” A 9-year-old girl said Emma “made me feel so much better about my situation.” Though the book is aimed at kids ages 8-12, several parents reported that their 7-year-olds enjoyed having the book read to them, even if some of the vocabulary was over their heads.
Emma and the E Club has received praise from Publishers Weekly, including: "The best part of this surprisingly lighthearted tale is Emma's sparkling personality, which makes reading this book feel like talking to a close friend." The review — published here in its entirety — concludes, "This entertaining, conversational story shows kids with enuresis and encopresis they're not alone."
Child psychologists, medical doctors, and other health professionals have weighed in with positive reviews as well.
Tina Payne Bryson, Ph.D., a psychologist and New York Times bestselling co-author of The Whole-Brain Child and No-Drama Discipline, calls Emma and the E Club “clever, validating, and informative all at once — brilliant!”
Laura Froyen, Ph.D. of the Balanced Parent Podcast, describes the book as "a beautifully compassionate book, for both children and parents" and says "the light-hearted tone makes a difficult topic easier to discuss.”
Mike Garrett, M.D., a family physician in Austin, Texas, calls the book “hilariously entertaining and encouraging for kids.”
In case you’re wondering, Eden, the girl whose video inspired the character of Emma, approves of the book, too. Recently, Suzanne Zoomed with Eden, who is now 10, and her mom, who’s a nurse practitioner.
Eden told Suzanne her encopresis has long since cleared up, but she still has a tendency toward constipation and does enemas periodically. “I do enemas when I feel like it,” she said, “like if my poops are starting to get a little big or if my tummy feels uncomfortable.”
On the Zoom call, Eden told Suzanne that at first she was so afraid of enemas that she’d hide in her closet. But she also felt left out of sleepovers, and that motivated her to step outside her comfort zone.
“I was tired of having accidents,” Eden said, “so finally I was like, OK, I’ll just try it.”
If your child is similarly tired of accidents but reluctant to give enemas a try, Emma and the E Club might just might help. Kids who are already on board will feel validated by the book, and both kids and parents will get a good chuckle.