How to Stop Bedwetting with M.O.P.
- Steve Hodges, M.D.
- Jun 30
- 3 min read
By Steve Hodges, M.D.
Few conditions are as misunderstood and mismanaged as nocturnal enuresis, aka bedwetting.
Parents are told their child will “outgrow it,” that bedwetting is a “normal part of childhood development” and doesn’t warrant treatment until age 7, 10, or older. Common explanations run the gamut: an underdeveloped bladder, deep sleep, hormone imbalance, a bladder that “hasn’t caught up with the brain,” emotional stress or anxiety. Bedwetting has even become political shorthand for “excess worry,” with headlines like, “Democrats need to quit bedwetting.” As if accidents are within a child’s control!
But they’re not, and all those explanations are wrong. In reality, bedwetting is caused by chronic constipation.
A child’s enlarged, stool-packed rectum aggravates the nearby bladder nerves, triggering forceful “hiccups” that empty the bladder overnight. Constipation is easily seen on a plain abdominal x-ray, yet many parents have no idea their child is constipated. Even severe cases are often missed, because the standard definition of constipation is inadequate, and common diagnostic methods are unreliable. Children who poop daily can still be constipated, but that’s not common knowledge.
Misinformation sends families on wild goose chases — fluid restriction, midnight wake-ups, bedwetting alarms, special diets, sleep studies, reward charts, talk therapy, chiropractic, and drugs that fail. But these remedies don’t address the root cause: rectal stool buildup. Even when constipation is recognized, it’s often undertreated; kids may spend years on Miralax (PEG 3350) to no avail.
By the time families land in my clinic, children and parents alike feel discouraged, even despondent. Kids, terrified of being “found out,” avoid sleepovers and school trips. One mom in my private support group wrote, “Enuresis has basically ruined this kid’s social life and crushed his self-esteem, and I kept listening to ‘Don’t worry, he’ll outgrow it.’” A dad of a 17-year-old told me, “The poor kid is humiliated and feels trapped and stressed about going anywhere overnight, including the future he wants in college.”
Families grow tired of waiting for the magical day when bedwetting stops — a day that never seems to come. While most children do eventually stay dry without treatment, an unlucky minority never do. I see no benefit in waiting years to learn which group a child will end up in (nor any benefit in buying pull-ups for an extra 5 years). I treat bedwetting at age 4 and encourage early action. I’ve never met a parent who said, “I’m so glad we waited.”
Most families believe they’ve “tried everything” — but they haven’t tried the Modified O’Regan Protocol (M.O.P.), the most effective treatment available. M.O.P., based on the pioneering research of Sean O’Regan, M.D., a pediatric kidney specialist, and refined over 20 years, isn’t a single regimen but rather a whole treatment approach.
M.O.P. tackles constipation aggressively using enemas and laxatives. The goal: fully empty the rectum and keep it empty long enough for it to shrink to normal size and stop bothering the bladder. M.O.P. has multiple variations tailored to each child’s symptoms, history, preferences, and treatment response.
Know that M.O.P. is not magic. Chronic constipation develops over years and takes
more time to reverse than most families expect. Setbacks are common. Success
requires experimentation and persistence.
Expect two steps forward, one step back. This packet includes the M.O.P. Bedwetting
Algorithm — a treatment roadmap built on two decades of experience. The algorithm is not a rigid formula; there’s always more than one path to dryness.
But this game plan will save you time. Use it to make educated guess when you come to a fork in the road.
NOTE: Download the complete packet from our FREE DOWNLOADS page. This guide pertains to nighttime enuresis only. If your child also has daytime wetting and/or encopresis, please see our other guides.
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