By Steve Hodges, M.D.,
Even the world’s best poopers, children and adults alike, can get constipated while traveling.
Unfamiliar toilets, long car rides, airport security lines, time-zone changes, erratic schedules, more ice cream and fewer veggies — travel poses many obstacles to pooping daily, promptly, and completely.
If the urge strikes when you’re in a canoe or on a tour bus, you’re going to override it by clenching that sphincter. If you’re forced to poop in an airplane restroom, with a line of antsy passengers crowding the aisle, you’re likely to rush.
And if you’re a child with chronic constipation, you’ll probably delay pooping even longer and pop off the toilet faster.
It’s no wonder that for families dealing with enuresis or encopresis — conditions caused by chronic constipation — vacation often means more accidents, more laundry, and more worries.
“I would bring two washable bed pads, one for under the fitted sheet and one for on top, and disposable bed pads, and my son would wear small Depends,” a mom in our private support group posted, describing the challenges her son’s enuresis posed on trips. “I also would bring a travel bottle filled with laundry detergent for in-room washing, and I’d make sure the majority of our stays had washing machines.”
Traveling, she said, produced lots of “stress and anxiety.”
But as many families, including hers, have discovered, this stress can be alleviated by maintaining constipation treatment on vacation. Even the Modified O’Regan Protocol (M.O.P.), the enema-based regimen I recommend, can be managed away from home.
Yes, sticking with treatment requires planning and commitment, from parents and kids alike. You may need to administer enemas in a tent or carry laxatives through airport security. (“Miralax often gets the extra screening,” one mom in our group cautions. “I think it looks like something dangerous on the x-ray.”)
But families do it all the time, and the payoff is huge: fewer accidents, less stress, and more fun.
“We went on a wonderful trip to a national park, and I realized it was the first vacation we ever had without a single accident,” posted a mom with three children on M.O.P. “I brought a suitcase full of enemas and Ex-Lax and two toddler potties and a Squatty Potty, but it was well worth it to be able to go hiking and go in the hotel pool and not worry about accidents.”
A dad in our support group posted that he helped his 4-year-old son maintain M.O.P. on a Disney vacation, administering the daily enema each morning, and later on a week-long beach trip. “That was probably easier than being at home since we were with him all the time,” he wrote. “We came back to the house for lunch every day, so it became part of the routine.”
Even older kids are often amenable to keeping up the protocol while traveling.
“My otherwise stubborn son has become very compliant with the enemas,” posted a mom whose 10-year-old son administered his daily enemas throughout a 10-day European vacation. “He can tell it's helping, and he's tired of waking up wet.”
Her son stayed dry every night on the trip. “It was actually easy to stay on track despite staying in European hotels with smaller bathrooms,” she posted. “I just asked for extra bath towels each night so I could build him a comfortable spot.”
In addition to avoiding accidents, her son also avoided his usual stomachaches, too. “Before M.O.P., traveling was always stressful,” she wrote, “and I am grateful this time was easy. He typically gets constipated when traveling, so we were able to stay on top of it.”
Below, I offer tips from parents who have traveled with kids on M.O.P. and returned home to tell about it.
•Pack a collapsible potty and extra wipes.
“We brought a collapsible travel potty and could do an enema and potty sit in the trunk of our car in a pinch,” posted one mom, whose daughter is on M.O.P. for encopresis and nighttime enuresis.
She kept her daughter on M.O.P. while traveling in Europe for three weeks when the girl was 5 ½. “Private family bathrooms at the airports were essential for privacy and keeping to our schedule,” she noted.
Another mom, who has maintained M.O.P. on several wilderness camping trips, brings an Ikea portable potty fitted with grocery bags. “We bag all of our number-2s to carry out. We use baby wipes to get clean and just bag them with the poop."
The mom of a 6-year-old boy with enuresis brings along an Ikea potty, too. “We've done M.O.P. on a 4-day back-country canoe trip and also sorts of other vacations,” she posted. “I would give the enema in the tent, and then he'd sit on the potty outside the tent. We were in the back country, so privacy wasn't a concern.”
For taller kids, a toilet stool such as the Travel Porta Squatty helps, but when that’s not practical, families improvise. “We’ve found that an upside-down hotel bathroom trash can is a good height for a makeshift stool if you can’t fly with one!” one dad posted.
Of course, not all children feel comfortable pooping on a travel potty, so you may need to plan accordingly.
“We’ve determined that camping in campgrounds or locations with some sort of bathroom, even a vault toilet, as opposed to using our collapsible toilet, is key for getting our daughter to do the potty sit after the enema,” noted one mom, whose daughter is on Multi-M.O.P,, administering two liquid glycerin enemas per day.
•Use pre-made enemas — or not!
DIY enemas are a lot cheaper than the store-bought versions, but while traveling, some families prefer the convenience of pre-made, especially Fleet liquid glycerin suppositories or generic versions, which are smaller than phosphate (“saline laxative”) enemas. “They're small and easy to pack,” one mom noted.
But in many cases, homemade enemas work fine.
“Since we use old Fleet bottles with glycerin, it's no big deal to take a bottle of glycerin and refill the Fleet bottles as we go,” one mom posted. “Or, if it’s just one night, I pre-fill two bottles. We use Vaseline as a lubricant and wipe down the tip of the Fleet bottle between enemas, with some hand sanitizer for hygiene. I keep the enema bottles in a separate Ziploc baggie from the rest of our toiletries.”
A mom who uses the “syringe method” for DIY enemas (described on page 100 of the M.O.P. Anthology 5th Edition) packed her supplies in an unbreakable jar for a recent camping trip.
“After the enema, I didn't have access to a sink and didn't want to contaminate the lake, so I wiped the syringe off well with baby wipes and then sprayed it in alcohol to sanitize, then rinsed it. We did have to use more baby wipes then we would at home.”
One mom posted that she’s been able to maintain her child’s Double M.O.P. regimen — an overnight olive oil enema followed by a morning stimulant enema — even while staying at hotels.
“I just ask room service for a bottle of oil to keep in the room and bring an empty Fleet bottle for the enema,” she posted.
•When flying, bring back-up supplies.
Given how often airlines lose luggage, many parents say they pack enema supplies and laxatives in both carry-on bags and checked suitcases. Many countries don’t sell Ex-Lax or enemas in pharmacies or supermarkets, so if you arrive without your supplies, you may be out of luck.
Just remember that checked bags will be exposed to the elements en route.
“The Ex-Lax in our carry-on bag was fine,” one mom posted. “But the Ex-Lax in the checked bag melted.”
•Be flexible with your regimen, and don’t sweat the missed enema.
Even for children who aren’t prone to constipation, travel can result in clogged pipes, so a child on M.O.P. may need a higher laxative dose than usual.
“After a few trips, I realized that larger dosing of Ex-Lax was almost always needed,” one mom posted, “so I bring extra and make sure we increase right way if he's having a harder time going.”
The mom who used to pack multiple bed pads for her son, now 12, says that while her son is now accident-free and no longer needs enemas, he does take stimulant laxatives periodically, especially on trips.
"We have traveled since he’s been dry, and it’s so much less stressful than before," she posted. "Now we just keep an eye on the need for Ex-Lax and increase it during the trip at the first sign that he's having a harder time going."
Many parents give their child more PEG 3350 or give it more often.
While it’s generally easy to maintain a laxative regimen on the road, it’s not always easy to fit in the enema. Some families arrange their daily schedule with the enema in mind, whether that’s administering it first thing in the morning or regrouping mid-day at the AirBnB.
Or, as one mom posted, “When planning our itineraries, we would plan for extra time for enemas in the evening or just have a late night.”
But sometimes, the best laid plans go awry, and that’s OK.
“We travel with decent frequency, mostly camping, and enemas are just part of our routine now,” one mom posted. “Occasionally there might be a missed enema — showing up at a campsite at 12:30 a.m. after racing a winter storm over 4 mountain passes is such an occasion. But so long as they are occasional, they don't really have any effect.”
If you can enjoy your vacation and return home without a major setback, that’s a victory. And rest assured, all setbacks can be reversed.