Frequently Asked Questions About M.O.P.
What does M.O.P. stand for?
The Modified O'Regan Protocol. The regimen was developed in the 1980s by Sean O'Regan, M.D., a pediatric kidney specialist at Sainte Justine hospital in Montreal, who sought to resolve his own son's bedwetting. The regimen was "modified" by Steve Hodges, M.D., a pediatric urologist at Wake Forest University. Dr. Hodges named the regimen after Dr. O'Regan, whom he considers a genius.
What exactly does M.O.P. involve?
M.O.P. is more of a process than a strict protocol and involves trial and error. The gist:
•Phase 1: One enema per day for at least 30 days and until at least 7 days of dryness (day and night)
•Phase 2: Taper to one enema every other day for at least another 30 days
•Phase 3: Taper to two enemas per week for at least 30 days
•Phase 4: Take a daily osmotic laxative throughout M.O.P. and for at least 6 months after
The type of enema and laxative you choose depends on what works best for your child. Count on some experimentation to figure that out. The options are spelled out in
The M.O.P. Book: Anthology Edition.
Keep in mind that many children require more than 30 consecutive days of enemas to reach dryness. This is especially true for older children and for those who have daytime pee or poop accidents as well as bedwetting. Many families will need to shift to
Double M.O.P., or
Super M.O.P., more aggressive versions of the regimen.
Holy moly — that's a lot of enemas! Is that really necessary? Is that even safe?
Yes and yes. Accidents are caused by constipation: When poop piles up, the rectum stretches, pressing against and aggravating the bladder. Only when the rectum is fully cleaned out daily, and for months, can it shrink back to size and stop bothering the bladder. Daily enemas are required to achieve that complete clean-out.
The M.O.P. Book: Anthology Edition discusses enema safety in great detail.
What if my doctor is not on board with M.O.P.?
It's helpful to have a doctor in your corner, but it's not necessary. Many doctors have no experience with enemas and are downright hostile to them, in which case we recommend printing out
The Physician's Guide to M.O.P. and handing it to your medical provider.
Most families who implement M.O.P. do so without their physician's support. Many of them join our
private Facebook support group to get input ad reassurance from Dr. Hodges and other M.O.P. parents.
Another option is to have a 30-minute, one-on-one Facetime, Skype, or
phone consultation with Dr. Hodges.
What if there's no way my child will agree to enemas?
That's what most parents think! But you'd be surprised. Most kids are more bothered by accidents than they let on and are willing to give M.O.P. a try. Before long, enemas become routine. Many kids actually ask for their enema each day because they feel so much better.
This blog post will help:
11 Ways to Ease Your Child's Fear of Enemas.
Also, we highly recommend that all kids age 10 and under on M.O.P. read
Bedwetting And Accidents Aren't Your Fault. Most kids think they are the only one having these issues. They find the books very reassuring, and parents report their kids are more likely to comply with treatment when they read the book.