The Modified O'Regan Protocol:
How Enemas Can Help Resolve Bedwetting and Daytime Pee Accidents for Children
Recommended Enema Kit
2016 Enema Study for Bedwetting
Phases of the M.O.P.
Introducing Enemas To Your Child
Constipation and Bedwetting
Nighttime bedwetting and daytime pee accidents (known as enuresis) can be stressful and emotionally challenging problems to address for both children and their parents.
For many children, bedwetting is a short-term issue that they grow out of quickly on their own. For others, there can be underlying causes that prevent resolution to the issue, the most common of which is constipation.
Traditional solutions from doctors for constipation-related bedwetting typically involve timed voiding, constipation treatment with laxatives, biofeedback physical therapy, or medications that can calm an overactive bladder.
However, a 2016 study revealed that daily enemas may be a much more effective solution for treating constipation and bedwetting than these traditional methods.
Using Daily Enemas To Treat Constipation-Related Bedwetting
In the controlled trial carried out in 2016 by Dr. Steve Hodges and Dr. Marc Colaco, 60 children with non-neurogenic overactive bladders participated, 40 of whom received traditional treatment methods (laxatives, bladder-relaxing drugs, and biofeedback physical therapy), and 20 of whom received just daily enemas and laxatives.
In the 1980s, pediatric doctor Sean O'Regan used enemas to help treat bedwetting. Drs. Hodges and Colaco used his method, modifying it slightly for this study.
The results were significant: only 30% of the children treated with traditional methods reported symptom resolution after 3 months, compared to 85% of those treated with enemas.
Dr. O'Regan had noted the connection between constipation, a stretched or distended rectum, and bladder function. Constipation (when the colon is full of backed-up stool) can cause the rectum to stretch, which puts pressure on the bladder and can cause involuntary bladder voiding. This can be addressed by frequently emptying the rectum and colon of stool through the use of daily enemas and laxatives.
The Modified O'Regan Protocol (M.O.P.)
The Modified O'Regan Protocol (M.O.P.) to treat pediatric bedwetting involves several phases. The process can look different for each child, with trial and error expected along the way. It’s important to be flexible while following this protocol; there are no strict or precise rules.
Phase 1 involves administering one enema per day for at least 30 days, until you have at least 7 days with no accidents.
Phase 2: Once you achieve 7 days with no accidents, the second phase consists of tapering down to one enema every other day for 30 days.
Phase 3 is two enemas per week for at least 30 days.
The timelines for each of these phases are only rough guidelines, and will vary from child to child. Many children will need more than 30 days of daily enemas to achieve continence (dryness).
▶︎ Enema FAQs
Additionally it's beneficial for most children to take a laxative or stool softener such as reacted magnesium throughout all three phases, and for longer if necessary, to avoid constipation.
Introducing Enemas To Your Child
Enema reluctance is common. What if my child won't agree to do an enema? Also many parents wonder if that many enemas are really safe or necessary for children.
For many children experiencing bedwetting, the Modified O'Regan Protocol (M.O.P.) is a safe and effective protocol to relieve constipation and put an end to involuntary voiding. If you have concerns about administering enemas to your child, consult with your pediatrician or schedule a consultation with Kristina Amelong, CCT, CNC.
While children may be reluctant or afraid of enemas at first, as Dr. Hodges writes on his website, "most kids are more bothered by accidents than they let on and are willing to give M.O.P. a try," and may become more and more pro-enema as they start to feel better and better.
This blog post may also be helpful in learning how to ease a child's fear of enemas.
▶︎ IMPORTANT: You should never force a child to have an enema. Consent is crucial throughout this process.
Enemas vs. Laxatives
It may be tempting to just use a laxative as a solution rather than doing enemas. However, daily enemas are much more effective than using laxatives alone, because they can dislodge hard masses of stool and keep the rectum completely clear so that it has a chance to regain tone and sensation and heal from the distention caused by constipation.
It's also important that children eat well, drink a lot of water, and get plenty of exercise to help avoid constipation.
Recommended Enema Kit
For giving enemas to children, I recommend using our 2-Quart Silicone Easy Enema Kit with Junior Flex Tip Nozzle. This kit comes with a narrow, flexible nozzle designed for use with children. The nozzle has a natural bend to indicate the safest maximum insertion point.
It's important to stay positive and not get frustrated or angry with your child. Children cannot control wetting and will likely feel embarrassed, scared, and frustrated themselves.
▶︎ This website is a great resource for parents who are guiding their child through M.O.P.
▶︎ Enema Instructions and Recipes
For many children, constipation can be an underlying cause of bedwetting or daytime pee accidents. Traditional solutions from doctors involve timed voiding, use of laxatives, biofeedback physical therapy, or medications that can calm an overactive bladder. However, a 2016 study demonstrated that daily enemas may be a much more effective solution for treating constipation and bedwetting than traditional treatments.
The Modified O'Regan Protocol (M.O.P.) is a multi-phase approach to enema treatment to address bedwetting.
DISCLAIMER: This material is presented for informational purposes only and is not a substitute for medical advice, diagnosis, or prescribing from a licensed healthcare professional. We make no claim or guarantee for cure or relief of any specific symptom, medical condition, or disease when using any of the products or protocols referenced here. Consult with a licensed healthcare professional before altering or discontinuing any current medications, treatment, or care, or starting any diet, exercise, cleansing, or supplementation program, or if you have or suspect you might have a health condition that requires medical attention.
By Kristina Amelong, CCT, CNC
I-ACT-Certified Colon Hydrotherapist
Certified Nutritional Consultant