By Steve Hodges, M.D. When a child is undergoing treatment for both nighttime and daytime enuresis, a frustrating pattern often emerges: Daytime wetting resolves pretty quickly, and then progress stalls. And stalls. And stalls. Only months later does bedwetting finally start to diminish.   The delay period is so common that I’m giving it a name: the Long Lag.   Though I make a point of preparing families for this plateau, many parents become distressed, anyway. I hear two comments in particular:   •”We were doing so well, and now we’re stuck. What are we doing wrong?”   ..read more

By Steve Hodges, M.D. Here's a round-up of recent questions about enuresis and encopresis that I've received via email and our private Facebook support group. Q: My 13-year-old wets the bed every night, and instead of using toilet paper, he uses his clothing to wipe and then hides his dirty underwear. What do you suggest I do?   A: Poop smears, aka “skid marks,” aren’t caused by a failure to use toilet paper; rather, they signal the child’s rectum is harboring stool and the child is struggling to hold it in — in other words, chronic constipation. Bedwetting (enuresis), too, is a class ..read more

By Steve Hodges, M.D. Q: My mother, a retired physician, has expressed concern about my daughter’s gut microbiome and malabsorption while on Multi-M.O.P. with two liquid glycerin suppositories (LGS) a day. What would you say in response to this concern?   A: The small intestine is involved in the digestion of food and absorption of nutrients, whereas the intestine is mostly involved in absorbing water. Since enemas clear stool from the rectum, the end of the colon, nutrient absorption is minimally affected.   As for the gut microbiome, if a child is backed up enough to have pee and ..read more

In his chat with psychotherapist Chananya Abraham, Dr. Hodges answered: • Can you speed up potty training by having your child wear underwear instead of diapers so they can “feel the wetness”? •How do you know when your child is ready to potty train? •Can you really resolve constipation with dietary improvements? •How can you prompt children to poop when the urge strikes? What does it mean to “fully empty,” and why does that matter? •What are the subtle signs of constipation parents should look for? •Is it true that deep sleep and urine overproduction are causes of bedwetting? LISTEN HERE ..read more

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 ..read more

By Steve Hodges, M.D. If there’s one critical lesson I’ve learned in my 20+ years of medical practice, it’s this: Encopresis and enuresis must be taken seriously and treated aggressively.   Doctors routinely underestimate the distress that poop accidents and wetting accidents cause families, and they continue to push useless treatments, such as endless doses of PEG 3350 (aka the Miralax merry-go-round). Medical providers assume most kids will eventually “outgrow” accidents and (I’m guessing) don’t feel an urgency to step up treatment because, well, accidents aren’t life-threatening. &nb ..read more

By Steve Hodges, M.D.   Recently I appeared as a guest on The Hamilton Review, a podcast hosted by Dr. Bob Hamilton, the affable pediatrician who created the “Hamilton Hold” method for soothing crying babies.   During our enjoyable half hour, Dr. Hamilton and I chatted about enuresis (bedwetting and daytime wetting) and encopresis (poop accidents), common symptoms of chronic constipation. At one point, he asked, “Are you saying there’s a lot of constipation that’s going unrecognized by parents and doctors?”   Yes! That’s what I have been saying for two decades!   In fact ..read more

Listen to popular parenting podcaster and pediatrician Bob Hamilton, M.D., creator of the "Hamilton Hold" method of soothing crying babies, interview Dr. Hodges! The two doctors talked about: •The patient who changed Dr. Hodges’ career and thinking about constipation •Why Dr. Hodges started x-raying his bedwetting patients •Why chronic constipation in children is usually overlooked •The definition problem with the term “constipation” •Why bladder medication is more effective when a child’s constipation is treated •Why Dr. Hodges believes that having a child wear diapers until around age 3 is ..read more

Dr. Jessica Hochman of "Ask Dr. Jessica" chats with Dr., Hodges about: •How a child can poop every day and still be constipated •The most accurate definition of “constipation” •Why the “genetic” explanation for bedwetting often sabotages treatment •Why bedwetting is “never normal” and should be treated even in 4- and 5-year-olds •How x-rays can be used to confirm constipation •That children do not have accidents “on purpose” or because they’re “lazy” Listen HERE ..read more

Emily Saunders of "Healthy Discourse" chatted with Dr. Hodges about: •Why poop withholding is common among kids •Why so many kids become constipated despite eating a "clean" diet •The lesser-known signs of constipation that parents should be aware of •Why parents should never dismiss accidents as a "phase" •Why Miralax falls short for resolving constipation in kids with enuresis Listen to the podcast here ..read more