Christy—Yes, it is very difficult to adjust Miralax to a point where you don’t have constipation with hardened stools or go to the opposite extreme of “…runny poop all the time.”  Your solution of going over 3 days without pooping is not desirable and will inevitably wind up with an enlarged and weaker colon causing potential physical problems later on.  You may see more irritability and oppositional behavior as he “fills up”.  The occasional accidents, even just once a month for 3 consecutive months still meets the definition of encopresis.  The regressions that you observe when you have a change in his environment are not unusual.  Our daily BMs typically become a “habit” as to the place and time of day, maybe with the assist of eating or coffee which can “prime” our holding-voiding reflex sequence.  Observe yourself or your husband if you take a trip, go camping, or go through a busy, stressful period and see if your voiding becomes delayed until normal stooling reasserts itself.  You could give your child an enema following two full days of holding as a stopgap measure to prevent excessive backing up.  But, if you do that, you may as well follow a more rational training program such as that set forth in the Clean Kid Manual-IV (CKM-IV) and join with other parents using it or have used it successfully and remain on the Soiling Solutions (SS) forum.  Access to that forum is free upon ordering the CKM-IV and it is exclusive to keep treatment issues more focused based on the manual.  Read on below for more insights.  Thanks for your questions.  My email reply to you was rejected, so please write to me again if you wish a copy of my medical journal article and a couple of editorials regarding it.