I think my 4 yr old has encopresis

I am sorry you are going through this! My daughter also had this problem, starting at about the same age. She is seven now, and will lapse back into it if her diet doesn't have enough fiber, but for the most part is doing great. What helped us was an initial "cleaning out" with a milk of magnesia and mineral oil cocktail in chocolate milk. Maybe not the most NFL thing in the world, but I had to do what I had to do. Then the main thing is to keep the diet really great after this so the colon can shrink and recover.
What worked for us: Children need their age plus 5 grams of fiber daily. So your daughter would need 9 grams per day. I think some people just have a predisposition to becoming constipated, and those people (like my DD) just need to be aware of it and eat plent of fiber. I make sure to kind of think about that. If we run out of fresh fruit, she wants eggs for breakfast,or we go out to eat more often, I make sure we are eating fiber rich muffins and whole grains to make up for it.
Water is equally important. She has her own water bottle in the fridge which I fill daily. She knows for her health she needs to drink the whole thing throughout the day. A fun bottle with a straw makes it fun.
Know the trigger foods. If bananas are not working, stop buying them for a while. Apples are great for my DD. I know if she eats 1 or 2 a day, combined with the fruits and veggies and whole grains we eat, she will be fine. If we run out of apples, I really have to pump up the fiber in another way. Pears and peaches are great too.
I know for my DD, one day between BM's is a problem that can escalate quickly. She has "sit time" with a book after breakfast each morning. It is part of our routine.
Good luck, I hope some of this helped. Let me know if you have any questions.

hmm, i just tried to copy my post in your other thread but it wouldn't let me paste.

epson salts baths
regular time on the pot--after the epsom salts bath is good
water, water, water
psyliuum (sp?) husks are a good product to get things moving

We've been dealing with encopresis with my dd for awhile. She has been on miralax for a year. I've tried weaning her from it, but as soon as she's off it for a day or two she starts holding again. Right before she went on the miralax she had an x-ray done and she was full of stool. I had no idea she was that constipated, but she was.

You may still need to do an enema or suppository to make sure to get out any hard blockages. It's important to get her cleaned out well, so things can begin to move once you start increasing fiber. Good luck.

Vitamin C every day just below bowel tolerance works wonders

Sodium ascorabte is the best form of C.

We mix into juice if the child cant swallow capsules I stuff.

i hope you find some fiberous foods that she will eat! maybe she can go to the store with you and pick it out. my son loves cheese, bananas, white flour, meats and such so i have to be careful. if he skips a day, then these things are off limits until he goes. he likes it when i read him a book while he sits and tries.

we try to keep around easy things that i know he will eat that have fiber: strawberries, grapes, raisins, apple juice (i know some ppl dont like juice), sometimes i can sneak prunes in his oatmeal. whole wheat panckaes help and so do bran muffins. the health food store sells whole grain mixes if you can't go from scratch! if the smoothie you made is too strong maybe tone it down. how about a berry smoothie with ground up flax seed or flax seed oil. or a peanut butter banana smoothie with spirulina. even with the banana, spirulina is a powerful antioxidant and the peanut butter covers up the taste.

i think the gentlest laxative that would be effective is best. i can't get my son to drink prune juice so smoothies and apple juices are the only things we have tried. the over the counter things mentioned have got to be better than Rx. the hard thing about the laxative from people i talked to is that is causes cramping, diarrhea, and they can't always make it to the bathroom in time. but if that is what it takes to get the colon shrunk back down, i guess it is worth it.
GOOD LUCK.

edited to add: i let him have all the fruit he wants. if all he wants to eat is grapes, then i just let him and it really helps. i wish he would eat more veggies. he does eat some, but not 3 servings a day. my point is don't be afraid to let them have LOTS of fruit if that is what it takes to get things moving.

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that link has an excellent point. my 8 year old has SID and i believe this is what causes the encropresis in him.

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I just wanted to add that we discovered fruit leathers (dried fruit snacks) http://www.stretchislandfruit.com/ and they add alot of fiber. I get them at my local supermarket but I imagine Trader Joe's and Whole Foods sells them. They make organic ones as well. My ds will not eat dried fruits like apricots or raisins or prunes but he will devour fruit leathers.