Hi Toni from out West.  There is nothing unusual about what you are doing in compliance with what is the standard medical advice for encopresis.  This is pretty much what physicians describe as “maintenance therapy” in hope of his eventually gaining control on his own over time.  The Miralax is used as a stool softener with the idea that it will prevent the stool from becoming dried out and “stuck”.  The Exlax is an irritant vegetable laxative which stimulates contractions in the colon intended to move the foodstuff along.  It makes some kind of simple Mr. Plumber sense and it does work for 40-60 percent of children.  The doctors may persist in this approach for way too long as they have in your case.  They have failed to address the real issue which is the voiding reflex at the end of the colon which has become dominated by the holding reflex.  We all hold, but do it just until we get to the bathroom, sit, and go.  Sounds simple, but your child just can’t initiate the voiding response at will and so he has repeated accidents when the poo just sneaks by.  In fact,  there is a book entitled “Sneaky Poo.” Playing around with diet is extremely common, but it all is buying time and hoping for magic in the majority of cases.  The waxing and waning of accidents is fairly common because he has not established a reliable voiding reflex habit.  If you keep reading on in my responses to parents below you will learn how my Soiling Solution protocol works to address this issue.  Basically it retrains awareness and associates the voiding reflex with sitting on the toilet stool.  If is definitive and effective, but resisted because it uses suppositories and enemas as training "primers" in a carefully structured way designed to have the child's own natural urges and voiding reflex to take over.  For now I will enclose a copy of my medical journal article and editorials concerning it in a separate email to you.  Readers who want this may simply write in with a request for the article and I will send it to them as an attachment.