Nearly four year old with recurrent soiling after constipation and impaction - HELP!

[Bofgmafia]

DS1 is coming 4 in the middle of the month and has been toilet trained since 25months.. last summer, we had faecal impaction which we got laxido to clear it, and then were on a maintenance dose of 1 sachet and then took him off it in October and there was no accidents until a one off in January. Started the laxido on half a sachet a day in Jan just to keep things right and he has been totally fine until this week. Massive soiling incident today. I’m struggling with it as he has a good diet and I don’t know what is causing constipation and finding the health professionals aren’t overly bothered. He gets so upset and I feel I have tried everything. Does this happen with impaction/chronic constipation? Feel like I should share that he doesn’t actually seem constipated any time he goes to the toilet daily and it all looks like the poo chart expected ones..
Any advice would be hugely appreciated, or just a us too! Did anyone just grow out of it? Yours, a tired of poo mumma.

It's tricky for sure, we have a similar ongoing situation. Bumping this for you... also if you haven't already, maybe try contacting the ERIC help line

It could be so many things but you have to go hard at the system if you want anything actively doing. Keep a food, drink, pain and activity diary for him immediately. Make sure he is drinking lots of water consistently and has enough fibre. Every time there is a significant incident, take him back to the doctor with diaries and ask what the next step is. Ask for an ultrasound every time, as it takes a while to get an appointment and get them to log the request if they say no or 'wait and see'. You have to go with evidence and knowledge of what you want doing and why. Maybe you'll notice something yourself in the patterns you are logging, like an intolerance. Feel his tummy as well to be able to tell what it is like normally and if it gets blocked in a regular area. Put that in the diary.