Hi. Thanks for your query. Noted the history of your 4 year old granddaughter having problems with passage of stool, constantly pooping in her panties and sometimes it is very large. The cause can be the regularization of the bowel passing clock and may be associated problems like colitis, intolerance to some food or some problem at the anal canal. I would advise you the following: Get an X-ray of the abdomen done and if fecoliths are present, pediatric enema and mild laxatives to be tried till the colon is clear. Also end the sample the stool for test. If there is an evidence of an infection, get a course of an antibiotic and metronidazole, anti-worm preparations. Also identify the foods and beverages that cause the problems. Also get clinical evaluation, examination and tests if required to a proper additional diagnosis and plan a proper treatment. Also needed is bowel training.