6 year old : 6 and Still Poops in Pants, HELP!

Question

My son will not poop in the toilet on his own. On a daily accurancy he will poop in his pants just enough to stink and make a mess in his pants. After I notice he will act all upset, change his pants and tell me he doesnt have to go to the bathroom. When I insist that he try, he usually goes in the toilet. I have tried punishments and rewards, altered his diet, gotten mad and stayed calmed. currently I have him clean out his own underwear but it is so gross. I worry about all the germs he is spreading. Nothing changes for any true amount of time. I am looking for a way to put this monkey back on HIS back. HELP

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