My daughter has was diagnosed with encopresis at age 7. She's had bad constipation since 5, but I thought it was a phase. She cries when she has a "flare up" as she calls it. I can see the pain in her eyes when they happen, and I want to help but I don't know how. She's had 3 disimpactions, which is probably not healthy. She's terrified of enemas and cried till she nearly passed out when she had one. We've done reward systems, bathroom time, and many medicines including
Dozens of Fiber supplements
And numerous others.
She's been out of school many times due to her pain. She cries and scream and I give in and keep her out. It's very hard to see her in so much pain, and how she's different from when she was 5. When she was 5 she'd get out large stool that didn't even look like it'd fit in her stomach. I've run out of ideas, and don't know what to do anymore.
A few things I noticed: the article recommends changing diet to include little or no dairy (specifically from cow's milk), and to include lots of high-fiber foods - not fiber supplements. Which isn't to say supplements would be ineffective, it just sounds like it's better to change the actual foods to include a lot of veggies and not a lot of dairy (and possibly reduce gluten).
Second thing I noticed: at the end, the article says that if functional constipation lasts longer than 6 months, the child should be referred to a pediatric gastroenterologist. I'm sure that you guys have been working with doctors, but have you seen a specialist of this type?
Third thing: does your daughter really understand what is happening and why? The article suggests explaining to children who are old enough to understand, and it suggests that some behavioral therapy accompany any medical treatments. Have you tried these things? It seems the fear of painful bowel movements is key here, and if she can understand that the pain is caused by refusing to poop, she may be more willing. The article specifically says that after a disimpaction the goal is to have 2 soft stools per day (with the help of oral aids) for six months (which may require staying home at first for comfort purposes).
Fourth: the article lists other ways than enemas of disimpacting that are non-invasive, they're just slower. If your daughter needs disimpaction again, maybe explore one of these options so it's less traumatic for her.
Finally, this seems not to be a "solved" problem, medically speaking, as the article indicates that about half of children with this problem don't improve even after 5 years of treatment, and a third don't improve after 7 years of treatment. This observation is not meant to be discouraging, but rather to suggest that if you find a doctor with innovative solutions to try, you might want to.