Thanks for your question.
Please ask your daughter to go to the ER again now. Don't delay as this can be due to intestinal obstruction and would need further investigations such as an abdominal x-ray to diagnose the exact cause. This is an emergency and cannot be managed conservatively in home with medications which are clearly not working. So now she needs emergency management to diagnose the cause and then treat the cause so that she will get relief.
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Is this constipation occurring for the first time? What was the result of her complete blood count? Does she also have other symptoms such as fever, vomiting, or abdominal pain?
Please ask your doctor whether rectal laxatives are indicated in her case. She will likely benefit from laxatives which are given rectally if there is no contraindication for their use.
So I feel that things are moving in the right direction now. Hopefully this problem will be solved today. The blood counts are normal means that there is no infection since that will cause a raised white blood cell count.
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There are many similar cases and this is not the first case.
There is definitely an alternative to surgery in most cases, but sometimes surgery is indicated and can be life saving. Therefore please be prepared for surgery if it is required. However take the opinion of another doctor in your location before going ahead with the surgery.
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The alternative is conservative treatment with medications and fluids after ruling out obstruction. When surgery is required adequate precautions will be taken by the surgeon to prevent sepsis. Please do not worry about this.
Do you mean a barium enema?
Yes this test is a diagnostic test and will show whether the bowel is normal or if there is some pathology.
Did they consider a CT scan if the x-rays were inconclusive?
Please inform the doctor who advised picolax and tell him/her that this has not worked and ask what to do next. Colon cleansing may help if done under medical supervision.
Please go to the emergency care in your hospital and get this resolved and ask for inpatient treatment.
That is not a requirement. They have to use rectal laxatives.
I don't have any suggestions except to take another doctors opinion preferably a gastroenterologist, and also to ask the present doctor for admission of your daughter to the hospital.