Strange “needles” pain in 4 year old with severe constipation

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My daughter (4.5) has Ehlers Danlos (connective tissue disorder) which affects her joints and muscles. It causes constipation, unsafe swallow and hyper mobility.

We’ve done disimpaction for weeks, many times. The poo that comes out burns her so badly that her skin gets covered in pin pricks of blood wherever it touches. She has to have thickener in her drinks (including movicol) which isn’t helping. She’s also on Docusate. She has overflow all the time and is so poorly with this she hasn’t attended nursery in months.

Her 4 older siblings are autistic and also have GI issues so there may be a degree of withholding.

She has a pain she calls “needles” which is excruciating. It happens when the poo gets stuck. It has her doubled over in pain, shaking and screaming. It’s torture for her and I feel helpless as I can’t help her. She says it’s in her bum. I doubt piles as she has no other symptoms whatsoever and it’s very very severe and painful.

Anyone any ideas? We have paeds appointment on Monday but they’re generally useless.