Teenage girl with toilet phobia dies from heart attack after going eight weeks without using loo
A teenager died from a heart attack caused by constipation - after going eight weeks without a bowel movement, an inquest heard.
Emily Titterington, 16, had a phobia of using the loo and would frequently withhold her stools for up to two months.
Eventually her bowel grew so large it compressed her chest cavity and caused the displacement of other organs.
The inquest heard how her life could have been saved with appropriate treatment but she had refused to be medically examined.
Home Office pathologist Dr Amanda Jeffery said her symptoms were in keeping with a condition known as "stool withholding", which is more frequent in children.
A post-mortem examination revealed that Emily had a "massive extension of the large bowel".
Asked by Coroner Dr Emma Carlyon to describe the severity of the condition, Dr Jeffery said: "It was like nothing I've ever seen before - it was dramatic."
The inquest in Truro, Cornwall, heard how Emily, who had mild autism, suffered with bowel problems for most of her life but doctors had been unable to pinpoint the cause.
Her GP Dr Alistair James said that, in the period leading up to her death, Emily's mother Geraldine, 59, had battled in vain to persuade her to be medically examined.
Dr James told the coroner that he had prescribed laxatives but had not examined Emily's abdomen.
"Had I done so, we would be having a different conversation," he said. "Her death could have been avoided with the right treatment at the right point."
Emily collapsed at her home in St Austell on February 8, 2013. Paramedics desperately tried to revive her but she was later pronounced dead in hospital.
Paramedic Lee Taylor attended the family's home twice on the night of her death.
On the first occasion he described Emily as "looking pale" and said she had complained of pain between her shoulder blades.
However, she refused to go to hospital and had been reluctant to be examined.
He said she wore a "loose nightie" and he did not notice any abdominal swelling.
Mr Taylor and his colleague, student paramedic Lisa Marie Edwards, were called back just after 4am.
He said: "We were allocated to an emergency at the house we'd just left.
"When we arrived her father James was outside shouting at us to help, saying something had gone badly wrong."
Inside they found Emily's mother leaning over her daughter, who was lying in the doorway of the bathroom.
Mr Taylor said: "As she moved away I could see that her abdomen was grossly extended.
"Her lower ribs had been pushed out further than her pubic bone - I was shocked."
Emily's sister Hannah Herbert, 29, last saw her four weeks prior to her death.
Her mother told her Emily had not been to the toilet for "six to eight weeks" and this was "routine", the inquest heard.
Hannah told the inquest she did not feel that Emily was in a "healthy, safe environment" and had previously contacted social services with her concerns.
But GP Dr James said he found "no evidence" of safeguarding issues.
In a statement read out to the court, Emily's brother-in-law, Brian Herbert, said the family had tried a number of different remedies for her bowel condition.
They included homeopathic pills, and a technique known as Body Talk, which involved so-called "distance healing".
The three-day inquest is expected to conclude later today.