Background

Shannon Baillie is 27. She has profound and multiple learning disabilities and has very little speech but can communicate with her mother and others through communication tools. Shannon hasn't eaten much for several days and seems to be in pain. Her mother is worried there may be something seriously wrong.

Mrs Baillie brings Shannon to the surgery to see her GP, Dr Oloko. She explains that Shannon has been really agitated for about five days and has barely eaten anything, even when presented with her favourite meals. She says Shannon’s not acting like her usual self at all.

Dr Oloko asks Shannon if she’s been drinking water. Her mother replies that, with a little persuasion, Shannon has had small sips of water every now and then, but any more than this and she becomes frantic and doubles over apparently in pain. As Mrs Baillie gestures towards Shannon’s stomach, Shannon screams and bats her hand away.

Dr Oloko feels that an examination is necessary but can see that it might not be straightforward.