Sheila Oliver's Campaigning Website

The Safeguarding Team at Suffolk and North East Essex might themselves need investigating.  

Currently sat in A&E - 16/7/2025

Do you know why I have to record interactions with my local Essex hospital @wesstreeting?
Because when people make errors or ignore 4 doctors requests they sometimes lie to cover up those facts.

Yesterday, my d saw a dietician.   That referral took months of waiting during which her BMI dropped to 0.4 percentile.   Often she is physically sick or in to much pain to eat.   Her Hirschprung and immunology tests have remained outstanding for years. Her transit study showed slow transit.  Her sibling is diagnosed with gastroparesis,

Today not long after visiting the GP I was notified that I have been safeguarded for failing to admit my d to hospital. The recording I have disproves what the dietician stated @hcpc.

So have I really been safeguarded for whistleblowing to @CQCProf@gmcuk?
 
From the blood results concealed by the hospital or not done as incorrectly couriered, to dodgy discharges, to writing factually incorrect information of a defamatory nature, or writing something completely different in the discharge summary, to overshadowing and bias in subject access requests, to now fabricating a safeguarding referral.

Hirschsprung disease is a congenital (present at birth) condition that affects the large intestine (colon) and causes severe constipation or intestinal obstruction. It occurs when nerve cells (ganglion cells) are missing from parts of the bowel, preventing normal movement of stool through the colon.

Quick Summary
Feature Description
Cause Missing nerve cells (aganglionosis) in the bowel wall
Primary symptom Chronic constipation, failure to pass meconium, or abdominal distension
Diagnosis Rectal biopsy (confirms absence of ganglion cells)
Treatment Surgery (removal of the affected segment of bowel)
Common in Newborns, but can present later in infancy or early childhood
Gender More common in boys

Cause
The enteric nervous system helps control bowel movements.

In Hirschsprung disease, nerve cells fail to develop in parts of the bowel during fetal development.

This results in a lack of peristalsis in the affected segment, causing stool to back up.

Symptoms
In newborns (most common presentation):

Failure to pass meconium within the first 48 hours after birth

Vomiting (often green or bile-stained)

Abdominal swelling

Reluctance to feed

In older infants/children:

Chronic constipation

Abdominal distension

Poor weight gain

Vomiting

Episodes of enterocolitis (fever, diarrhea, can be life-threatening)

Diagnosis
Abdominal X-ray or contrast enema – shows distended bowel.

Rectal biopsy (gold standard) – confirms absence of ganglion cells.

Anorectal manometry (in older children) – checks reflexes of the rectum.

Treatment
Surgical removal of the affected segment (called a pull-through procedure).

Sometimes a temporary colostomy is done first.

Long-term follow-up is often needed for bowel function, continence, and growth.

Types of Hirschsprung Disease
Type Description
Short-segment (most common) Only the rectosigmoid colon is affected
Long-segment A longer part of the colon is involved
Total colonic aganglionosis Rare, the entire colon is affected

Complications
Hirschsprung-associated enterocolitis: inflammation, fever, diarrhea — can be fatal if untreated.

Constipation or incontinence after surgery.

Growth delays if severe or untreated.

Genetic and Syndromic Associations
Sometimes runs in families.

Associated with Down syndrome, Waardenburg syndrome, and others.

CHAT GPT -

A BMI at the 0.4th percentile in a child or adolescent is extremely low and clinically significant, suggesting the individual is severely underweight. This is well below the normal range and warrants urgent medical evaluation and likely intervention.

Immediate Concern
The 0.4th percentile means that out of 1,000 children of the same age and sex, only about 4 would have a BMI this low or lower — indicating possible malnutrition, a medical condition, or an eating disorder.

What Should Be Done
1. Urgent GP/Paediatric Assessment
The individual should be seen immediately by a GP or paediatrician.

Full physical examination and medical history.

Screening for underlying causes such as:

Malabsorption (e.g., coeliac disease, inflammatory bowel disease)

Hyperthyroidism

Chronic illness

Eating disorders (e.g., anorexia nervosa)

Neglect or safeguarding concerns (in children)

2. Referral to Specialist Services
Depending on findings, the doctor may refer to:

Paediatric dietitian

Community paediatrics

Child and Adolescent Mental Health Services (CAMHS) (especially if eating disorder suspected)

Safeguarding teams, if neglect or abuse is suspected

3. Nutritional and Growth Monitoring
Accurate measurements of height, weight, and BMI over time.

Food intake diaries and possible blood tests (e.g., iron, B12, folate, albumin, thyroid, coeliac screen).

Growth charts to monitor trajectory — not just a snapshot.

4. Safeguarding Assessment (If Applicable)
If the individual is a child or vulnerable adult, a BMI this low may trigger a safeguarding referral to determine whether:

There is neglect

The environment is contributing to failure to thrive

There is a need for social services intervention

Red Flags That Need Emergency Action
Rapid weight loss

Refusal to eat or extreme food restrictions

Fatigue, fainting, or hypothermia

Menstrual irregularities (in adolescents)

Concerns about body image or exercise compulsion

Reference: BMI Percentile Categories (Children)
Percentile Category
< 0.4th Severely underweight
2nd Underweight
50th Average
85th–95th Overweight
> 95th Obese