A teenager has died after holding in bowel movements for up to two months, which caused her to have a heart attack.
Emily Titterington, 16, suffered from toilet phobia which meant that she would frequently withhold her stools.
According to the Telegraph, in the end her bowel became so large that it compressed her chest cavity and displaced her organs.
At an inquest into her death, paramedic Lee Taylor described the moment he was called to the 16-year-old's house.
"I could see that her abdomen was grossly extended," he said. "Her lower ribs had been pushed out further than her pubic bone - I was shocked."
Emily's GP told the coroner that he prescribed the 16-year-old laxatives but hadn't examined her abdomen.
"Had I done so, we would be having a different conversation," the GP said. "Her death could have been avoided with the right treatment at the right point."
According to Anxiety UK, there are various reasons a person might have difficulties in using the toilet. These include:
:: Social phobia – commonly involving worries that people are aware of you using the toilet, people noticing you using the toilet or that people may hear you using the toilet.
:: OCD (Obsessive Compulsive Disorder) – involves factors such as worrying that the toilet is contaminated or being unable to use facilities that are deemed “unclean”.
:: Agoraphobia – worrying about leaving the house unless there is a “safe” toilet that can be used combined with fears around soiling or urinating ones self if leaving a deemed “safe” locality.
:: Parcopresis – fear of defecating in public places.
:: Paruresis – fear of urinating in public places.
:: Panic attacks/panic disorder – fear of being unable to use a toilet in a public place.
:: Specific phobia – specific fear of a toilet or toilet-related situation.
Toilet phobia can affect anyone at any time, and can range from mild to severe disruption of daily life.
According to reports by the BBC, people with toilet phobia have in the past refused to take a job for fear of the toilet being located in a communal area, or denied themselves fluids to stop them from urinating, which can damage the kidneys.
Angus suffers from toilet phobia and spent many years choosing his job based around his toilet activities.
"I missed many outings, social opportunities, and was often totally dehydrated," he writes in a thread discussing personal experiences of toilet anxiety.
With the help of cognitive behavioural therapy (CBT), his condition is now far more manageable.
CBT is the recommended treatment for toilet phobia as it is an evidence-based therapy, according to Anxiety UK, .
However individuals can also try clinical hypnotherapy, counselling, guided self help and make changes to their lifestyle to try and manage the condition.