When we refer to a preexisting condition, we mean besides the holoprosencephaly. A reader on this site recently mentioned an important point. It has to do with body weight. One way to track Nora’s health would be to simply examine a timeline of photos, and estimate whether or not there are significant weight fluctuations, especially in the last few months of her life.
Nora appears to have a healthy weight in the image with her mother, perhaps the most frequently used image by the media. But in other images, Nora seems to be a lot thinner.
Nora’s physique is also related to those of her parents, both of whom are skinny.
Again, we have no images of Nora in Malaysia to work with. Strangely, all the images provided to the media thus far have been undated, although this one [below, which appears to be Nora on her 15th birthday] can be dated theoretically. Any images of Nora posted on Facebook can be dated theoretically too. But even Nora’s exact birth date [sometime in 2004] is currently unknown.
One site lists her weight as 55 kilograms, or 121 pounds. Her weight based on the autopsy report is also currently unknown.
True Crime Rocket Science II 
Weight loss is certainly one of many possible symptoms for a gastric or duodenal ulcer, along with pain, nausea and difficulty eating without feeling ill. If she’d had this before the holiday you’d expect that there would be visits to GP, hospital etc to find the cause. An endoscopic.camera down your throat is what usually confirms it. If she’d had obvious symptoms and wasn’t taken for medical assessment or diagnoses then that would be medical neglect by the parents.
LikeLike
Ps and once diagnosed treatment is fairly straight forward for most people, consisting of a cocktail of antibiotics and stomach acid blockers for about 3 weeks to get rid of the H pylori bacterium that @ 50% of us carry in our systems but which for unknown reasons in some people damages the GI lining leading to an ulcer and gastritis. I would think that it would be very unusual to go from having no ulcer at all to developing one and then it becoming bad enough to perforate the gut lining in a week or so.
LikeLike
Here is a very short article titled “Risk of upper gastrointestinal bleeding and perforation associated with Individual non-steroidal anti-inflammatory drugs”
https://www.sciencedirect.com/science/article/pii/S0140673694918430
A pre-existing condition, such as an ulcer, can be aggravated by non-steroidal anti-inflammatory drugs such as ibuprofen and aspirin. That would be the only types of drugs offered on a plane ride and Nora apparently had a “rough” journey.
But where I think this case also parallels the Madeleine McCann case or at least one thing in particular is depending on when the family actually arrived – be it 7 a.m. or 7 p.m., there would be no food in the house. Was she left behind – to rest – while the rest of them went either to the restaurant on-site, or the nearby grocery store? There are CCTV cameras of the resort reception area only – at the least those could be checked to determine when they checked in. If she was left to rest on her own essentially the cub was left behind the pride when she couldn’t keep up. She could have wandered, in her strange environment trying to find them – as Madeleine might have done looking for her parents.
LikeLiked by 1 person
Then there’s this: Matthew Searle of the Lucie Blackman Trust says Nora “would not have ventured into her own garden without a family member holding her hand.” Possibly true enough – but if they thought she was asleep, after a long journey, might they have left her for a short period of time thinking she would not venture anywhere until one of them was there to assist her, thereby thinking she would be fine for a short amount of time. In that case, she could have been put to bed anywhere for a nap – but the most logical place for a nap would be the downstairs bedroom, knowing she would be at risk upstairs until supervised.
LikeLiked by 1 person
They certainly tell you to keep away from all nsaids when you’ve been diagnosed as there is a risk of causing a bleed which can be catastrophic. And regular over use of them can lead to a GI bleed i believe. I’m wondering though about whether it’s a signifier of possible wider neglect – before they even came to malaysia. Where a child who hasn’t got the vocabulary to fully explain could have been suffering ulcer symptoms that should have been checked out and were maybe ignored – or even treated with nsaids.
LikeLiked by 1 person
How are ulcers found – CT scans? Maybe they didn’t know she had an ulcer. It might have been difficult for her to tell them if she was experiencing pain, or where she had the pain so it could have gone undetected.
LikeLike
This is quite a good overview of causes, symptoms, diagnoses.
https://www.healthline.com/health/stomach-ulcer#causes
LikeLike
Could she have been anorexic as well? I just read that Adam Lanza was anorexic, something I hadn’t known before among his many problems which were mostly behavioral.
LikeLike