Have you heard about some unusual incident like people eating hair?
It may sound gross but it is true.
But what’s the reason for such unusual behavior that made people do such gross and unhealthy stuff?
The habits of hair eating and patchy alopecia are common symptoms of Rapunzel syndrome.
Rapunzel syndrome is an extremely rare intestinal condition in humans resulting from ingesting hair (trichophagia).
The syndrome is named after the long-haired girl called Rapunzel in the fairy tale by the Brothers Grimm.
Trichophagia is sometimes can be associated with the hair-pulling disorder trichotillomania.
This syndrome is also used for the term called trichobezoar (gastric ‘hairball’) which has a tail-like extension into the small bowel through the pylorus causing gastric outlet obstruction.
Signs & Symptoms
The use of the term Rapunzel syndrome first appeared in the literature in 1968.
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- The body of a trichobezoar (hairball) located in the stomach, and its tail (hence the reference to Rapunzel in the syndrome’s name) in the small bowel and/or in the right colon.
- Small or large bowel obstruction
- Occurring in psychiatric patients
- Trichotillomania
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- Abdominal pain
- Nausea
- Bloating
- Feeling full
- Weight loss
- Low weight and intense fear of weight gain (anorexia nervosa)
- Vomiting after meals
- Pain or discomfort under your ribcage (acute epigastric pain)
- Patchy hair loss on your scalp (alopecia)
- Bad breath (halitosis)
- Gut perforation
- Vitamin B12 deficiency
- Acute pancreatic necrosis
Causes :
If someone have Rapunzel syndrome, they’re more likely to have other mental health conditions at the same time,such as:
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- Pica (an urge to swallow things that aren’t food)
- Mental disorders, such as schizophrenia, PTSD, ADHD and others
- Depression
- Anorexia nervosa
- Obsessive-compulsive disorder
- Bereavement (grief after losing a loved one)
Researchers have found that many people with Rapunzel syndrome have experienced childhood abuse or neglect.
Further complications
✔Obstructive jaundice
✔Physical blockage in your belly or small intestine
✔Erosion of the mucus lining in your stomach and small intestine
✔Holes within the small intestine (small bowel perforation)
✔Inflammation in the stomach lining (peritonitis)
✔Swelling of the pancreas (acute pancreatitis)
Diagnosis:
Doctors may run some imaging tests to diagnose this syndrome.
This diagnosis will help them figure out the size of the hair ball growth and how far it reaches.
Tests can include:
- X-ray
- Ultrasound
- CT scan
- Fluoroscopy barium study (barium swallow test). For this imaging test, the patient will swallow barium, a type of chemical that makes certain areas of the body show up more clearly on an X-ray.
- Endoscopy: In this method the doctor passes a thin, flexible tube with a light and camera down patients throat to see the inside of their body clearly in real time.
- Blood tests to check for anemia (iron deficiency) or other possible nutritional deficiencies.
Treatment:
Rapunzel syndrome is often diagnosed when the hair ball has grown too big and starts to cause symptoms. Doctors may try to remove it endoscopically through the patient’s mouth. But if the hair ball is too big,they’ll need to perform surgery.
- Laparotomy: It’s a type of surgery in which a surgeon makes a cut in the belly of patient’s to open and examine his/her stomach cavity and take out the hair ball.
- Laparoscopy: This is an alternative procedure to laparotomy. The surgeon will make a smaller keyhole-sized cut on the belly to remove the hair ball. The recovery is much shorter with this method.
How Do You Treat the Cause of Rapunzel Syndrome?
Therapy: Cognitive behavioral therapy or other forms of psychiatric evaluation might help a psychologist or psychiatrist pinpoint and address mental health problems which might be causing someone to eat hair.
Medications: Doctors may also prescribe medications to help the patient gain control over his mental health.
Increased awareness regarding risk factors for trichotillomania and trichophagia, such as developmental delay and anemia as a cause of pica, is crucial for the early diagnosis.
Thus, Rapunzel syndrome must never be forgotten since its early detection hinders the occurrence of further complications.
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Writer
Kulsuma Bahar Bethi
Content Writing Intern
YSSE