- by Dr. Vivekanand N Bhat
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- Oct 25 2017
RAPUNZEL SYNDROME: IS YOUR HAIR KILLING YOU?
Trichophagia or more famously known as the “Rapunzel Syndrome” is an extremely rare medical condition, characterised by excessive hair pulling (Trichotillomania).
Trichophagia comes from the Greek words “tricha” meaning hair and “phagein” meaning to eat. Trichophagia is described as the compulsive eating of one’s hair. It does not occur when a person is mindlessly chewing on the ends of their hair, something that most children do. Trichophagia is when the pulled hair is chewed and then swallowed. The hair will eventually collect in the individual’s stomach, causing gastrointestinal problems such as indigestion and pain.
Why Rapunzel Syndrome?
First described in 1779 by a French doctor, M. Baudamant, it was first recorded in medical literature by Vaughan et al in 1968. The name Rapunzel syndrome is derived from the Brothers Grimm's fairy tale about a princess trapped in a tower who grew her hair long enough to throw out of the tower's window like a rope so her prince could climb up her hair and rescue her. It is so named because trichobezoar, once removed from the stomach, has a long, rope like tail at its end.
Once a person is diagnosed with Rapunzel syndrome, medical professionals often look for signs of trichotillomania and alopecia on the head in order to establish signs of hair pulling and baldness. The presence of trichotillomania indicates that patients were possibly eating their own hair.
The syndrome is much more common in girls than in boys and often occurs with the onset of adolescence.
Why would anybody eat their hair?
Intellectual disabilities and some psychiatric disorders coerce people into eating their own hair. Trichotillomania and Pica are the two most common mental disorders prevalent among subjects who indulge in Trichophagia.
In trichotillomania, people feel compelled to pull out their hair to the point of visible hair loss. They often play with the removed hair strands.
Pica is not very easy to diagnose in children and infants as they can be usually seen mouthing (accidentally ingesting) non-food substances. Pica is quite common in children, pregnant women and people suffering from intellectual disabilities such as autism.
Iron deficiency or coeliac disease have been found to be present in people with Trichophagia and pica. Once treatment has been carried out, the compulsive habit generally stops.
Trichophagia can be easily diagnosed with the help of an abdomen ultrasound or a CT scan, which will show the mass formation.
Signs to watch out for:
- Abdominal pain
- Loss of appetite
- Weight Loss
- Gastric ulcers
- Intestinal bleeding
- Gastrointestinal diseases
- Tenderness in the abdomen
This condition usually requires surgical intervention in the form of an endoscopy, a non-invasive surgical removal of the solid mass or a surgical gastronomy process. The psychological treatment involves a variety of cognitive, behavioural, acceptance therapies and habit reversal training.
Although the recurrence of Rapunzel syndrome is quite rare, it is important to follow-up and complete the psychological treatment.
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