Rapunzel syndrome is a really rare condition by which a big hairball (trichobezoar) lodges in your stomach and extends into your small intestine. This makes the hairball appear like a comma symbol. The disease was first described in 1968. She is called after the fairytale character Rapunzel, who was known for her long hair.
This disease is far more common in women than in men. And in about 8 out of 10 cases it occurs in children, adolescent girls and young women under the age of 30.
It is difficult to detect this disease early because one can remain without symptoms for a few years. If you do that, the hairball is generally so large and compacted that it could actually cause serious blockage in your stomach. To remove it, surgery is required.
Trichophagia is a condition that involves repeatedly eating hair. It is commonly related to trichotillomania, or the urge to drag hair out of the scalp. These conditions often go hand in hand. If you may have one or each conditions, they usually tend to cause Rapunzel syndrome.
Long hair has a smooth surface that is commonly difficult for the stomach to interrupt down and digest. Hair also doesn't move well through your digestive tract since it contracts and relaxes (a process called peristalsis) to maneuver food and liquids out of your mouth into your anus.
This could cause the hair to get stuck in your stomach cavity. Over time, eating your hair could cause it to form right into a huge hairball.
As the hairball increases in weight and size, it’s more more likely to clump along with the food you eat and mucus from the stomach lining. Eventually the hairball reaches the border of your stomach wall. Since there isn’t a way out, the matted hair can protrude through the stomach opening (pylorus) and grow into the small intestine.
Symptoms are frequently attributable to the blockage or related health problems. This may include:
- stomach pain
- Flatulence
- Feeling of satiety
- weight reduction
- nausea
- Underweight and severe fear of gaining weight (anorexia nervosa)
- Vomiting after eating
- Pain or discomfort under your chest (acute upper abdominal pain)
- Patchy hair loss on the scalp (alopecia)
- Bad breath (halitosis)
If you may have Rapunzel syndrome, you usually tend to produce other mental illnesses at the identical time, similar to:
- Pica (urge to swallow things that usually are not food)
- Mental disorders similar to schizophrenia, PTSD, ADHD and others
- depression
- Anorexia nervosa
- Obsessive Compulsive Disorder
- Grief (grief after the lack of a loved one)
Researchers have found that many individuals with Rapunzel syndrome experienced abuse or neglect during their childhood.
As the hairball grows in your stomach, it could actually result in other problems in your body over time, similar to:
- Obstructive jaundice
- Physical blockage within the abdomen or small intestine
- Erosion of the liner in your stomach and small intestine
- Holes within the small intestine (small intestinal perforation)
- Inflammation of the stomach lining (peritonitis)
- Swelling of the pancreas (acute pancreatitis)
Your doctor will take an in depth medical history. They will ask you if you may have swallowed certain objects similar to human, animal or doll hair. They may also perform an intensive physical examination to find out if there’s any patchy hair loss and bad breath.
To diagnose Rapunzel syndrome, your doctor may do some imaging tests. This will help them determine the scale of the hairball growth and its range.
Tests may include:
- roentgen
- Ultrasonic
- CT scan
- Fluoroscopy barium examination (barium swallow test). For this imaging test, you swallow barium, a chemical that causes certain areas of your body to look more clearly on an X-ray. Fluoroscopy is a medical procedure by which doctors repeatedly send X-rays through your body to acquire a real-time video of a body part.
- Endoscopy. Your doctor threads a skinny, flexible tube with a lightweight and camera down your throat to obviously see the inside your body in real time. It also allows your doctor to take a sample of what’s causing the blockage in your stomach.
Your doctor may do blood tests to ascertain for anemia (iron deficiency) or other possible nutrient deficiencies.
Rapunzel syndrome is commonly diagnosed when the hairball has grown too large and is causing symptoms. Your doctor may attempt to remove it endoscopically through your mouth. However, if the hairball is just too large, surgery shall be mandatory.
Laparotomy. It is a kind of surgery by which a surgeon makes an incision in your abdomen to open your stomach cavity, examine it, and take away the hairball. In some cases, infection and scar tissue across the incision could cause complications.
Laparoscopy. This is another procedure to laparotomy. The surgeon will make a smaller, keyhole-sized incision in your stomach to remove the hairball. Recovery is far shorter with this method.
Therapy. Cognitive behavioral therapy or other types of psychiatric evaluation might help a psychologist or psychiatrist discover and address mental health problems that may very well be causing you to eat your hair. This also can include counseling parents.
Medication. Your doctor may prescribe medication to assist you take control of your mental health.
Research shows that almost all individuals with Rapunzel syndrome do quite well in the long run after surgery in the event that they receive behavioral therapy and keep their follow-up therapy appointments frequently. This will help prevent them from getting it again.