Beware of 'Rapunzel' syndrome

Rapunzel syndrome causes patients to lose control of their urge to eat hair, requiring emergency care and surgery.

Named after the Grimm brothers’ fairy tale where the princess lets her hair down the tower for the prince to climb, Rapunzel syndrome is not pleasant. It is a dangerous medical condition that causes people to repeatedly swallow their hair. As a result, the hair gets tangled and stuck, forming a large hairball in the stomach with the ends extending into the small intestine.

To date, the world's medical literature has only recorded 89 cases of Rapunzel syndrome. Most recently, the BMJ published the case of a 38-year-old woman (USA) with a 15x10 cm hairball in her stomach and a 4x3 cm hairball in her small intestine. Like 85-95% of other patients, she came to the hospital with abdominal pain, nausea and vomiting.

Other signs of the syndrome include bloating, loss of appetite, weight loss, constipation or diarrhea. In more severe cases, a punctured bowel can cause sepsis. About 4% of Rapunzel patients die. Fortunately, the woman recovered after surgery.

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The BMJ reports that nearly 70% of people with Rapunzel syndrome are women under the age of 20. The youngest patient is a child under 3 years old and the oldest is a 55-year-old man. Women are more susceptible to the disease because they have long hair.

According to Medical Daily, the cause of hair swallowing is still unknown. The medical community hypothesizes that people who already suffer from mental illnesses such as trichotillomania and pica are more likely to develop Rapunzel syndrome. Specifically, people withTrichotillomania is feeling compelled to pull hair out of the head and play with the hair to relax.A study of 24 trichotillomania patients found that 25% of them had hair stuck in their stomachs due to swallowing too much hair.

People with picaPica is a disorder in which children eat odd objects such as clay, paper, soap, cloth, wool, rocks, and hair. Pica is not diagnosed in children under the age of 3 because putting non-food objects in their mouths is considered normal at this age. It is common in young children, pregnant women, and people with intellectual disabilities, especially autism.

Surgery is the optimal treatment for Rapunzel syndrome. Doctors can also use chemicals to break the hairball into smaller pieces and then treat it with a laser or remove it endoscopically, although the effectiveness is not as high as the first option.

Psychological intervention is also recommended to prevent recurrence of hair-eating, especially in patients with trichotillomania or stress-induced pica. The involvement of parents or spouses throughout the psychological treatment process is essential to help patients understand that they are not alone.

According to VNE