Rapunzel syndrome is a very rare disease that occurs in the presence of a mass of hair in the stomach or intestine due to voluntary and compulsive ingestion of the hair itself (triphagia).
This disorder is associated with trichotillomania and causes serious gastrointestinal complications, in this article we will learn about trichotillomania and trichophagia, what their symptoms are and what are the most effective interventions.
- It is a disorder that mainly affects young women and the causes are not entirely clear.
- But it is suspected that it is associated with problems of low self-esteem.
- Anxiety and depression.
- In addition to the aforementioned trichotillomania.
- Which we will talk about later.
- And other mental disorders.
A tricobezoar is a mass that forms in the stomach or intestine due to hair ingestion; however, trichophagia does not always cause trichobezoars.
The time between when the person starts ingesting hair and when symptoms begin to appear is variable, some of the symptoms that may indicate the presence of a tricobezoar are:
Diagnosis is difficult because patients often deny having taken hair. The presence of any of the above symptoms may be an indicator of tricphagia.
In addition, the presence of alopecia may indicate that the person has a hair removal disorder (trichotillomania), sometimes associated with ingestion, which can help guide the diagnosis.
The definitive diagnosis can be made by stool analysis, ultrasound, MRI or gastroscopy, the latter being the best technique to confirm the presence of trichobezoars.
Trichotillomania or hair removal disorder is an effort to pull the strands. Depilated hair can come from any area of the body, the most common areas being the scalp, eyebrows and eyelids (eyelashes).
Can pulling be associated with various rituals, such as choosing a certain type of hair, manipulating it, putting it in your mouth?
Some people have strange and uncomfortable sensations before pulling their hair, which are then relieved. Pulling hair is usually not painful, although this can lead to hair loss, which is often extremely visible.
This disorder most often affects women and can occur at any age. Their association with tricphagia is also more common in women. It is a chronic fluctuating disorder, although it can be improved with appropriate treatment.
The first step in correcting the disorder may be to apply a treatment for trichotillomania, because limiting hair tearing can also reduce intake.
The most recommended treatment for trichotillomania is the reversal of the habit, by Azrin and Nunn, whose main components are:
Exposure can also be used with response prevention, which involves exposing the patient to unpleasant sensations that precede hair removal and block the execution of the response (pulling the hair).
The purpose of this is that the person can get used to the feeling without having to issue the commonly used compulsive response.
Treatment of Rapunzel syndrome involves dissolving capillaries, chemically or enzymatically, or removing trichobezoars by endoscopy or surgery, as well as medical treatment of possible and serious complications.
It was first described by surgeon Vaughan ED and his collaborators in 1968, but in the 12th century a. C. , animal tribezoars were already ingested because they were thought to have medicinal properties.
It is a very rare disease and currently has just over 100 cases described worldwide. The name of the syndrome comes from the story of the Brothers Grimm, in which Princess Rapunzel became trapped in a tower and had to pull her long hair by the prince. to go upstairs and save her.
The appearance of a trichobezoar can resemble the shape of Rapunzel’s hair and be similar to a braid or ponytail. Regardless of the color of the ingested hair, the color of the bezoard is always very dark black and can also contain traces of undested food. Accumulations can be of different sizes, shapes and weights, reaching up to 3 kg.