Rapunzel syndrome is a mental illness that occurs primarily in adolescent women. The patients show abnormalities by chewing on their long hair or swallowing fibers from blankets and stuffed animals. These are indigestible and lead to serious problems in the organism.
What is Rapunzel Syndrome?
Trichophagia or the popularly known Rapunzel syndrome describes compulsive behavior on the part of the patient. It involves ingestion as well as eating your own hair for a long period of time. Since hair cannot be digested by the organism, it gradually accumulates in the body and clumps. See AbbreviationFinder for abbreviations related to Rapunzel Syndrome.
The result is severe abdominal pain and even gastrointestinal disorders. The disease occurs more frequently in girls and young women under the age of 20. The disease has not been observed in older women.
The symptoms described by the patient are mostly diffuse, non-specific and can indicate various other digestive diseases. Characteristic of the Rapunzel syndrome is a strong weight loss with a simultaneously significantly swollen upper abdomen. This is often accompanied by intense hair loss or alopecia.
Causes
The most common causes of Rapunzel syndrome are mental health problems. The disease is usually accompanied by behavioral problems or nervousness. Impulse control problems result in patients chewing or biting their hair.
Those affected experience uncomfortable tension throughout their body, which is compensated for by impulsive behavior such as chewing their hair. As the disease progresses, the hair swallowed by continuous chewing can fill the entire stomach, wrap around other organs and lead to a painful intestinal obstruction.
The onset of the disease is often associated with the loss of, or separation from, a loved one. This can be a spatial change as well as an emotional distancing of this person, which is not processed. Perceived rejection or a lack of attention lead to psychological problems.
It is unimportant whether the loss that has occurred was originally chosen by the patient himself or was fundamentally determined by external circumstances. Likewise, there is no difference in whether the separation came suddenly or was prepared.
Symptoms, Ailments & Signs
Those affected nibble on their hair, stuffed animals or blankets, mostly when they are not being observed. This is often a sign of isolation, loss, or deprivation. Relatives are therefore well advised to examine the patient’s hair tips for moisture from the saliva.
Patients with Rapunzel syndrome initially report stomach pains and a general feeling of being unwell. As the disease progresses, nausea and vomiting occur. An important note is that patients do not vomit secretly. People lose weight and have trouble keeping down food they eat.
Nevertheless, they do not suffer from loss of appetite. The abdomen becomes significantly thicker in parallel with weight loss. A movable knot that can easily be mistaken for a tumor can be easily felt in the stomach area. In addition, patients apparently lose their hair.
Diagnosis & course of disease
The course of the disease is insidious and is triggered by an emotional loss. Persistent emotional deficiency or rejection can also lead to the development of Rapunzel syndrome. It is important to carefully observe the patient’s behavior in supposedly unobserved moments.
Checking for strokes of fate in the past few months can help to identify the disease in good time. Using an ultrasound examination or an X- ray with a contrast agent for the gastrointestinal area, the braid-like clumps of hair can be easily diagnosed by the doctor and differentiated from a tumour. Since complications in the gastrointestinal tract can be fatal in extreme cases, it is advisable to sharpen awareness of the patient’s behavior.
Complications
If Rapunzel syndrome exists, this can have serious complications. In the long term, eating your own hair leads to gastric perforation, intestinal obstruction or wall necrosis of the small intestine. As the disease progresses, the walls of the stomach or intestines may perforate. This causes further complications such as blood poisoning, infections of the gastrointestinal tract and severe pain.
Ultimately, untreated Rapunzel syndrome leads to the death of the patient. Less severe, but also problematic, are feelings of pressure, chronic pain and digestive problems caused by the clumps of hair in the gastrointestinal tract. In general, Rapunzel syndrome is also associated with psychological problems for those affected.
If these are not recognized and treated early, serious psychiatric disorders can develop. During the surgical removal of the bezoars, injuries to the stomach walls or the intestines can occur. Infections and wound healing disorders cannot be ruled out either. Possible complications after the operation are also chronic gastrointestinal complaints, sensory disturbances in the area of the operation and the formation of scars.
Prescribed medicines can cause side effects and interactions and in some cases also cause allergic reactions. In the absence of therapy, further clumps of hair often develop, which can further damage the already irritated gastrointestinal tract.
When should you go to the doctor?
Rapunzel syndrome should always be treated by a doctor. In most cases, this disease does not heal itself and the quality of life is significantly reduced. In order to avoid further complications, a doctor should always be consulted at an early stage. As a rule, the doctor should be consulted if the person concerned is chewing on their own hair or stuffed animals. The chewing itself can occur in different situations and is usually also observed by outsiders. Above all, the outsiders have to react correctly and persuade the person concerned to seek treatment.
In many cases, after chewing, there is also vomiting or severe nausea. Not infrequently, those affected by Rapunzel syndrome also suffer from loss of appetite and are very dissatisfied with their lives. If these symptoms occur and do not go away on their own, a doctor must be consulted in any case. The treatment of Rapunzel syndrome takes place primarily with a psychologist. However, an examination of the stomach must also be carried out frequently, since the hair can lead to severe abdominal pain.
Treatment & Therapy
Since the hair ingested orally has caused clumping, medical intervention is necessary. The so-called bezoars can no longer be eliminated from the body in a natural way. Therefore, they are surgically removed through an operative procedure. Small clumps of hair that are recognized in good time can sometimes also be removed endoscopically.
In order to avoid future accumulations and clumping of hair in the body and especially in the gastrointestinal tract, an accompanying intensive psychiatric treatment of the affected person is necessary. Recurrence of Rapunzel syndrome after surgery is very likely.
If the cause of the behavioral problems that have arisen and the associated obsessive-compulsive disorder has not been clarified, problems will probably continue to arise. An educational measure is not recommended, as it is classified as unsuccessful.
The patient is often unaware of his own behavior because he is emotionally overwhelmed by what he has experienced. Only through good therapy will he learn to change his behavior and resist the impulse to chew his hair.
Prevention
To prevent Rapunzel syndrome, psychotherapeutic treatment is recommended in life-changing situations. As soon as a separation or the loss of a person is to be lamented, it should be observed whether the person concerned is processing it well.
Since there is usually a lack of a neutral view due to personal experience, it is advisable to have the situation assessed by an expert. The loss of an important person or social isolation can be dealt with therapeutically and the likelihood of obsessive-compulsive disorder developing can be reduced.
Aftercare
Rapunzel syndrome occurs primarily in female adolescents and requires extensive medical treatment once diagnosed. This is done on the one hand with medication or, in severe cases, also with an operation, but on the other hand it is mainly psychotherapeutic. The physical symptoms such as severe stomach cramps and abdominal pain caused by swallowing the hair can be alleviated.
For this it is necessary to encourage the child to drink a lot and also by giving laxative foods that support the digestive process. Teas with sage and chamomile can also be served for natural pain relief. However, the focus is often on the therapeutic treatment of those affected by a psychologist.
First of all, the doctor must determine the cause of the illness and use appropriate strategies to stabilize the mental health of the child. Talk therapy can help, as can visiting self-help groups to talk to other sufferers. Changes in the child’s social environment, sometimes also in school, can also have a positive effect on the psyche.
Regular exercise or new hobbies can also help. In most cases, Rapunzel syndrome requires long-term therapy and therefore demands a lot of understanding, patience and empathy from the parents concerned.
You can do that yourself
Persons suffering from Rapunzel syndrome first require comprehensive medical treatment. Drug and therapeutic treatment can be supported by treating the affected child through talks or other approaches. The parents must treat the sick child with understanding.
The medical treatment can be supported by laxative foods. For example, dried plums, pear juice and drinking a lot have proven to be good. In the case of severe symptoms, laxative preparations from the drugstore or pharmacy can help. If the hairball is already in the gastrointestinal tract, it can cause severe cramping and other discomfort that can be relieved with natural painkillers. For example, herbal teas with chamomile or sage are recommended.
Furthermore, the affected persons must be treated therapeutically. The specialist can determine the cause of the disease and work with the patient to develop strategies to improve mental health. Depending on the cause, this can be talk therapy, participation in self-help groups or changes in the environment and job. Rapunzel syndrome requires long-term therapy, which can be supported at home with behavioral training and distraction. Sport and new hobbies in particular have proved their worth in the past.
