Rapunzel syndrome: symptoms, causes and treatment

When we delve into the world of psychopathology, we find that there are truly amazing and serious disorders. In this article we will talk about one of them, the Rapunzel Syndrome.

This syndrome is also known as trichophagia, and consists of swallowing one's own hair (or even that of others) compulsively and without being able to avoid it. We will discuss its symptoms, possible causes, and treatments.

• Related article: "Trichotillomania: the strange obsession with pulling your hair out"

Rapunzel syndrome: features

The Rapunzel Syndrome is about a very rare and complex entity, first described in 1968 by surgeon Vaughan ED Jr. and colleagues. To date, 108 pediatric cases have been described in the world literature, of which two have been published in Spain.

The name of this pathology comes from the famous character in the tales of the Brothers Grimm. The Rapunzel Syndrome appears especially in young women.

It is a compulsive psychological disorder, characterized by the individual who suffers from it ingests his own hair without being able to avoid it, causing an intestinal obstruction

extremely rare and serious.

Symptoms

The person with Rapunzel Syndrome will occasionally pull out their hair, taste it, bite it and finally swallow it; Sometimes it can even eat other people's hair.

Over time, these patients end up developing a kind of ritual. Behavior can also include eyebrow hair and even eyelashes.

This is a serious syndrome, since the human gastrointestinal tract does not have the capacity to digest the hair, so what happens is that it tends to stay in the stomach for a period of time dragged on. This leads to the formation of a large ball of hair (called a trichobezoar) in the stomach, and that the only way to remove it is surgically.

This hairball can cause gastrointestinal discomfort, and in severe cases, obstruct the intestinal tract. In addition, the syndrome can cause diarrhea, weight loss, and abdominal pain, among other symptoms.

complications

Thus, the Rapunzel Syndrome can be very complicated. If the hairball ends up forming in the stomach, and if it is also of a considerable size, the effects can be really serious for the person, since as we have seen the intestinal tract is unable to digest the main component of hair, keratin.

In these cases, surgery must be performed. One of them became known in the US; that of a 38-year-old woman who had come to lose 7 kilos in 8 months. His symptoms were nausea, vomiting, and constipation. She had accumulated a hairball in her stomach and they had to intervene with surgery.

Associated disorders

The Rapunzel Syndrome is associated with trichotillomania (also a disorder belonging to obsessive-compulsive disorders in DSM-5), a disorder involving compulsive hair pulling; if the individual also swallows their own hair, we are talking about trichophagia (equivalent to Rapunzel Syndrome).

Causes

The causes of Rapunzel Syndrome are not entirely clear. However, existing cases (estimated at 4% of the US population), are related to depressive problems, anxiety and low self-esteem.

• You may be interested in: "What is anxiety: how to recognize it and what to do"

Treatment

Rapunzel Syndrome treatment will be focused on eliminating these serious compulsive behaviors; exposure behavioral therapy with response prevention can be used, in which the person avoids the behavior of pulling, biting or swallowing the hair. Also habit reversal therapy, where it is intended to replace harmful habits with alternative and incompatible behaviors.

In addition, cognitive-behavioral therapy would also be indicated, to treat thoughts associated errors as well as cognitive distortions and/or anxious and depressive symptoms that may appear.

They can also be used, always under medical prescription and in consultation with a specialist, drugs to alleviate anxiety and depressive symptoms associated with the disorder, such as anxiolytics or antidepressants.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-5. Massón, Barcelona.
• Beristain-Silva, J.L., Cordero-Barberena, R., and Beristain-Hernández, J.L. (2016). Rapunzel syndrome: A rare cause of abdominal pain. Gastroenterology Magazine Mexico, 81(3), 119-180.
• Germani, M., Beltrà, C. and Hernandez, C. (2014). Rapunzel syndrome: laparoscopic treatment. Annals of Pediatrics, 80(2), 69-1