Bengaluru: The expression "I was so stressed I almost pulled out my hair" is often used casually. However, in some cases, individuals actually engage in pulling out and even consuming their own hair, a behavior that can lead to the formation of a hairball inside the stomach, medically termed a trichobezoar. Recent cases in the city have highlighted the psychiatric conditions of trichotillomania and trichophagia, where a person experiences a compulsive urge to pull out and ingest hair.
Recent Cases in Bengaluru
In one notable instance, a 23-year-old woman underwent surgery to remove a massive trichobezoar measuring 24x14 cm from her stomach. She had been suffering from abdominal discomfort, poor appetite, and frequent vomiting for several months before scans revealed that a large hairball occupied most of her stomach. In another exceptionally rare case, a two-year-old child developed Rapunzel syndrome, a severe and potentially fatal condition where the hair mass extends from the stomach into the intestines. Doctors reported that the child had been ingesting hair, rubber bands, and pieces of balloons since infancy, leading to the formation of a massive trichobezoar that caused severe abdominal pain, persistent vomiting, and reduced food intake.
Medical Insights
Dr. Deepak Ganga P, senior consultant in medical gastroenterology, hepatology, and interventional endoscopy at KIMS Hospitals, Mahadevapura, explained that trichobezoar is commonly associated with underlying psychiatric or behavioral conditions. Many patients suffer from trichotillomania, where they continuously pull out their hair and eventually ingest it. He added that this behavior can also be linked to pica, a disorder characterized by the consumption of non-food substances such as hair, sand, or mud. The condition is more frequently observed in children and young women, though men can occasionally develop it as well.
Life-Threatening If Untreated
Doctors warn that trichobezoars can become life-threatening if left untreated, as they may obstruct the passage of food from the stomach into the small intestine. A significant challenge is that many patients do not exhibit obvious symptoms until the condition becomes severe. Dr. Leenatha Reddy N, consultant pediatrician and neonatologist at Medicover Hospitals, who treated the two-year-old child, emphasized that pica in young children is often overlooked in early stages. Parents may not realize its seriousness until complications arise. Early identification of such unusual eating habits and timely medical evaluation can prevent life-threatening conditions.
Symptoms to Watch For
Doctors advise family members to be vigilant for vague symptoms such as vomiting, decreased appetite, abdominal pain, and patchy hair loss, especially in individuals with underlying psychiatric conditions. Dr. Kumar Parth, consultant surgical gastroenterologist at Sagar Hospitals, who operated on the 23-year-old woman, described hair-eating as primarily psychiatric in nature. It is a compulsive behavioral disorder often associated with obsessive-compulsive tendencies, stress, or depression. Patients may pull out hair not only from the scalp but also from eyebrows and eyelashes. While small amounts of ingested hair may pass through the digestive tract naturally, long hair tends to accumulate and form a mass inside the stomach.
Treatment and Prevention
Treatment typically involves surgical removal of the hairball, followed by psychiatric medication, behavioral therapy, and counseling to prevent recurrence. Doctors stress the importance of early medical intervention and psychological support to address the root causes of these disorders.
