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Rapunzel Syndrome
Rapunzel syndrome is an extremely rare intestinal condition in humans resulting from ingesting hair (trichophagia). The syndrome is named after the long-haired girl Rapunzel in the fairy tale by the Brothers Grimm. Trichophagia is sometimes associated with the hair-pulling disorder trichotillomania. This syndrome is a rare and unusual form of trichobezoar. Since 1968, there have been fewer than 40 documented cases in the literature. This syndrome occurs when the trichobezoar (hairball) reaches past the small intestine, and sometimes even into the colon producing a long tail-like extension of hair (NCBI, 2016). Signs and symptoms The use of the term Rapunzel syndrome first appeared in the literature in 1968. Characteristics of the syndrome include: * The body of a trichobezoar (hairball) located in the stomach, and its tail (hence the reference to Rapunzel in the syndrome's name) in the small bowel and/or in the right colon * Small or large bowel obstruction * Occurring in psychi ...
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Psychiatry
Psychiatry is the medical specialty devoted to the diagnosis, prevention, and treatment of mental disorders. These include various maladaptations related to mood, behaviour, cognition, and perceptions. See glossary of psychiatry. Initial psychiatric assessment of a person typically begins with a case history and mental status examination. Physical examinations and psychological tests may be conducted. On occasion, neuroimaging or other neurophysiological techniques are used. Mental disorders are often diagnosed in accordance with clinical concepts listed in diagnostic manuals such as the ''International Classification of Diseases'' (ICD), edited and used by the World Health Organization (WHO) and the widely used '' Diagnostic and Statistical Manual of Mental Disorders'' (DSM), published by the American Psychiatric Association (APA). The fifth edition of the DSM (DSM-5) was published in May 2013 which re-organized the larger categories of various diseases and expanded upon the p ...
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Gastroenterology
Gastroenterology (from the Greek gastḗr- “belly”, -énteron “intestine”, and -logía "study of") is the branch of medicine focused on the digestive system and its disorders. The digestive system consists of the gastrointestinal tract, sometimes referred to as the ''GI tract,'' which includes the esophagus, stomach, small intestine and large intestine as well as the accessory organs of digestion which includes the pancreas, gallbladder, and liver. The digestive system functions to move material through the GI tract via peristalsis, break down that material via digestion, absorb nutrients for use throughout the body, and remove waste from the body via defecation. Physicians who specialize in the medical specialty of gastroenterology are called gastroenterologists or sometimes ''GI doctors''. Some of the most common conditions managed by gastroenterologists include gastroesophageal reflux disease, gastrointestinal bleeding, irritable bowel syndrome, irritable bowel dise ...
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Trichophagia
Trichophagia is the compulsive eating of hair associated with trichotillomania (hair pulling). In trichophagia, people with trichotillomania also ingest the hair that they pull; in extreme cases this can lead to a hair ball (trichobezoar). The term is derived from ancient Greek θρίξ, ("hair") and φαγεῖν, ("to eat"). Signs and symptoms Trichophagia is characterized by the person eating hair, usually their own; primarily after pulling it out. Most often, hair is pulled out and then the ends of the root bulb are eaten, or occasionally the hair shaft itself. The hair eventually collects in the gastrointestinal tract (on occasion, and depending upon severity of symptoms) causing indigestion and stomach pain. Ritual is a strong factor, and may involve touching the root bulb to the lips, tasting the hair, and occasionally chewing it. Sometimes those with the disorder may even eat the hair of others. In the psychiatric field it is considered a compulsive psychological disorder ...
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Rapunzel
"Rapunzel" ( , ) is a German fairy tale recorded by the Brothers Grimm and first published in 1812 as part of ''Children's and Household Tales'' (KHM 12). The Brothers Grimm's story developed from the French literary fairy tale of ''Persinette'' by Charlotte-Rose de Caumont de La Force (1698). The tale is classified as Aarne–Thompson type 310 ("The Maiden in The Tower"). Its plot has been used and parodied in various media. Its best known line is, "Rapunzel, Rapunzel, let down your hair". Plot A lonely couple, who long for a child, live next to a large, extensive, high-walled subsistence garden, belonging to a sorceress.), despite the common modern impression. The wife, experiencing pregnancy cravings, longs for the ''rapunzel'' that she sees growing in the garden (''rapunzel'' is either the salad green and root vegetable ''Campanula rapunculus'', or the salad green ''Valerianella locusta''). She refuses to eat anything else and begins to waste away. Her husband fears ...
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Brothers Grimm
The Brothers Grimm ( or ), Jacob (1785–1863) and Wilhelm (1786–1859), were a brother duo of German academics, philologists, cultural researchers, lexicographers, and authors who together collected and published folklore. They are among the best-known storytellers of folk tales, popularizing stories such as "Cinderella" ("), "The Frog Prince" (""), "Hansel and Gretel" ("), "Little Red Riding Hood" (""), "Rapunzel", "Rumpelstiltskin" (""), "Sleeping Beauty" (""), and "Snow White" (""). Their first collection of folk tales, ''Children's and Household Tales'' (), began publication in 1812. The Brothers Grimm spent their formative years in the town of Hanau in the Landgraviate of Hesse-Kassel. Their father's death in 1796 (when Jacob was eleven and Wilhelm was ten) caused great poverty for the family and affected the brothers many years after. Both brothers attended the University of Marburg, where they developed a curiosity about German folklore, which grew into a lifelong de ...
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Trichotillomania
Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. A brief positive feeling may occur as hair is removed. Efforts to stop pulling hair typically fail. Hair removal may occur anywhere; however, the head and around the eyes are most common. The hair pulling is to such a degree that it results in distress and hair loss can be seen. The disorder may run in families. It occurs more commonly in those with obsessive compulsive disorder. Episodes of pulling may be triggered by anxiety. People usually acknowledge that they pull their hair, and broken hairs may be seen on examination. Other conditions that may present similarly include body dysmorphic disorder; however, in that condition people remove hair to try to improve what they see as a problem in how they look. Treatment is typically with cognitive behavioral therapy. The medication clom ...
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Trichobezoar
A hairball is a small collection of hair or fur formed in the stomach of animals, and uncommonly in humans, that is occasionally vomited up when it becomes too big. Hairballs are primarily a tight elongated cylinder of packed fur, but may include bits of other elements such as swallowed food. Animals with hairballs are sometimes mistaken as having other conditions of the stomach such as lymphosarcoma, tuberculosis, and tumor of the spleen. Cats are especially prone to hairball formation since they groom themselves by licking their fur, and thereby ingest it. Rabbits are also prone to hairballs because they groom themselves in the same fashion as cats, but hairballs are especially dangerous for rabbits because they cannot regurgitate them. Due to the fragility of their digestive systems, hairballs in rabbits must be treated immediately or they may cause the animal to stop feeding and ultimately die due to dehydration. Cattle are also known to accumulate hairballs but, as they do ...
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Bowel
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and other animals, including the esophagus, stomach, and intestines. Food taken in through the mouth is digested to extract nutrients and absorb energy, and the waste expelled at the anus as feces. ''Gastrointestinal'' is an adjective meaning of or pertaining to the stomach and intestines. Most animals have a "through-gut" or complete digestive tract. Exceptions are more primitive ones: sponges have small pores ( ostia) throughout their body for digestion and a larger dorsal pore (osculum) for excretion, comb jellies have both a ventral mouth and dorsal anal pores, while cnidarians and acoels have a single pore for both digestion and excretion. The human gastrointestinal tract consists of the esophagus, stomach, and intestines, and is divi ...
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Colon (anatomy)
The large intestine, also known as the large bowel, is the last part of the gastrointestinal tract and of the digestive system in tetrapods. Water is absorbed here and the remaining waste material is stored in the rectum as feces before being removed by defecation. The colon is the longest portion of the large intestine, and the terms are often used interchangeably but most sources define the large intestine as the combination of the cecum, colon, rectum, and anal canal. Some other sources exclude the anal canal. In humans, the large intestine begins in the right iliac region of the pelvis, just at or below the waist, where it is joined to the end of the small intestine at the cecum, via the ileocecal valve. It then continues as the colon ascending the abdomen, across the width of the abdominal cavity as the transverse colon, and then descending to the rectum and its endpoint at the anal canal. Overall, in humans, the large intestine is about long, which is about one-fifth o ...
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Trichotillomania
Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. A brief positive feeling may occur as hair is removed. Efforts to stop pulling hair typically fail. Hair removal may occur anywhere; however, the head and around the eyes are most common. The hair pulling is to such a degree that it results in distress and hair loss can be seen. The disorder may run in families. It occurs more commonly in those with obsessive compulsive disorder. Episodes of pulling may be triggered by anxiety. People usually acknowledge that they pull their hair, and broken hairs may be seen on examination. Other conditions that may present similarly include body dysmorphic disorder; however, in that condition people remove hair to try to improve what they see as a problem in how they look. Treatment is typically with cognitive behavioral therapy. The medication clom ...
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Pica (disorder)
Pica is the eating or craving of things that are not food. It can be a disorder in itself or a sign of other cultural or medical phenomena. The ingested or craved substance may be biological, natural or manmade. The term was drawn directly from the medieval Latin word for magpie, a bird subject to much folklore regarding its opportunistic feeding behaviors. According to the '' Diagnostic and Statistical Manual of Mental Disorders, 5th Edition'' (DSM-5), pica as a standalone eating disorder must persist for more than one month at an age when eating such objects is considered developmentally inappropriate, not part of culturally sanctioned practice, and sufficiently severe to warrant clinical attention. Pica may lead to intoxication in children, which can result in an impairment of both physical and mental development. In addition, it can cause surgical emergencies to address intestinal obstructions, as well as more subtle symptoms such as nutritional deficiencies and parasitosis. ...
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Human Gastrointestinal Tract
The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the digestive system that leads from the mouth to the anus. The GI tract contains all the major organs of the digestive system, in humans and other animals, including the esophagus, stomach, and intestines. Food taken in through the mouth is digested to extract nutrients and absorb energy, and the waste expelled at the anus as feces. ''Gastrointestinal'' is an adjective meaning of or pertaining to the stomach and intestines. Most animals have a "through-gut" or complete digestive tract. Exceptions are more primitive ones: sponges have small pores ( ostia) throughout their body for digestion and a larger dorsal pore (osculum) for excretion, comb jellies have both a ventral mouth and dorsal anal pores, while cnidarians and acoels have a single pore for both digestion and excretion. The human gastrointestinal tract consists of the esophagus, stomach, and intestines, and is ...
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