Trichophagia

Trichophagia is the compulsive eating of hair associated with trichotillomania (hair pulling).[1] In trichophagia, people with trichotillomania also ingest the hair that they pull; in extreme cases this can lead to a hair ball (trichobezoar).[2] The term is derived from ancient Greek θρίξ, thrix ("hair") and φαγεῖν, phagein ("to eat").

Trichophagia
SpecialtyPsychiatry

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.

Prognosis

Rapunzel syndrome, an extreme form of trichobezoar in which the "tail" of the hair ball extends into the intestines, and can be fatal if misdiagnosed.[2][3][4][5] In some cases, surgery may be required to remove the mass;[6] a trichobezoar weighing 4.5 kilograms (9.9 lb) was removed from the stomach of an 18-year-old woman with trichophagia.[7]

History

Trichophagia is most often covered in the medical literature only "as a rare symptom of trichotillomania."[8] In the 18th century French doctor M. Baudamant described the condition in a 16-year-old boy.[8]

In media

Trichophagia is mentioned in the 1000 Ways to Die episode "Stupid Is As Stupid Dies" featuring a young woman who died from it. It is also mentioned in Grey's Anatomy season 9 episode 11 "The End Is the Beginning Is the End". As well as Season 3 episode 16 of “The Resident,” “Reverse Cinderella.”

References
  1. Chamberlain SR, Menzies L, Sahakian BJ, Fineberg NA (April 2007). "Lifting the veil on trichotillomania". Am J Psychiatry. 164 (4): 568–74. doi:10.1176/appi.ajp.164.4.568. PMID 17403968.
  2. Sah DE, Koo J, Price VH (2008). "Trichotillomania" (PDF). Dermatol Ther. 21 (1): 13–21. doi:10.1111/j.1529-8019.2008.00165.x. PMID 18318881.
  3. Ventura DE, Herbella FA, Schettini ST, Delmonte C (2005). "Rapunzel syndrome with a fatal outcome in a neglected child". J. Pediatr. Surg. 40 (10): 1665–7. doi:10.1016/j.jpedsurg.2005.06.038. PMID 16227005.
  4. Pul N, Pul M (1996). "The Rapunzel syndrome (trichobezoar) causing gastric perforation in a child: a case report". Eur. J. Pediatr. 155 (1): 18–9. doi:10.1007/bf02115620. PMID 8750804.
  5. Matejů E, Duchanová S, Kovac P, Moravanský N, Spitz DJ (September 2009). "Fatal case of Rapunzel syndrome in neglected child". Forensic Sci. Int. 190 (1–3): e5–7. doi:10.1016/j.forsciint.2009.05.008. PMID 19505779.
  6. Gorter RR, Kneepkens CM, Mattens EC, Aronson DC, Heij HA (May 2010). "Management of trichobezoar: case report and literature review". Pediatr. Surg. Int. 26 (5): 457–63. doi:10.1007/s00383-010-2570-0. PMC 2856853. PMID 20213124.
  7. Levy RM, Komanduri S (November 2007). "Images in clinical medicine. Trichobezoar". N. Engl. J. Med. 357 (21): e23. doi:10.1056/NEJMicm067796. PMID 18032760. Lay summary – CNN (2007-11-22).
  8. Grant JE, Odlaug BL (2008). "Clinical characteristics of trichotillomania with trichophagia". Compr Psychiatry. 49 (6): 579–84. doi:10.1016/j.comppsych.2008.05.002. PMC 2605948. PMID 18970906. Citing Baudamant M. "Description de deux masses de cheveux trouvee dans l'estomac et les intestines d'un jeune garcon age de seize ans." Hist Soc Roy Med, Paris. 1777–1779;2:262–63.
Classification
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