Soumya Chaudhary
Introduction
The ingestion of hair is a disorder that develops after a series of disorders and can be fatal if not looked after. Trichotillomania is characterized by repetitive pulling out of one's hair leading to functional impairment and possibly alopecia (Grant et al. 2015). Individuals who engage in trichotillomania also tend to develop trichophagia. Regularly engaging in trichophagia can cause the formation of a hairball in the stomach called Trichobezoar in the gastrointestinal tract which can result in life-threatening complications. Not seeking proper medical care and interventions can cause the symptoms to progress to the point of fatality (Snorrason et al., 2021). Many people tend to ignore their symptoms and refrain from visiting the doctor due to feelings of shame and embarrassment. Since this issue is growing in prevalence among individuals and has a stigma attached to it, this research study aims to find the cause, motivation, and treatment for this disorder among children, adolescents, and adults. Growing awareness about this issue and encouraging victims to speak about their disorders would help the victims be more comfortable in talking about themselves, making them less vulnerable to facing more serious complications like death and surgeries.
Hair eating disorder in children
Studies have shown that adolescent females are the most prone to developing hairballs in their abdomen. The symptoms vary in adolescents and are unrecognisable for the particular disease. One of the cases of a 12-year-old child said that she had been facing nauseous symptoms and complaints of dull aching abdominal pain. There had also been emesis of ingested food particles 15 minutes after the meal. After her examination, it was discovered that a 20 cm × 20 cm firm, non-tender, well-defined, mobile lump was present in the epigastric, left hypochondriac, and periumbilical region. On further examination, it was found that the child liked plucking fibres from gunny bags and occasionally plucking and eating her hair and eating them. A 20 cm × 10 cm × 5 cm gastric trichobezoar was found in the child's stomach which had to be later removed through surgical processes (Srinivas et al., 2017)
Mental Health and Hair Eating Disorder
Psychiatric disorders can cause motivation for hair-eating disorders. For example, psychiatric disorders such as pica, obsessive-compulsive disorder, depression, and anorexia nervosa may be associated with hair-eating disorders (Gorter et al., 2010). Studies have also shown that treating hair-eating disorders with selective serotonin reuptake inhibitor fluoxetine and supportive psychotherapy has improved the hair-pulling syndromes (Bouwer & Stein, 1998). A particular study involved a 15-year-old girl with a 10cm x 14 cm mass on her left upper quadrant mass was conducted. It also states that in the interview conducted with the girl, she revealed that she had started eating her hair at the age of 13, during which her father abused her. Later, she was also diagnosed with major depression disorder and suicidal ideation (Armstrong et al., 2001). These results explain how having mental health issues can cause individuals to gain disorders, and how not taking care of one's mental health can cause fatal symptoms. Many teenagers are scared to speak up about hair-eating disorders and many fail to bring it to notice too. Trachiphagia, if not spoken about, can cause a build-up of hairballs which can choke our abdomen and make it difficult to digest food particles, ultimately causing death. Speaking up while facing difficulties and asking for help, is the strongest thing we can do.
Methods to ease symptoms and potential cures:
● Behavorial therapies
As explained above, hair-eating disorders can be caused due to issues like obsessive-compulsive disorder, trauma, and depression. Taking therapies like cognitive behavioural therapy and mindfulness-based therapy would help the individuals get professional help to reduce the symptoms of compulsion. It would help them break through the hair-pulling habit. Awareness training and the use of a competing response are found to be essential components in breaking habits (Woods & Miltenberger, 1995).
● Surgery Treatments
Hair buildup in the abdomen can cause symptoms of ingestion, stomach ache, vomiting, and even choking. Without medical help, this can be fatal. To get emergency help and remove the hair buildup, surgery is the best option. Surgeries such as laparotomy and gastrostomy have produced the best results; however, less invasive laparoscopic techniques have also been published (Lamanna et al., 2018).
Conclusion
Hair-eating disorders, although dangerous, are rarely talked about. It is important to bring this disorder to notice since many victims of this disease find it difficult to talk about their feelings and not talking about this can also be fatal. Trichotillomania is the hair pulling disorder which can lead to alopecia and hair loss from the scalp. This can advance up and cause hair eating disorder called trichophagia. Not curing trichophagia can cause the formation of hairballs in the abdomen called Trichobezoar. This can choke the person and cause symptoms of ingestion and be fatal. Psychiatric disorders can aid hair-eating disorders and it has been proven that psychiatric disorders like depression,anxiety, obsessive-compulsive disorders and anorexia nervosa can cause hair - eating disorders. Taking professional help such as behavioural therapies and surgery treatments will help an individual suffering from such a disorder.
References
1. Grant, J. E., Odlaug, B. L., & Chamberlain, S. R. (2015). The endocannabinoid system and trichotillomania. In Elsevier eBooks (pp. 415–423). https://doi.org/10.1016/b978-0-12-417041-4.00017-5
2. Snorrason, I., Ricketts, E. J., Stein, A. T., & Björgvinsson, T. (2021). Trichophagia and trichobezoar in trichotillomania: A narrative mini-review with clinical recommendations. Journal of Obsessive-Compulsive and Related Disorders, 31, 100680. https://doi.org/10.1016/j.jocrd.2021.100680
3. Srinivas, M., Gupta, A., & Mittal, D. (2017). Gastric trichobezoars in children: Surgical overview. International Journal of Trichology, 9(2), 50. https://doi.org/10.4103/ijt.ijt_38_17
4. Gorter, R. R., Kneepkens, C. M. F., Mattens, E. C. J. L., Aronson, D. C., & Heij, H. A. (2010). Management of trichobezoar: case report and literature review. Pediatric Surgery International, 26(5), 457–463. https://doi.org/10.1007/s00383-010-2570-0
5. Bouwer, C., & Stein, D. J. (1998). Trichobezoars in Trichotillomania. Psychosomatic Medicine, 60(5), 658–660. https://doi.org/10.1097/00006842-199809000-00025
6. Armstrong, J. H., Holtzmuller, K. C., & Barcia, P. J. (2001). Gastric trichobezoar as a manifestation of child abuse 1 1The assertions and opinions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense. Current Surgery, 58(2), 202–204. https://doi.org/10.1016/s0149-7944(00)00469-4
7. Woods, D. W., & Miltenberger, R. G. (1995). Habit reversal: A review of applications and variations. Journal of Behavior Therapy and Experimental Psychiatry, 26(2), 123–131. https://doi.org/10.1016/0005-7916(95)00009-o
8. Lamanna, A., Sidhu, A., Foo, J., & Aly, A. (2018). A case of large gastric trichobezoar: case report and review of literature. Archives of Clinical and Medical Case Reports, 02(03). https://doi.org/10.26502/acmcr.96550031
Comments