Trichophagia and trichobezoar in trichotillomania: A narrative mini-review with clinical recommendations

Snorrason, Ívar; Ricketts, Emily J.; Stein, Aliza T.; Björgvinsson, Thröstur

doi:10.1016/j.jocrd.2021.100680

Cited by 10 publications

(3 citation statements)

References 46 publications

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“…Interdisciplinary collaboration between psychiatrists, nutritionists, pediatricians, and pediatric surgeons is crucial not only during the acute phase but also for long-term management and prevention of recurrence [45].…”

Section: Discussionmentioning

confidence: 99%

Indigestible Trichobezoar Mimicking Inflammatory Bowel Disease: A Case Report and a Literature Review

Bellini,

Franzone,

Pezzotta

et al. 2024

Emergency Care and Medicine

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A 15-year-old girl was admitted to the Pediatric Emergency Department due to abdominal discomfort, anorexia, diarrhea, emesis, and weight loss. An inflammatory bowel disease diagnosis was suspected and a complete endoscopic investigation was deemed necessary. Initially, only colonoscopy with ileoscopy was performed, with evidence of widespread ileal ulcers, whereas a subsequent esophagogastroduodenoscopy revealed a huge trichobezoar that was further surgically removed. Trichobezoars are intraluminal conglomerates composed of ingested hair and are typically associated with underlying psychiatric disorders. Bezoars can be asymptomatic or present with various gastrointestinal symptoms, mimicking, among other conditions, inflammatory bowel disease. They may extend through the pylorus into the jejunum leading to Rapunzel Syndrome, which may cause intestinal obstruction. The treatment of trichobezoar depends on its location and volume. An endoscopic approach is possible for small-sized trichobezoars, but to avoid bezoar tail migration along the intestine, causing obstruction, conventional laparotomy is the only valid treatment for patients with Rapunzel Syndrome. Due to the increasing incidence of psychiatric disorders in pediatric age during the SARS-CoV-2 pandemic and their relationship with trichobezoars, an increase in cases of trichobezoars was observed. Thus, interdisciplinary collaboration between psychiatrists, pediatricians, and surgeons is crucial not only during the acute phase but also for long-term management and prevention of recurrence.

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Section: Discussionmentioning

confidence: 99%

Indigestible Trichobezoar Mimicking Inflammatory Bowel Disease: A Case Report and a Literature Review

Bellini,

Franzone,

Pezzotta

et al. 2024

Emergency Care and Medicine

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“…Найбільш часто така проблема зустрічається у дітей, особливо у дівчаток з довгим волоссям [2,3,11]. Це основна причина появи волосяних грудок.…”

Section: обговоренняunclassified

Hematological manifestations of trichobezoar in a child

Nykytyuk

Bodnarchuk²,

Boyarchuk

et al. 2022

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Background. Trichobezoar is a dense compound in the human stomach, consisting of swallowed hair, food particles, and gastric mucus. Sometimes it passes into the initial part of the small intestine. Its clinical picture is very similar to that of a tumor, so it is necessary to conduct a thorough diagnosis. Materials and methods. The article deals with a case of severe protein-vitamin-iron deficiency anemia in a 5-year-old girl on the background of trichobezoar. Results. The child’s condition is severe due to the clinical picture of iron-protein-deficiency anemia of a very severe degree. During her stay in the hospital, the girl’s condition deteriorated sharply due to the rapid increase in weakness and pallor of the skin, anasarca. Due to the critical growth of the anemic syndrome, the question of the need for blood transfusion and further surgery arose. Conclusions. The peculiarity of this case is a critical increase in anemia in the absence of classic signs of hemolysis on the background of chronic eating and psychosomatic disorders. Thus, it is necessary to form vigilance in pediatricians to trichobezoar and increase the level of knowledge about the correct diagnostic algorithm in such cases.

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“…It is commonly associated with negative affective states like boredom, tension, or depressive mood ( Duke et al, 2009 ) and can affect any hairy parts of the body. The symptoms can lead to substantial distress and health problems such as depression or anxiety ( Stemberger et al, 2000 ; Deckersbach et al, 2003 ) or trichobezoar ( Snorrason et al, 2021 ). The prevalence of Trichotillomania ranges from 0.6 to 15.3% ( Mansueto and Rogers, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Short-term intervention complemented by wearable technology improves Trichotillomania – A naturalistic single-case report

Leibinger,

Murray,

Aschenbrenner

et al. 2023

Front. Psychol.

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There is a growing interest in using wearable technology for the treatment of body-focused repetitive behaviors (BFRBs), such as Trichotillomania. Yet, to our knowledge, few studies address the applicability and use of wearable technology as a therapeutic element in more naturalistic situations. Here we would like to introduce its potential use combined with a Habit-Reversal Training in a single-case experimental design. In practice, individuals with BFRBs frequently show complex constellations of psychiatric disorders. Accordingly, the here presented participant was diagnosed with Trichotillomania as well as comorbid ADHD and examination phobia. The participant was offered to wear an unobtrusive and user-friendly vibration device that sent an alarm when her critical hairpulling behaviors occurred. The complementing Habit-Reversal Training included an Awareness Training supported by the vibration alarm of the wearable device. It further included a Competing Response Training by learning benign behaviors that could replace the hairpulling behavior. The frequency of hairpulling episodes was assessed using daily self-reports and by using the monitoring function of the wearable device. The intervention procedure was implemented into the participant’s everyday life and evaluated over the course of 214 days. The results indicated a significant reduction in the daily episodes of hair pulling. Our preliminary findings suggest that the here applied intervention has the potential to effectively treat Trichotillomania in individuals with comorbid disorders in psychotherapeutic outpatient care. Certainly, group-studies will need to further validate the approach’s effectiveness.

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Trichophagia and trichobezoar in trichotillomania: A narrative mini-review with clinical recommendations

Cited by 10 publications

References 46 publications

Indigestible Trichobezoar Mimicking Inflammatory Bowel Disease: A Case Report and a Literature Review

Indigestible Trichobezoar Mimicking Inflammatory Bowel Disease: A Case Report and a Literature Review

Hematological manifestations of trichobezoar in a child

Short-term intervention complemented by wearable technology improves Trichotillomania – A naturalistic single-case report

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