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By studying these extraordinary health conditions, we uncover new perspectives and potential avenues for medical advancements, ultimately contributing to improved healthcare practices and patient care.
The Effect of Trichophagia
Have you ever heard about trichophagia before? Well, compared to the hair-pulling disorder a.k.a trichotillomania, trichophagia has been receiving less attention than it should be, considering its rarity.
Trichophagia is a compulsive need to eat hair which is usually correlated with trichotillomania.
I’m not an expert in psychiatric medicine (even though I’m a doctor), but people who have the compulsion to pull some hairs will usually have the tendency to eat them.
If you have some questions regarding the factor which triggered the compulsion for an affected individual to commit such act, well, there is no definite answer for that. The compulsion can be triggered by a variety of factors which could include:
- Boredom
- Anxiousness
- Feeling tense
- Stress
- Frustration
- Depression
People who have trichophagia/trichotillomania were usually presented with a few psychiatric co-morbidities such as depression and obsessive-compulsive disorder.
Well, I’m not going to talk more about the details of trichotillomania or trichophagia.
In this section, let’s talk about Rapunzel syndrome.
Wait, what? Rapunzel? Isn’t that a princess with a ridiculously long hair? Yes, she is but the hair in this case, instead of extending through the window down the prison tower,
it extends from the stomach into the intestine as a consequence of trichophagia.
In 2012, a case report was published by a surgeon from a military hospital located in Jamnagar, India regarding a 24- years old woman who presented to the hospital with a few signs and symptoms which suggested trichobezoar.
Trichobezoar is a collection of ingested hairs which trapped in the gastrointestinal system as a consequence of trichophagia; it is a rare but fatal outcome of trichophagia.
In Rapunzel syndrome, there is a continuity of the trichobezoar up to the jejunal area (usually) and it is often diagnosed intraoperatively. The patient was operated and made a full recovery within a week. She was referred to a psychiatrist for a psychiatric evaluation afterwards.
Accumulation of hairs within the stomach can progress to a full pyloric obstruction causing a few symptoms such as abdominal pain, vomiting blood, nausea and anaemia.
Without a proper surgical intervention, they were prone to get a bacterial infection which could lead to peritonitis and ultimately, death. 83 out of 88 documented cases of Rapunzel syndrome were contributed by women.
People who have been diagnosed with Rapunzel syndrome should be put under a long-course psychiatric treatment to prevent recurrences.
There are some cases of recurrence which have been published in a few journal publishing sites, so the role of a psychiatrist is vital in preventing it from happening ever again.
An Urge To Steal
Being diagnosed with a mental disorder is depressing.
It will be even more depressing when the mental disorder emerged as one of the side effects of a surgery. In 2016, a 40 years old woman has decided to undergo a plastic surgery for cosmetic purposes.
The surgery was considered successful but she developed a side effect as a result of brain injuries which deprived a certain portion of the brain of oxygen. This leads to a serious mental condition called kleptomania.
Kleptomania is a psychiatric illness which can be characterised by a compulsive need to steal anything from other people which can be considered invaluable and are generally not needed by the affected individual.
After the cosmetic surgery, the patient complained of memory deficits, lack of enthusiasm to do something, a little bit disorientated and somnolence (problem with sleep).
A few radiological investigations were carried out to identify the culprit behind this mess, and they found two things:
- There is a hypoxic-ischaemic injury in a few areas of the brain
- There is a reduced blood flow to the frontal lobe, cingulate gyri, cerebellum and basal ganglia of the brain
It was not until 2 days later when she felt the urge to steal something which she doesn’t need and after committing such act, she felt relieved. If we are in her shoes, it will be quite devastating when we had the urge to steal something and were unable to control that impulse.
It’s hard to determine the onset of kleptomania as it can occur spontaneously at a random time. The item they were stealing was usually had no value or they can afford to buy it without stealing.
I mean, it’s probably strange to see a rich guy stealing an apple when he was full right?
Encouraging people with kleptomania to seek help from a psychiatry might be difficult.
Stealing is a crime and they were afraid they will be prosecuted once they confessed their “crime” to a psychiatrist. Most of the time, people were diagnosed to have kleptomania when they were caught by the authorities.
If the act of stealing was caused by psychiatric illnesses (kelptomania), a doctor will usually refrain from reporting their own patient to the authority; the last thing the patient needs is to coop up in a prison with the other guys who might have some sort of borderline or anti-social personality.
Nevertheless, after a few days of treatment, the symptoms went away, and the patient eventually free from the obsessive thoughts of stealing from other people.
She was lucky that thing isn’t permanent. It would be suck if you have to live with an impulse to steal from other people for the rest of your life just because you’ve decided to opt for a cosmetic surgery. It’s definitely not worth it.
Being Infested By Taenia Saginata
Eating an improperly cooked meat will put you at a greater risk of being infested by a tapeworm.
If you think that’s an exaggeration, you might want to rethink that again.
Tapeworm is a parasite which means they can only live in a living thing that we called as the host.
In Ethiopia, eating raw meats are common among the majority of the population which put them at risk of getting infested by tapeworms.
In January 2016, a paper about a 38 years old Chinese man, who has been living with a tapeworm inside his gut, has been published in The New England Journal of Medicine.
He presented to a hospital located in Central China with abdominal pain, vomiting and weight loss for 3 days duration. Apparently, he had the same complaints for the past two years but he has never been treated for a tapeworm infestation before.
It’s possible that creature has been living inside him for 2 years duration, salvaging any essential nutrients.
There are a lot of prescriptions that have been given by various local clinic doctors, you name it, gastric, anaemia and abdominal pain medications but never for a tapeworm.
After taking an oral medication designed specifically for tapeworm infestation, he passed the tapeworm in his faeces 2 hours later.
The tapeworm was identified as Taenia Saginata, one of the commonest parasites found in an improperly cooked beef meat.
The tapeworm measured around 6 metres and 3 months after, all of the symptoms improved.
He was no longer anaemic and gained an appropriate amount of weight. It’s difficult to diagnose such case in Central China as tapeworm infestation is only common in northwest and southwest of China.
It’s important for a doctor to be able to elicit a good history in order to achieve the right diagnosis.
In this particular case, it is vital to ask history pertaining to his diet. Whatever it is, I’m sure he will be staying away from uncooked/improperly cook meat for a long period of time (possibly ever).
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