A 16-year-old girl from Massachusetts was admitted to Massachusetts General Hospital after should be in complaining about stomach pain for weeks. The doctors did a CT scan on her stomach and ran the usual battery of tests. There was nothing wrong with her. Eventually, after several rounds of testing that all turned up negative, they found the answer: a rare condition called Rapunzel syndrome.
Doctors conducted all those tests again two weeks later and still, they found nothing wrong with her. They discharged her with just some pain medication, a pill for nausea and vomiting, and another to treat peptic ulcers. The pain persisted.
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Finally, the doctor started to think outside the box. What if her condition was not something treatable with medication but required a deeper, more invasive look to determine exactly what was going on? They suspected something called a bezoar — a mass made up of a foreign object.
The exact identity of the object was unclear, so they ordered a medical procedure with the longest name I have ever seen: esophagogastroduodenoscopy. Those 28 letters describe a procedure where doctors run a camera into your mouth, down your esophagus, into your stomach, and finally into the duodenum—the part of your GI tract just before your intestines.
While a CT scan can detect masses, those masses can sometimes be indistinguishable from a piece of food moving through the intestine. A camera was the way to go. And it’s a good thing they did because what they found was a two-and-a-half-inch wad of matted hair. But this was a very special kind of disgusting wad of matted hair because the wad of matted hair was dangling down from the stomach into the small bowel, thus earning the diagnosis of Rapunzel syndrome.
Hair is resistant to digestion, hence why your cat coughs up hairballs. Doctors aren’t sure why all that hair was clumped up in the girl’s stomach, but they suspected she was likely chewing on her own hair.
Usually, if doctors suspect that kind of behavior, after they treat the blockage they will refer the patient to a mental health professional to deal with the underlying psychological conditions that led to the hairball. But after the teenager had the hairball removed, she didn’t attend follow-up care and instead told her doctors that she would see a hypnotherapist.
She was saved by modern medicine and then turned to a treatment that can be described as speculative at its most generous. There’s just no helping some people.
