Bezoars

I received an email last week entitled "Please blog on this . . . . eeeewwwww!" with this link to a story on a 10-pound hairball in an eighteen-year-old woman.

I'm happy to oblige.

I did find two items in the article somewhat unsettling: the photo of the hairball, and the description of it as a "mass of black, curly hair."

A bezoar is a mass of indigestible material found in the stomach or intestines. A trichobezoar is composed of hair (a hairball), and a phytobezoar consists of vegetable fibres.

Trichobezoars are caused by the ingestion of hair, either one's own (from the scalp, eyebrows, eyelashes or elsewhere) or from others. Most cases involve young children who chew hair out of habit, or young women with trichotillomania and trichophagia, psychiatric conditions where anxiety is relieved by pulling and swallowing hair.

There are 24 cases in the medical literature of Rapunzel syndrome, where the body of the trichobezoar lies in the stomach, but a long extension of it trails further down the gastrointestinal tract to as far as the colon. Sorry to ruin that fairytale for you.

Phytobezoars are caused by the concretion of indigestible vegetable fibres, usually in postgastrectomy (stomach removal) or diabetic patients. Orange segments are a common culprit. Improper chewing of food, often due to poorly-fitting dentures, can also be a contributing factor. Persimmons predispose to this condition, and there have been epidemics of persimmon bezoars in regions where the fruit is common.

Bezoars are treated in a variety of ways. Some are removed endoscopically, others are dissolved with enzymes (one case in the literature used Adolph's Meat Tenderizer with success), and others require surgery.

This is a condition where an ounce of prevention is worth a pound - or ten - of cure.