In 2008, a 27-year-old woman in Portugal reached a point where the stress in her home had become difficult to bear. She was raising two young children while living with a critical mother-in-law. Her husband was abroad for work, and she had given up her education to care for her family.
Then severe stomach pain and vomiting sent her to the hospital.
Doctors initially considered conditions such as an ulcer or stress-related gastritis. But during an examination, a doctor felt a hard mass in her upper abdomen.
A CT scan showed a large mass near her stomach. An endoscopy revealed something unexpected: a large hairball covered in mucus.
The mass was a trichobezoar, a collection of swallowed hair that had built up inside her stomach. Doctors linked it to trichophagia, a condition in which a person repeatedly eats their own hair.
A Young Mother Under Constant Stress
Mary’s problems had been building for years.
She had married about a decade earlier and hoped to continue her education. Her husband initially supported those plans. But shortly after the marriage, she became pregnant.
Around the same period, her husband moved abroad for work. Mary remained in Portugal with her mother-in-law and became responsible for raising the children.
Her mother-in-law offered little support and often criticized Mary when the children became difficult to control.
By 2008, Mary was caring for two boys. One was 4 years old and the other was 8.
On one particularly difficult morning, both children were upset and making a mess in the living room. Her younger son was crying and having a tantrum, while her older son was jumping on the couch and throwing toys.
Mary was exhausted.
Her mother-in-law was nearby, but instead of helping, she continued eating breakfast at the dining table.
The Moment Everything Became Too Much
The situation became even more difficult when Mary’s younger son grabbed her hair and began pulling it.
She tried to calm him while also dealing with her older son’s behavior.
Then her mother-in-law shouted at her to make the children quiet.
Mary shouted back that she was trying.
But then something changed.
She suddenly felt an intense pain in her stomach. The pain was much stronger than the stomach discomfort she had experienced before.
A wave of nausea followed.
She collapsed and vomited on the floor.
At that moment, Mary realized that she could no longer ignore what was happening to her body.
Doctors Found a Hard Mass in Her Abdomen
Mary went to a hospital in nearby Aveiro.
She told doctors about her stomach pain, nausea and the extreme stress she had been experiencing at home.
At first, doctors suspected a stomach ulcer or stress-related gastritis.
Both conditions can cause significant stomach discomfort, so further examination was needed.
During the physical examination, however, the doctor noticed something unusual.
While pressing on Mary’s abdomen, he felt a hard mass in the upper part of her stomach.
Mary immediately became worried.
She wondered whether the mass could be cancer. The doctor could not tell what it was simply by feeling it, so imaging and further examination were needed.
A CT Scan Revealed a Large Mass
A CT scan showed an unusual mass near Mary’s stomach.
It was roughly oval-shaped and about the size of a fist. The mass was pressing against the stomach wall and had areas with different densities.
The scan showed that something solid was present, but it did not immediately reveal what the mass was.
Doctors therefore performed an endoscopy.
During an endoscopy, a flexible tube with a small camera is passed through the mouth and into the digestive tract. It allows doctors to see the inside of the esophagus, stomach and upper digestive system.
What they saw inside Mary’s stomach was unexpected.
The Endoscopy Revealed a Giant Hairball
As the camera reached Mary’s stomach, doctors saw a dark mass covered in mucus.
At first, it was difficult to identify.
But as the doctor moved the camera around the stomach, the appearance of the mass became clearer.
It was a large collection of hair.
Doctors recognized it as a trichobezoar.
A trichobezoar is a compact mass of hair that forms inside the digestive system after hair is swallowed repeatedly.
In Mary’s case, the hair had accumulated in her stomach until it formed a large solid mass.
The discovery explained why she had been experiencing severe stomach pain, nausea and vomiting.
What Is Trichophagia?
Trichophagia is the repeated eating of hair.
It can occur in people who have a strong urge to pull out their hair and may sometimes be associated with trichotillomania, a condition involving recurrent hair pulling.
Some people who pull out their hair also swallow the hair. Because human hair is difficult for the digestive system to break down, repeated ingestion can allow it to accumulate.
Over time, the hair can form a bezoar.
When the bezoar consists mainly of hair, it is called a trichobezoar.
Stress and anxiety can play an important role in these behaviors, but the condition is more than simply a bad habit. It can require both medical and psychological treatment.
How a Trichobezoar Can Cause Stomach Problems
Hair does not break down easily in the digestive tract.
If a person repeatedly swallows hair, it can gradually collect in the stomach.
A small amount may pass through the digestive system. But large amounts can accumulate and form a dense mass.
A larger trichobezoar may cause symptoms such as:
- Stomach pain
- Nausea
- Vomiting
- Feeling full quickly
- Loss of appetite
- Weight loss
- Digestive discomfort
In serious cases, a large bezoar can cause complications and may require removal.
Why Mary’s Stress Was Important
Mary’s physical symptoms were not simply a stomach problem.
She had been living under severe emotional pressure for years.
She had abandoned her education, raised two children largely on her own and lived with a family member who constantly criticized her.
She was also experiencing sleep problems and weight loss.
Her stomach symptoms became increasingly severe.
The discovery of the trichobezoar showed that her psychological distress and physical health were closely connected. The hair-eating behavior had become a dangerous coping mechanism.
Stress itself does not mean that every stomach problem is psychological. Severe or persistent abdominal pain always deserves proper medical assessment.
In Mary’s case, medical testing revealed a physical mass that needed treatment.
Surgery Was Needed to Remove the Hairball
Once doctors identified the trichobezoar, Mary needed surgery to remove it from her stomach.
The procedure removed the accumulated hair and allowed doctors to address the immediate physical problem.
But removing the hairball was only part of the treatment.
If the behavior that caused the hair accumulation continued, another trichobezoar could potentially develop.
Mary therefore also received medication and counseling to address her anxiety and psychological distress.
After about a month of treatment, she was feeling much better physically and mentally.
Mary Finally Changed Her Life
The experience forced Mary to confront the situation she had been living with for years.
After recovering, she left her mother-in-law’s home.
She took her two sons and moved abroad to reunite with her husband.
For Mary, the hospital visit became more than the discovery of an unusual medical condition. It became the point at which she finally recognized that her living situation and mental health needed to change.
What This Case Shows About Stress and Physical Health
Mary’s story shows why unusual physical symptoms should not be ignored.
Stress can affect sleep, appetite, digestion and many other parts of the body. But symptoms such as severe abdominal pain, repeated vomiting, unexplained weight loss or a noticeable abdominal mass need medical attention.
It also shows why unusual repetitive behaviors can have serious physical consequences.
Trichophagia may seem harmless at first. But repeated hair ingestion can lead to a trichobezoar and, in severe cases, serious digestive complications.
Early psychological support can therefore be important for people struggling with compulsive hair pulling or hair eating.
Conclusion
Mary went to the hospital believing that years of stress might have caused an ulcer or another stomach condition.
Instead, doctors discovered a large trichobezoar made from hair.
The hairball had formed because Mary had been pulling out and eating her hair as a way of coping with overwhelming stress.
Surgery treated the immediate physical problem, while counseling helped address the behavior and anxiety behind it.
Her recovery also gave her the opportunity to change her home life. She left her mother-in-law, took her children and reunited with her husband.
The case is a reminder that psychological distress can sometimes appear through unexpected physical symptoms. When severe pain, nausea, vomiting or unexplained weight loss develops, seeking medical help can reveal problems that cannot be identified from symptoms alone.