If one can treat the hair pulling, then hair swallowing can be avoided, he said. He added that most people don't eat enough hair to cause hairballs to form.
Dr. Samantha Cook, a pediatrician at Marshall University in Huntington, W.Va., said that common signs of stomach hairballs include bad breath, occasional vomiting, stomach pain, dark green-to-black colored stools, decreased appetite, weight loss, and stunted growth -- though she added that these signs are not always present. Occasionally, hair swallowers will eat other strange things, such as soil, rocks, foam, even rubber gloves.
Removal of hairballs depends on their size and location. "Small ones may be removed via endoscopy," she said, "[while] larger ones must be surgically removed by cutting open the stomach." (To watch a video of the surgical removal of a giant hairball, click here.)
Five years ago, Cook said she cared for a patient with a special type of giant hairball, known as Rapunzel syndrome. This term is used to describe a stomach hairball blockage that has a "tail" that extends into the intestines, in honor of the long-haired fairytale princess who dangled down her tresses to her prince suitor.