Pica (disorder)

Pica is a disorder in which a person ingests non-food items or food with no nutritional value. Those with pica may eat relatively safe materials, such as ice, or potentially hazardous items, such as lead paint or soil. Pica is a compulsive disorder that can be spurred by nutritional deficiencies or mental illness. Pica can lead to serious health complications, such as lead poisoning or bacterial infections depending on the materials that a person consumes. Pica is more common among certain groups of people but can manifest in anyone. Although pica is usually temporary, it is sometimes a serious, long-term condition.

Background

Several conditions cause pica, and a patient can have multiple causes of the disorder. Pica among children and pregnant women is most often linked to nutritional deficiencies, the most common being an iron deficiency. An untreated iron deficiency can lead to serious health conditions, such as heart failure. Doctors believe that because the body recognizes that it needs more of a particular nutrient, a person can develop unusual cravings to try to replenish low nutrient levels.

Similarly, dieting and malnourishment can also lead to pica. While a pregnant woman’s pica may be caused by nutritional deficiencies, it can also be stimulated by pregnancy hormones, which cause cravings for certain foods. Some people develop pica because they crave the texture or flavor of certain items. In some cultures, it is acceptable to consume some non-food items, such as clay.

Overview

While anyone can by pica, it is most common among children and pregnant women. Studies have also found that lower-income people are more likely to have pica than those with higher incomes. Studies have also shown pica in which a person eats clay or soil is the most common type of pica in developing countries. Children and pregnant women often experience pica for a limited time. As children grow, they become less likely to engage in the behavior, as do women after they give birth.

People with certain mental illnesses, such as schizophrenia, are more likely to experience pica. People with mental disabilities may also experience pica. Pica is often long-lasting for those with mental illnesses or mental disabilities. In these patients, pica is usually also harder to treat.

Doctors often diagnose pica because the behavior is reported by the patient or a loved one. Pica is generally diagnosed when the behavior persists for at least one month. If the patient is a child, the behavior must be outside of what is considered normal for the patient’s stage of development. (For example, a young toddler ingesting a non-food item is most likely developmentally normal and not a sign of pica.)

Different types of pica exist. Often, a patient with pica will eat one type or a few types of items, rather than a variety of types. However, some patients—especially those with mental illness—may eat many types of objects. These are some of the common types of pica:

• Acuphagia: compulsively eating sharp objects.
• Amylophagia: compulsively eating starch, including cornstarch and laundry starch.
• Geophagia: compulsively eating soil, sand, or clay.
• Hyalophagia: compulsively eating glass.
• Pagophagia: compulsively eating ice.

People with pica also commonly eat buttons, hair, chalk, glue, paint, cigarettes and cigarette ashes, soap, and feces.

The adverse effects of pica come from the dangers posed by the items that people ingest. For example, a person with pagophagia who eats ice will most likely have few negative effects from the disorder. Often, such types of pica are not reported to doctors because they are seen as harmless. However, other types of pica can cause much more serious complications. Although the majority of small non-food objects that people eat will pass harmlessly through the gastrointestinal system, sharp or long objects can cause puncture wounds or impaction, which can lead to intestinal obstruction. Other complications can include intoxication, parasitosis (a false belief that one has parasites), and worsening nutritional deficiencies. Children with pica may have adverse effects on their physical and mental development. People who have ingested harmful material should be taken immediate for medical care.

Because pica happens for various reasons, no proven way exists to prevent the disorder. Medical professionals believe that to prevent children from developing pica and the serious health problems resulting from it, adults should closely monitor them, especially those with developmental disabilities. Instances of pica in which people eat food items, such as flour or ice, are usually not reported or treated as aggressively as instances when people eat non-food items. However, people with pica who eat non-food items are more likely to receive medical care.

Medical professionals generally first treat patients with pica by treating any health problems caused by the disorder. They will often use laboratory tests, including blood tests and X-rays, to determine if ingested objects have harmed a patient. Sharp objects and impacted objects sometimes have to be removed through surgery. Medical professionals may also give patients antibiotics or antifungal medications. Doctors may also treat high levels of lead through chelation therapy, which is a chemical process to remove heavy metals from the body. They may conduct tests to determine if a patient has a nutritional deficiency that may be causing pica. They will most likely prescribe vitamin or mineral supplements to treat any deficiencies. Doctors may also use behavioral interventions to help people with pica. Sometimes simply redirecting patients’ attention can help them deal with the disorder.

Bibliography

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