Pica is an eating disorder, characterized by, compulsively eating items which have zero nutritional value. The Handbook of Clinical Child Psychology suggests that pica 4%-26% prevalent among the populations. They tend to eat items, such as ice, chalk, etc. Some of the items are potentially dangerous like, pieces of metals which can lead to serious consequences, like lead poisoning. This disorder is seen mostly in children and pregnant women and is usually transient. Treatment is effective and helps you avoid serious side effects. It often begins in childhood and usually lasts for a few months; however, it is more severe and long-lasting in people with severe intellectual and developmental disabilities.
The patients are generally found eating substances like:
- Ice, buttons, clay, metal pieces, pencil leads, chalk, sand, dirt, cigarette ashes, glue, feces, hair, soap.
Once pica is suspected, a complete medical evaluation is essential to detect for possible anemia, intestinal blockages, or toxicity from non-edible substances. If present symptoms indicate pica, then the doctor begins an evaluation consisting of a complete medical history and physical exam. Certain tests such as X-rays, endoscopies, and blood labs are performed, to check for systemic diseases like anemia, toxins and other harmful substances in the bloodstream, and blockages in the small and large intestines. The patient is also checked for possible bacterial or amoebic infections due to the consumption of contaminated substances loaded with bacteria or other organisms. The person’s eating habits are also reviewed.
Along with the diagnosis of pica, associated abnormalities such as intellectual and developmental disabilities, obsessive-compulsive disorder are also assessed — as a possible cause of the erratic eating behavior. Only if these patients regularly eat non – food items for at least a month, then they are qualified for pica.
Health consequences associated with Pica:
There are many potential health consequences of pica, such as:
- On consumption of items, such as paint chips, lead pencils may cause lead or other toxic substances poisoning and eating them can increase the risk of complications including learning and developmental abnormalities, especially in children and brain damage. This is the most lethal and potentially alarming consequence of pica.
- Eating non-edible substances can interfere with the absorption of healthy food, which may further lead to nutritional deficiencies.
- Most of the non- food substances cannot be digested, such as sand, stones, clay and may cause constipation, irritable bowel syndrome or other abnormal changes in the bowel movements. Also, pointed or sharp objects (such as pins or metal scraps) can irritate the stomach lining and cause tears in the esophagus or intestines.
- The contaminated objects like clay or dirt may lead to serious bacterial or amoebic infections.
- Co-existing developmental disabilities can hamper the treatment.
Medical monitoring of the eating behavior is an essential part of the treatment plan, given the risk of medical complications (such as lead poisoning, infections) associated with pica. Additionally, counseling by a mental health team skilled in treating pica is also required for complete treatment of these cases.
The Handbook for Clinical Child Psychology suggests general behavioral modifications as the most effective treatment plan for pica. In which the patients are trained to spot the difference between edible and non- edible food stuffs, through the use of positive reinforcement. The first-line of treatment for pica involves checking for mineral or electrolytes imbalances and nutrient deficiencies and restore those. In most of the cases, eating behaviors normalize, when the deficiencies are corrected; however, if the disorders are not due to malnutrition or do not cease after nutritional treatment, other behavioral interventions are executed.
Scientists dealing with autism, have developed and put forth, many different effective interventions, including re-orienting the patient’s attention from the desired non-food item and rewarding them for discarding or avoiding the non-food item.
There are no specific ways to prevent pica. However, careful attention towards their eating rituals and close monitoring of them may help detect the disorder before complications can occur.