Definition Pica is an eating disorder in which a person repeatedly eats non-food items.
What is going on in the body? Someone with pica may eat clay, dirt, metal, paper, animal faeces, paint, or hair. This disorder is most common in children, persons with mental retardation, and pregnant women. It usually occurs for no known reason.
What are the signs and symptoms of the condition? The only symptom of pica is repeated eating of non-food items. Symptoms must occur for at least one month. If the item eaten is dangerous, such as lead paint, symptoms may occur due to the toxic effects of the substance.
What are the causes and risks of the condition? The exact cause of pica is often unknown. It's considered normal for children younger than 18 to 24 months old to put things in their mouths. After this age, eating non-food items is thought to be abnormal. Some people are more likely to have pica:
What can be done to prevent the condition? Most cases of pica cannot be prevented. Eating a well-balanced diet following the Australian Guide To Healthy Eating can prevent some cases due to zinc or iron deficiency.
How is the condition diagnosed? There is no test that can diagnose pica. The diagnosis is made when there is a history of eating non-food items for more than one month. The doctor will often order blood tests to rule out iron or zinc deficiency. These tests may include a serum iron level, a zinc level, and a full blood count. The full blood count (FBC ) measures the number of blood cells. This is done because iron deficiency can cause anaemia, or low counts of red blood cells.
What are the long-term effects of the condition? Pica in children often goes away by the teenage years. Pregnant women often stop having pica after delivery. The disorder may be permanent in someone with mental retardation or severe psychological problems.
Other long-term effects are related to the substance eaten. For example, eating chips of lead paint may cause permanent brain damage from lead poisoning. Eating other toxic substances can result in poisoning and death.
What are the risks to others? Pica is not contagious and poses no risk to others.
What are the treatments for the condition? Treatment is directed at the cause of the pica, if known. For example, those with iron or zinc deficiency are given mineral supplements to correct the problem. Pregnant women and children are often given counselling. Children are observed to see if they "grow out of it."
In those who continue to eat non-food items, behaviour therapy can be tried. This often involves punishing the bad behaviour with a mild shock, a loud noise, or a medication that causes vomiting. Another type of behavioural therapy is rewarding good behaviour. For example, a child may be given lollies each night he or she has avoided eating non-food items. Increased attention from parents can also help some children. Counselling is often useful.
What are the side effects of the treatments? There are few side effects to these treatments for pica. Iron supplements can cause constipation. Counselling may bring up issues that upset the person. This can sometimes worsen the behaviour for a short period of time.
What happens after treatment for the condition? As mentioned, most children and pregnant women "grow out of" this condition and need no further treatment. Those with zinc or iron deficiency often get better when these problems are fixed. In individuals with mentally retardation or psychological problems, treatment is often less effective. These individuals may need close monitoring to make sure they do not eat harmful materials. Those who do eat harmful items may need monitoring and treatment for the effects these items have on the body.
How is the condition monitored? Parents or other caregivers can help monitor the affected person at home. Behaviour therapies usually require the caregiver to give punishments or rewards when certain behaviours occur. Any new or worsening symptoms should be reported to the doctor.
Author: James Broomfield, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
