Pica

Pica
ICD-10	F50.8, F98.3
ICD-9	307.52
DiseasesDB	29704
MeSH	D010842

WikiDoc Resources for Pica
Articles
Most recent articles on Pica Most cited articles on Pica Review articles on Pica Articles on Pica in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Pica Images of Pica Photos of Pica Podcasts & MP3s on Pica Videos on Pica
Evidence Based Medicine
Cochrane Collaboration on Pica Bandolier on Pica TRIP on Pica
Clinical Trials
Ongoing Trials on Pica at Clinical Trials.gov Trial results on Pica Clinical Trials on Pica at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Pica NICE Guidance on Pica NHS PRODIGY Guidance FDA on Pica CDC on Pica
Books
Books on Pica
News
Pica in the news Be alerted to news on Pica News trends on Pica
Commentary
Blogs on Pica
Definitions
Definitions of Pica
Patient Resources / Community
Patient resources on Pica Discussion groups on Pica Patient Handouts on Pica Directions to Hospitals Treating Pica Risk calculators and risk factors for Pica
Healthcare Provider Resources
Symptoms of Pica Causes & Risk Factors for Pica Diagnostic studies for Pica Treatment of Pica
Continuing Medical Education (CME)
CME Programs on Pica
International
Pica en Espanol Pica en Francais
Business
Pica in the Marketplace Patents on Pica
Experimental / Informatics
List of terms related to Pica

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pica is an appetite for non-nutritive substances (e.g., coal, soil, chalk, paper etc.) or an abnormal appetite for some things that may be considered foods, such as food ingredients (e.g., flour, raw potato, starch). In order for these actions to be considered pica, they must persist for more than one month, at an age where eating such objects is considered developmentally inappropriate. The condition's name comes from the Latin word for the magpie, a bird which is reputed to eat almost anything. Pica is seen in all ages, particularly in pregnant women and small children, especially among children who are developmentally disabled, where it is the most common eating disorder.

Pica in children, while common, can be dangerous. Children eating painted plaster containing lead may suffer brain damage from lead poisoning. There is a similar risk from eating dirt near roads that existed prior to the phaseout of tetra-ethyl lead in gasoline or prior to the cessation of the use of contaminated oil (either used, or containing toxic PCBs or dioxin) to settle dust. In addition to poisoning, there is also a much greater risk of gastro-intestinal obstruction or tearing in the stomach. This is also true in animals. Another risk of dirt eating is the possible ingestion of animal feces and the accompanying parasites.

Causes

The scant research that has been done on the root causes of pica suggests that the majority of those afflicted tend to suffer some biochemical deficiency and more often iron deficiency. The association between pica and iron deficiency anemia is so strong, that most patients with iron deficiency will admit to some form of pica. Often the substance eaten by those with the disorder does not contain the mineral of deficiency. If a mineral deficiency is not identified as the cause of pica, it often leads to a misdiagnosis as a mental disorder.

Pica may also be a symptom of a hookworm infection.

Unlike in humans, in dogs or cats, pica may be a sign of Immune-mediated hemolytic anemia, especially when it involves eating substances such as tile grout, concrete dust, and sand. Dogs exhibiting this form of pica should be tested for anemia with a complete CBC or at least Hematocrit levels.

Treatment

Treatment emphasizes psychosocial, environmental, and family guidance approaches. Treatment options include: discrimination training between edible and nonedible items, self-protection devices that prohibit placement of objects in the mouth, sensory reinforcement involving screening (covering eyes briefly), contingent aversive oral taste (lemon), contingent aversive smell sensation (ammonia), contingent aversive physical sensation (water mist), brief physical restraint, and overcorrection (correct the environment, or practice appropriate or alternative responses).

This involves associating negative consequences with eating non-food items and good consequences with normal behavior. Medications may be helpful in reducing the abnormal eating behavior, if pica occurs in the course of a developmental disorder, such as mental retardation, or pervasive developmental disorder. These conditions may be associated with severe behavioral disturbances, including pica. These medications enhance dopaminergic functioning, which is believed to be associated with the occurrence of pica.

Examples

• Amylophagia (consumption of starch)
• Coprophagia (consumption of excrement)
• Geophagy (consumption of soil, clay, or chalk)
  • Consumption of dust or sand has been reported among iron deficient patients.
• Hematophagy (ingestion of blood)
• Hyalophagia (consumption of glass)
• Pagophagia (pathological consumption of ice)
• Self-cannibalism (rare condition where body parts may be consumed; see also Lesch-Nyhan syndrome)
• Trichophagia (consumption of hair or wool)
• Urophagia (consumption of urine)
• Xylophagia (consumption of wood)

In popular culture

• Michel Lotito has made a career in entertainment of eating chopped "inedibles" like a Cessna 150 small airplane.
• A patient suffering from Pica was featured in the Season Four premiere of Grey's Anatomy.