Monday, November 7, 2011

PICA?!


Chewing a pencil in class? We’ve all done it!
However, chewing and swallowing? Now that’s a different story!
You say it’s impossible for someone to eat a pencil, a paper, a light bulb, etc.
I say it happens all the time!
… And it is called Pica!

What?

Pica is an eating disorder typically defined as the persistent ingestion of nonnutritive substances, for a period of at least 1 month, at an age when such behavior is developmentally inappropriate. Ok! Let’s make it simpler. When you were 1 or 2 years old, you used to chew on anything. And even though you don’t remember, that was a perfectly normal behavior. However, being 31 and eating the foam inside your couch cushions is not really ok! (pic)
Pica eaters ingest a wide variety of nonnutritive substances. We are talking about dirt, sand, stones, hair, feces, lead, paper, burnt matches, chalk, wood, plaster, light bulbs, and the list goes on…

Who?

Pica is very common in children, individuals with developmental disabilities and in pregnant women. It may also occur exclusively during the course of another mental disorder such as schizophrenia.

Why?

Why would anyone do such a thing? Well, there could many reasons…

Nutritional deficiencies: Some researchers suggest that nutritional deficiencies in iron, calcium, zinc and other nutrients have been associated with pica. So basically, the theory suggests that pica eaters ingest those nonnutritive substances to provide themselves with those nutrients. However, these findings are not supported by studies. So we’re still facing the dilemma of whether the deficiency came first or whether the ingestion of those foods caused it.

Cultural and familial factors: In some social groups, the ingestion of clay or soil is perfectly normal. Some parents may teach their children to eat those substances. Clay eating and starch eating is seen in some southern, rural, African American communities, primarily among women and children. Starch eating, is frequently started in pregnancy as a treatment for morning sickness.

Stress: Any stress that affects a child’s life may result in pica. What we mean by stress is parent separation, parent neglect, abuse, etc…

Low socioeconomic status: Malnutrition and hunger may result in pica.

Non discriminating oral behavior: As we said before, individuals with developmental disabilities may suffer from pica. This is due to an inability to discriminate between food and nonfood items. Some findings also suggest that there often is an aggressive search for nonfood items.

Then?

So what if I ate all those things? Well, the body is not made to either ingest or digest some products. Besides, there are substances that may be harmful and potentially kill the person ingesting them.

Lead Poisoning: Lead can be found in paint, soil, children’s toys, etc. It is a poisonous metal. A long term exposure to it can damage almost every organ in the body. It can ultimately cause death in children and miscarriage in pregnant women.

Hyperkalemia: It is the elevation of potassium in the blood. Due to ingestion of burnt match heads, it can cause the impairment of neuromuscular, gastrointestinal and cardiac organ systems.

Soil-borne parasitic infections such as toxoplasmosis and toxocariasis: It is due to geophagia (soil or clay ingestion) and it can be fatal specifically to people with a weakened immune system such as AIDS patients or pregnant women.

Gastrointestinal tract complications: the ingestion of non-food products can be very damaging to the GI tract. It can cause mechanical bowel problems, constipation, ulcerations, perforations, intestinal obstructions. The last three can be fatal as they can cause internal hemorrhages (bleeding).

Nutritional effects: data suggests that the ingested material displace normal dietary intake or interfere with the absorption of necessary nutritional substances causing deficiencies, especially in iron and zinc.

Dental effects: Pica results in severe tooth abrasion and surface tooth loss.


How?

Effective treatment should involve:

A psychologist that will analyze the function of pica behavior and ask all the right questions. He will attempt a behavioral modification such as discrimination training between edible and non edible items and other.

A social worker to assess the familial situation of the patient, educate regarding the negative effects of pica and remove toxic substances from the environment.

A physician to deal with the treatment of the consequences of the disorder.

A dietitian to address any identified nutritional deficiencies.

A dentist that will fix any damages to the teeth.

There is no specific medical treatment for patients with pica.


Pica can remit spontaneously in young children and pregnant women. However, if left untreated, it can persist for years. So if you suspect any behavior of this sort in a family member, friend or neighbor, please help them get treated!

41 comments:

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