PICA: A less-known eating disorder

What is PICA?

PICA is a type of eating disorder where you eat things that aren’t food. The name comes from a species of bird that eats unusual objects. Someone with PICA consumes items that are not food and serve little nutritional or functional purpose. PICA can be natural, expected, and harmless depending on when and why a person does it. If a person with this PICA eats something toxic or hazardous, it could lead to serious issues.
PICA can affect anyone at any age. It’s most common in pregnant people, young children, people who have specific mental health conditions, and neurodivergent people. PICA can be misdiagnosed in children as it is very common for young children to put toys and other random objects in their mouths due to teething and their development stages.

Symptoms of PICA

In children with PICA, the most often consumed substances include dirt, clay, and flaking paint. Items like glue, hair and cigarette ashes are sometimes consumed but less typical. Whereas pregnant people, tend to crave inedible items like dirt. This may be caused due to a lack of iron and zinc. The most common symptoms of PICA include:
    • Stomach pain
    • Stomach upset
    • Blood in the stool
    • Digestive problems
The more severe symptoms range from lead poisoning as a result of eating flaking paint, intestinal blockage and tears, infections from bacteria in dirt and injuries to the mouth and teeth. nn

Causes of PICA

nn The ultimate cause of PICA is unknown, but it is believed that there are multiple factors that can increase someone’s risk of developing this eating disorder. Factors that contribute to how likely someone is to develop PICA are:
    • Cultural or learned behaviours: Certain cultures and faiths have common, socially acceptable PICA practices.
    • Stress or anxiety: People with stress or anxiety problems may use PICA as a release or a coping method.
    • Negative conditions during childhood: PICA is more prevalent in children from low socioeconomic backgrounds. PICA may also be used as a coping mechanism for children going through abuse or neglect.
    • Nutritional deficiencies: People who exhibit PICA symptoms frequently have dietary deficiencies such as deficiencies in zinc or iron.
    • Mental health conditions: schizophrenia, intellectual difficulties, autism etc.
    • Medical conditions: such as pregnancy and sickle cell anaemia.

How is PICA diagnosed?

PICA can be diagnosed by a doctor through various tests and procedures. Usually, tests such as a blood, urine or stool test can be done to check for indications of poisoning, infections, and electrolyte abnormalities. Diagnostic tests such as EKG or ECGs are also carried out. These check for issues with the electrical rhythm of your heart, which can occur when certain electrolyte imbalances or parasitic infections occur. Finally, x-rays, CTs, MRIs and ultrasounds can be used to look for any indications of internal harm or obstruction resulting from this illness.

Treatment of PICA

PICA is typically outgrown in children, especially when they learn the distinction between edible and non-edible goods and items. Removal of troublesome objects and supervision are both crucial for kids with intellectual disabilities. Pregnancy-related PICA also disappears on its own. Therapy is also an option in treating people with PICA. References: 1. Cleveland Clinic (2022) 2. Rose et al. (2000) 3. Staff and Rice, A. (2021)

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