Pica is a eating disorder that involves the persistent eating of non nutritive or non edible substances (such as clay or chalks) and habit must be persist for more than 1 month of an age in which this behavior is developmentally inappropriate.
Types of Pica
The types of pica are characterized by which substance eaten by child, for example:
Pagophagia: Consumption of ice
Geophagia: Consumption of soil, mud, chalk and clay
Pagophagia: Consumption of ice
Coprophagia: Consumption of animal feces
Trichophagia: Consumption of hair
Urophagia: Consumption of urine
Causes of Pica
- Nutritional deficiencies e.g.- zinc, iron and calcium deficiencies
- Stress- May be used as coping mechanism for these people
- Low Socioeconomic condition- such as poverty
- Mental health conditions
- Medical conditions eg.- Pregnancy, sickle cell anemia
Symptoms of Pica
- Anemia (Low iron)
- Roundworm infection
- Electrolyte imbalance
- Irregular heart rhythms
- Intestinal blockage
- Lead poisoning
Diagnosis of Pica
Diagnosing pica requires three criteria (with the mentioned exceptions explained after the list):
- Time. This means persistent eating items or substances with no food or nutrition value for at least one and half month.
- Mental development. This means a person has developed past a certain point mentally and should know not to eat things that have no nutritional value.
- No social and cultural factors. This means the person doesn’t have social or cultural background reasons to explain the behavior.
Lab and Imaging Test of Pica
These can include a variety of lab, diagnostic and imaging tests, such as:
- Blood, urine and stool tests. These are used for checking any signs of infections, poisoning and electrolyte imbalances.
- Imaging tests. These are used for checking any signs of blockage or internal damage from this condition. These can include computerized tomography (CT) scans, X-rays, magnetic resonance imaging (MRI), ultrasound and more.
- Diagnostic tests. These are used for checking any indications of serious health problems that can happen with pica. E.g.- Electrocardiogram (ECG or EKG), which looks for problems with your heart electrical rhythm which can happen with an electrolyte imbalances or parasitic infections.
Management divided into 3 therapies
- Other Treatment Techniques
A few therapy methods that are possible include:
- Mild aversive therapy– This therapy involves teaching people to avoid pica behaviors using mild aversions (consequences) to teach people to avoid non-food items and positively reinforcing (rewarding) healthy eating behaviors.
- Behavioral therapy– This therapy involves teaching a person coping mechanisms and strategies to help them change their behavior.
- Differential reinforcement– This therapy involves people learn to avoid pica behaviors by focusing on other behaviors and activities.
- There are very few medications that are likely to help with pica. Antipsychotic medications might help, but the possible side effects usually keep these medications from seeing widespread use.
- Iron tablets for iron deficient anemia
Other Treatment Techniques
Pica may be managed by combination of psychosocial, dietary and family guidance approach. Other treatment techniques are as follows:
- Discrimination training between edible and non-edible items.
- Detect nutritional deficiencies and treat them.
- Make meals time pleasant.
- Do not leave the child alone.
- Meet the emotional needs of child.
- Keep the child busy as much as possible because boredom may give child time for eating non-edible substances.