Pica

• Causes, incidence, and risk factors

  Pica is seen more in young children than adults. Between 10 and 32% of children ages 1 - 6 have these behaviors.

  Pica can occur during pregnancy. In some cases, a lack of certain nutrients, such as iron deficiency anemia and zinc deficiency, may trigger the unusual cravings. Pica may also occur in adults who crave a certain texture in their mouth.

• Symptoms

  Children and adults with pica may eat:

  • Animal feces
  • Clay
  • Dirt
  • Hairballs
  • Ice
  • Paint
  • Sand

  This pattern of eating should last at least 1 month to fit the diagnosis of pica.

• Signs and tests

  There is no single test that confirms pica. However, because pica can occur in people who have lower than normal nutrient levels and poor nutrition (malnutrition), the health care provider should test blood levels of iron and zinc.

  Hemoglobin can also be checked to test for anemia. Lead levels should always be checked in children who may have eaten paint or objects covered in lead-paint dust. The health care provider should test for infection if the person has been eating contaminated soil or animal waste.

• Treatment

  Treatment should first address any missing nutrients and other medical problems, such as lead exposure.

  Treatment involves behavior and development, environmental, and family education approaches. Other successful treatments include associating the pica behavior with bad consequences or punishment (mild aversion therapy) followed by positive reinforcement for eating the right foods.

  Medications may help reduce the abnormal eating behavior, if pica occurs as part of a developmental disorder such as mental retardation.

• Expectations (prognosis)

  Treatment success varies. In many cases, the disorder lasts several months, then disappears on its own. In some cases, it may continue into the teen years or adulthood, especially when it occurs with developmental disorders.

• Complications
  • Bezoar
  • Infection
  • Intestinal obstruction
  • Lead poisoning
  • Malnutrition
• Calling your health care provider

  Call your health care provider if you notice that a child (or adult) often eats non-food materials.

• Prevention

  There is no specific prevention. Getting enough nutrition may help.

Review Date: 2/6/2008

Reviewed By: Christos Ballas, M.D., Attending Psychiatrist, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.