When you hear of an eating disorder, you think about conditions with troubled ‘food’ habits. What if I tell you an eating disorder is not about eating food? Pica is a non-food cravings disorder. It comprises of a tenacious consumption of substances other than food for over a month. Also, these items have no nutritional value.
Pica usually commences during childhood years. Typically, it lasts for a few months. However, it is likely harder to manage in developmentally disabled children.
Moreover, it is most likely to prevail in underdeveloped countries. Additionally, it can infect children, adolescents as well as adults of both genders. According to the National Library of Medicine, it persists in about 10-32% of children between the ages of 1 to 6 years.
PICA: SYMPTOMS AND BEHAVIOR
Clinical presentation of pica is highly variable. The disorder is associated with the resulting medical conditions and the ingested substances.
- Persistent eating of non-nutritional substances. For instance:
– Animal faeces (coprophagia)
– Blood (hematophagy)
– Burnt matches (cautopyreiophagia)
– Clay (geophagia)
– Dirt (geophagy)
– Dust (Coniophagia)
– Glass (Hyalophagia)
– Hair (trichophagia)
– Ice (pagophagia)
– Lead (Plumbophagia)
– Metal (metallophagia)
– Mucus (mucophagia)
– Paper (papyrophagia)
– Pebbles or stones (lithophagia)
– Sharp objects (acuphagia)
– Soil (geophagy)
– Starch (amylophagia)
– Urine (urophagia)
– Vomit (emetophagia)
– Wool (trichophagia)
– Wood (xylophagia)
- Children are not averse to ingesting food.
- Associated mental disorders, such as intellectual disability, autism, and schizophrenia.
- Medical conditions like pregnancy and iron deficiency anaemia are often associated with the condition.
- Trichotillomania, i.e. hair pulling disorder and excoriation, i.e. skin picking disorder may be associated along with Pica.
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Disorder pica may have many potential life-threatening complications. Such as:
- Certain metal-based items such as paint may contain lead or any other toxic substances. Ingesting these things causes heavy metal poisoning, which further increases the risk of learning disabilities and brain damage in children. Moreover, it has cardiovascular, endocrine, hematologic, neurologic, and renal consequences.
- Consuming non-food objects leads to vitamin and mineral deficiencies, due to interference with healthy food consumption.
- Consumption of stones or any other non-digestible item causes constipation and obstruction in the alimentary canal. Hemorrhage is also a result in particular cases.
- Sharp objects such as paper clips can cause tearing and perforating of the alimentary canal lining.
- Dirt contains bacteria or parasites, which cause serious toxoplasmosis, toxocariasis, and ascariasis infections in the body. Eventually, it leads to organ damage.
- Gastrointestinal tract may trap a mass of indigestible material called bezoar.
- Dental manifestations including severe tooth abrasion, erosion, and surface tooth loss.
The Handbook of Clinical Child Psychology encourages behavioural strategies as the most effective treatment approach for Pica. Mild aversion treatment therapy associates the pica behaviour with negative consequences or punishment. Further, through the use of positive reinforcement, patients are trained to consume edible foods.
Also, medicines may help reduce the abnormal eating behaviour. Further, few pieces of evidence suggest that drugs that enhance dopaminergic functioning, like olanzapine, provide treatment alternatives.
Due to the risk of medical complications, such as lead poisoning, close medical monitoring is necessary throughout treatment.
Surprisingly, there exists no specific way to prevent pica. However, careful attention towards eating habits and close supervision of children can help. Additionally, it catches the disorder before any further complications can occur.
MR. EAT-ALL: A CASE STUDY
Michel Lotito, a French entertainer, was popular for consciously consuming indigestible objects. He ingested some unusual items after breaking them into small pieces. Such as bicycles, shopping carts, televisions, chandeliers, beds, skis, aircraft Cessna 150, water bed, and coffin. Following this was drinking mineral oil, which would help in lubrication.
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