It is proposed that the pica behaviour is possibly a mechanism to compensate for a nutritional deficiency. Public Health Rep Wash DC 1974.1990 Feb;105(1):29–35. Copyright 2010-2012 South Sudan Medical Journal. This behaviour is linked to a condition called pica, where patients develop cravings for … Pica is only just starting to embed itself in the human conscious. Mohave County US. Instead, the diagnosis is made from a clinical history of the patient. In many cases, concerning eating behaviors disappear as deficiencies are corrected. Pica. She had no lower abdominal pain, per vaginal discharge, dyspareunia, or dysmenorrhea and did not use any contraceptives. A medical professional should assess if the behavior is sufficiently severe to warrant independent clinical attention (e.g., some people may eat nonfood items during pregnancy, but their doctor may determine that their actions do not indicate the need for separate clinical care). Pica is seen more in young children than adults. Thrombocytosis occurred only in women and was more prevalent in those with pica (20.4% vs. 8.3%; p = 0.0050). Introduction: Pica is a mysterious condition characterised by patients developing cravings for non- nutritive substances that may escalate into serious medical complications. In 1985, Shapiro and Linus described a 33-year-old woman with hypertension and history of dysfunctional uterine bleeding who experienced very similar salt cravings and was diagnosed with salt pica secondary to iron deficiency anemia [4]. Pica often occurs with other mental health disorders associated with impaired functioning (e.g., intellectual disability, autism spectrum disorder, schizophrenia). [cited2016 Oct 9]. Most physicians believe pica is an effect rather than a cause of iron deficiency [9]. J Med Case Reports. We are convinced that pica is an important pointer to iron deficiency and clinicians should suspect occult blood loss in a patient presenting with pica symptoms. Pica remains a challenging clinical condition despite being documented for centuries [5]. Both our patients responded well to managing the primary cause of blood loss and iron supplementation. Pica symptoms usually go unnoticed until a physician inquires explicitly about them or when the associated complications occur [4]. Dumaguing NI, Singh I, Sethi M, Devanand DP. Washington DC, London England: American Psychiatric Publishing; 2013. p. 329–31. It is thus crucial to inquire about pica especially in the presence of any form of bleeding, malignancies, and in cases of pregnancy, where the condition is not uncommon and if not properly managed, may put both the mother and the foetus at risk [16]. Although the condition has been documented since antiquity [5], many sufferers are diagnosed with life- threatening complications such as intestinal obstruction, electrolyte imbalances, renal and liver damage [4,6]. Because pica can occur in people who have poor nutrition, the health care provider may test blood levels of iron and zinc. The treatment continued for further two weeks by which time the Hb had risen to 11g/dl, and all the symptoms had subsided. There was a significantly higher prevalence of pica among patients homozygous for Hb S (Hb SS, sickle cell anemia) compared with the combined group of double heterozygous patients with Hb SC, Hb SD, and Hb Sβ thallasemia (Sβ + or Sβ 0) (35.6% vs 25.5%; P = .03). A 16-year-old school girl presented with a history of intermittent epistaxes. The eating of these substances must be developmentally inappropriate. Another idea is that eating clay or dirt helps relieve nausea, control diarrhoea, increase salivation, remove toxins and alter odour or taste perceptions during pregnancy [13]. 1992 Mar;160:341–54. The persistent eating, over a period of at least one month, of substances that are not food and do not provide nutritional value. Check the full list of possible causes and conditions now! Symptoms. A peripheral blood smear showed anisocytosis and pencil-shaped red blood cells. Alternatively, the behaviour may just be a preference and enjoyment of the taste and texture of the items being consumed [12]. The clinical presentation of pica is highly variable and is associated with the specific nature of the resulting medical conditions and the ingested substances. Iron-deficiency anemia and malnutrition are two of the most common causes of pica, followed by pregnancy. Conclusion: Despite being practised for centuries, the clinical significance of pica symptoms is often not recognised particularly among the younger physicians. Pica is typically defined as the persistent ingestion of non-nutritive substances for at least one month at an age when this behaviour is developmentally inappropriate. Diagnosing pica should be accompanied by tests for anemia, potential intestinal blockages, and toxic side effects of substances consumed (i.e., lead in paint, bacteria or parasites from dirt). Lead levels should always be checked in children who may have eaten paint or objects covered in lead paint dust to screen for lead poisoning. There are a few studies on serum trace element levels of patients with pica. It most likely is more prevalent in developing countries. Pica is an eating disorder. Lacey EP. List of causes of Pica and Anemia, alternative diagnoses, rare causes, misdiagnoses, patient stories, and much more. J Nutr. All patients met criteria for pica under the DSM-5 criteria [1] and they all responded well to treatment. Statistics & Research on Eating Disorders, Other Specified Feeding or Eating Disorder (OSFED), Avoidant Restrictive Food Intake Disorder (ARFID). Blood tests can also be done to test for anemia . Pica may be benign, or it may have life-threatening consequences [1]. Hb was 8g/dl. Pica in the geriatric mentally ill:  unrelenting and potentially fatal. There was no history of bleeding from the gums, easy bruising or familial bleeding disorders. A 25-year old female college graduate presented with a six-month history of abnormal uterine bleeding. Pica is the ingestion of nonfood items with wool sucking being a form of pica, in which the cat sucks on the material but may not ingest it. There are more sufferers than ever, it seems, but is that because more are being open about it or because there is an epidemic? Visit to know long meaning of PICA acronym and abbreviations. The pica ceased before the anemia was cor- rected. Iron Deficiency Anemia and Pica Iron deficiency anemia is the most common nutrient deficiency worldwide. 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