What are signs of pica?

People who suffer from a strange disease known as pica will eat practically anything – dirt, paper, ice, or crunchy food. Recent research indicates the problem may simply be a lack of iron.

Not long ago one of Australia’s oddest surgical cases was reported in the medical journals.

It related to a 31-year-old Victorian woman who had suffered from the strange disease clinically known as pica.

Her daily diet included five to 10 tissues, half a page of a newspaper, and an occasional page from an exercise book or some blotting paper.

By the age of 15 paper was an established part of her diet.

At 17, working in an office, her predilection for blotting paper was still strong, but she started consuming petty cash vouchers as well.

Then she nursed for three years and felt it was undignified to munch paper all day. But when she married she again took up the habit despite her husband’s protests.

Medical intervention became necessary many years later, and the surgeons removed from her large bowel a mass of paper weighing almost 700 grams! The bowel had been perforated, but the hole was plugged by the mass of paper.

The patient survived this serious intestinal obstruction and apparently is now back to reasonable health.

But for every pica case that receives surgical attention many more persist in a quiet manner. Many doctors are probably unaware of the syndrome and most people have probably never heard of it.

Pica seems to be a worldwide problem and one that doctors are only now being made aware of.

The Journal of the American Medical Association (JAMA) published a series of articles about pica for the benefit of the 100,000 doctors who read the magazine.

Eating small pieces of paper or various other objects may or may not be harmful but, as JAMA pointed out, eating the printed word could be very serious.

The ink on the page of a black and white magazine may contain as much as eight parts per million of lead. With colored pages this may escalate up to 3600 parts per million.

Lead is a known poison, and one of its many sinister side effects is to produce various degrees of mental retardation.

The range of items eaten by the pica patient is little short of incredible.

An American doctor named C. A. Coltman discovered some of his patients were devouring large quantities of ice. He termed this pagophagia, but really it is a form of pica.

Some of his patients were eating as much as 9000 grams of ice a day! One patient wore out two sets of dentures before being cured.

The craving for ice was totally irrational, and the patients seemed quite normal in every other respect.

Other people have food pica. Often the individual will compulsively eat one particular type of food. Recorded cases involve celery, potato chips, carrots, peanut butter, sunflower seeds, parsley, soda crackers, pickles, orange juice, chocolate ice-cream, lettuce, mints, chewing gum, and pretzels.

Often the food is brittle in nature, and gives a crunching sensation when ground between the teeth.

Some doctors interested in treating obesity are wondering if their patients are compulsive eaters or if they are in fact suffering from pica.

Unfortunately, many pica patients are regarded as psychiatric misfits who should be treated with tranquilizers and sedatives. Such therapy is totally useless.

The patient is usually humiliated by the habit, finds it difficult to stop, and is reluctant to discuss the problem with family, friends, or the doctor.

The family concerned can also be ashamed and prefer not to discuss the matter.

Often the person who is habitually at the refrigerator seeking ice or a favorite food is not really hungry but could be a pica sufferer. This habit can lead to a quick, accurate diagnosis of the problem.

Dr. William Crosby, an expert on this topic who researches and practices at the Scripps Clinic and Research Foundation in La Jolla, California, says: “Pica turns out to be a common complication of iron deficiency. In my recent experience, more than 50 percent of patients with iron deficiency have pica of one kind or another.”

“About half of them eat ice. The other half have food pica. It is a disorder of iron metabolism. These people are not neurotic. The cause has often been attributed to neurosis, mental aberration, starvation, and social pressure. The relationship to iron deficiency has only been noted recently.”

So, if pica is a problem in your family do not despair. Treatment is terribly simple and symptoms have been known to disappear within a few weeks of beginning a course of iron tablets.

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