This behaviour is linked to a condition called pica, where patients develop cravings for … 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 can also occur during pregnancy. Abdominal ultrasound and stool analysis was done from a collection of a freshly voided stool which was then processed using direct technique (saline and iodine mounts) to identify intestinal parasites about which all the findings were all unremarkable. You can call our confidential Helpline Monday-Thursday from 11am to 9pm ET, and Friday from 11am to 5pm ET. J Geriatr Psychiatry Neurol. Sodium chloride pica is a very rare form of pica [4]. It may be diagnosed if you constantly eat nonfood items for at least 1 month. In these cases, eating non-food items can lead the sufferer to feel full. Looking for the definition of PICA? The definition is occasionally broadened to include the chewing non-nutritive substances. Those who are pregnant and craving nonfood items should only be diagnosed with pica when their cravings lead to ingesting nonfood items, and the ingestion of those items poses a potential medical risk (either due to the quantity or type of item being ingested). Treating this deficiency with medication or vitamins often resolves the problems. In some cases, a deficiency in iron, zinc, or another nutrient may be associated with pica. Clotting time was 5 minutes under simplate II technique skin bleeding. There are no laboratory tests for pica. Iron deficiency is usually considered a symptom rather than a cause. A peripheral blood smear showed anisocytosis and pencil-shaped red blood cells. Iron-deficiency anemia and malnutrition are two of the most common causes of pica, followed by pregnancy. Her pica symptoms and anemia resolved fol- They may include paper, soap, cloth, hair, string, wool, soil, chalk, talcum powder, paint, gum, metal, pebbles, charcoal, ash, clay, starch, or ice. Within genotype, mean Hb levels were significantly lower and reticulocyte counts were significantly higher in the patients with pica. 1992 Mar;160:341–54. Alternatively, the behaviour may just be a preference and enjoyment of the taste and texture of the items being consumed [12]. The literature contains contracting data on the levels of oxidative stress and antioxidant levels in patients with iron-deficiency anemia (IDA). It most likely is more prevalent in developing countries. There was no history of bleeding from the gums, easy bruising or familial bleeding disorders. 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]. A 34-year-old woman presented with iron deficiency anaemia refractory to treatment for more than a decade. The pattern of menstrual bleeding was irregular, prolonged with up to 14 days period between cycles. A craving to constantly chew on non-food or non-nutritive substances can be a sign of an eating disorder called pica. Whenever the underlying cause for pica is related to some mineral or vitamin deficiency, it is very important to include food items rich with that particular mineral or vitamin in the daily diet as directed by the nutrition advisor. The treatment continued for further two weeks by which time the Hb had risen to 11g/dl, and all the symptoms had subsided. Am J Med. Introduction: Pica is a mysterious condition characterised by patients developing cravings for non- nutritive substances that may escalate into serious medical complications.We present two case reports with a somewhat unusual nature of presentation attributed to iron deficiency. 2008 Jul1;121(7):e1. Conclusion: The medical practice is full of challenges and complexity; and clinicians need to be vigilant all the time in their practice to appreciate unusual and rare manifestations of common clinical conditions like IDA and CD. Pica symptoms usually go unnoticed until a physician inquires explicitly about them or when the associated complications occur [4]. Acknowledgments: We acknowledge the staff of Paradise specialised clinic for their support. Dumaguing NI, Singh I, Sethi M, Devanand DP. Pica has been practiced for centuries without a clear etiology. Download full-text PDF ... parameters diagnostic for iron deficiency anemia. Culture, Diet, and Nutrition: Selected Themes and Topics. All rights reserved. Disclaimer, Author(s): Azan A Nyundo (a), Godfrey Mwasada (b), Bonaventura C.T Mpondo (c). Pagophagia is a form of pica that involves craving and compulsively consuming ice. We describe two patients who presented with a habit of ingesting non-nutritive substances which was associated with iron deficiency and blood loss. 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. Pica, the ingestion of substances that are inappropriate for consumption, is associated with iron deficiency and may be under-diagnosed. It is unclear how many people are affected by pica. It is one of the best place for finding expanded names. Visit to know long meaning of PICA acronym and abbreviations. She was discharged on etamsylate tabs and haematinics containing iron and vitamin C. Follow-up two weeks later she was no longer complaining of bleeding, but she was still chewing rubber bands. Both presented with haematological parameters diagnostic of iron deficiency anaemia. Scientists in the autism community have developed several different effective interventions, including redirecting the person’s attention away from the desired object and rewarding them for discarding or setting down the non-food item. Typical substances ingested tend to vary with age and availability. Examination showed that she was pale with active bleeding from the nose. Introduction: Pica is a mysterious condition characterised by patients developing cravings for non- nutritive substances that may escalate into serious medical complications. Treating this deficiency with medication or vitamins often resolves the problems. It is the link between iron deficiency anemia and … Iron deficiency occurs when the levels of hemoglobin carried by the red blood cells are decreased. Mean total iron-binding capacity was higher and mean serum ferritin was lower in patients with pica. 2003 Sep 1;16(3):189–91. A high sodium diet increases risk for nephrolithiasis. Pica in the geriatric mentally ill:  unrelenting and potentially fatal. One study used a definition of anemia in children age 1–14 years as Hb <2 standard deviations below the mean, serum iron <9 ng/mL, or transferrin saturation under 12% (Ece et al. Pica. J Nutr. 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. Anemia is defined as a decrease in hemoglobin or hematocrit levels below the 2.5th percentile for age, race, and sex. The consumption of dirt, clay, and chalk for the nutritional value that they might contain is called geophagy (1). Talk … List of causes of Pica and Anemia, alternative diagnoses, rare causes, misdiagnoses, patient stories, and much more. Even if you don’t have full-blown iron deficiency anemia, ... cause you to crave non-food items like paper, ice, dirt, chalk or clay! 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]. Parry-Jones B, Parry-Jones WL. Check the full list of possible causes and conditions now! Washington DC, London England: American Psychiatric Publishing; 2013. p. 329–31. This is seen as bizarre eating disorder, and many are now asking questions about the causes, the symptoms and, eventually, the treatment. 2010;4:86. 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]. This practice is prevalent among pregnant women, and in some communities might reach up to 60% of the population (1). Khoushabi F, Ahmadi P, Shadan MR, Heydari A, Miri A, Jamnejad M. Pica practices among pregnant women are associated with lower hemoglobin levels and pregnancy outcome. The second is 15- year old African girl who presented with bleeding from the nose, habitual smelling of soil, consuming ice packs and chewing rubber bands. It is commonly associated with other pica cravings [4-6], and has been mostly reported with iron and/or calcium deficiency [7-11] and thus, responds to treatment of underlying deficiency without any other intervention.In the present case, there was no other pica craving or iron and calcium deficiency. An unusual but completely reversible form of pica in the form obsessive compulsive sponge eating (pervasive disorder) was reported as an odd manifestation of IDA and CD. Pica is defined as developmentally inappropriate consumption of nonnutritive substances for at least 1 month. It might also be a sign that something in your body is out of balance. Nineteen patients developed a second episode of iron deficiency or depletion; concordance of recurrent pica (or absence of pica) was 95%. Pica is only just starting to embed itself in the human conscious. Generally, those with pica are not averse to ingesting food. All vital signs were stable. Talk to our Chatbot to narrow down your search. In these individuals, pica is a sign that the body is trying to correct a significant nutrient deficiency. 2005Feb;118(2):185–8. We present two case reports with a somewhat unusual nature of presentation attributed to iron deficiency. Sugita K. Pica :pathogenesis and therapeutic approach.Nihon RinshoJpn J ClinMed. In: Diagnostic and statistical manual of mental disorders.5th edition. Dieting and malnourishment can both lead to pica. Am J Med. Iron-deficiency anemia and malnutrition are two of the most common causes of pica, followed by pregnancy. World J Biol Psychiatry.2009 Jan 1;10(4–3):936–8. Mouthing may sometimes result in ingestion. Pica is an eating disorder that involves eating items that are not typically thought of as food and that do not contain significant nutritional value, such as hair, dirt, and paint chips. 1994 Jun;124(6 Suppl):954S–962S. The condition is often associated with iron deficiency with the majority of cases responding well to iron replacement [9]. Interestingly, though, for our cases, the pica behaviour was noticed by caretakers who thought the behaviour had a medical significance and sought medical attention. A lesson on pica. Most physicians believe pica is an effect rather than a cause of iron deficiency [9]. 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). In many cases, concerning eating behaviors disappear as deficiencies are corrected. Coltman described a form of pica, compulsive ice eat- ing, that he called pagophagia.4 In double-blind studies, he found that iron-deficient ice eaters lost their craving for ice approximately 2 weeks after iron supplemen- tation. Learn more about eating disorders statistics >. Lacey EP. The first is a 25-year old African woman with abnormal uterine bleeding presenting with a fondness for eating clay, cold drinks, and icepacks. It is unclear how many children with pica intentionally consume dirt (geophagy). Broadening the perspective of pica: literature review. Both our patients responded well to managing the primary cause of blood loss and iron supplementation. Pagophagia can occur alongside nutrient deficiencies, such as iron deficiency anemia, although it … On arrival she had profuse bleeding that required etamsylate injection and adrenaline nasal pack. Khan Y, Tisman G. Pica in iron deficiency: a case series. Pica in an urban environment. Grivetti LE. Pagophagia, or ice eating, is one of the most common forms of pica and is closely associated with the development of iron-deficiency anemia. The prevalence and type of pica depend on ethnic and cultural factors that affect dietary practices . Get PICA full form and full name in details. However the nature of some of the ingested items such as ice, rubber, or dirt lack any nutritional value [12]. Open J ObstetGynecol.2014 Aug 5;04(11):646. Because pica can occur in people who have poor nutrition, the health care provider may test blood levels of iron and zinc. Pica is an eating disorder. 2001Mar;59(3):561–5. The soil can be prepared by baking or frying, and the amount of dirt ingested ranges from 20-40g, and can range from consuming pieces of pottery, or eating beans that have a high concentration of dirt found in them (1). Anemia, especially iron-deficiency anemia, is one of the known causes for this eating disorder. 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