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Pica Disorder - Causes, Symptoms, and Management

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Pica is an eating disorder where children put non-food items, like chalk or dirt, in their mouth. This article will further discuss its causes and management.

Medically reviewed by

Dr. Patel Bhavesh Ashokkumar

Published At September 15, 2022
Reviewed AtFebruary 21, 2023

What Is Pica?

Children are perpetually very curious about their surroundings from birth. They are, by nature, constantly exploring them with their developing senses. This phase of exploring continues throughout their childhood. Whether it is edible or non-edible items, it is very normal for them to put everything in their mouth. This phase is usually known as the “mouthing phase,” and it lasts from the age of six months till they turn two years old. Normally, they put dirt or mud into their mouths. Sometimes, the habit of eating mud persistently carries through the later years; in this situation, eating this kind of non-edible item is called “pica disorder.” Continuously eating these items can cause many health-related complications in children. Moreover, sometimes the children suffering from this disorder can have eating compulsions for relatively dangerous items such as pieces of metals or plastics. This habit can even choke the child and cause a life-threatening situation.

What Are the Substances Children With Pica Eat?

Children suffering from pica disorder have a habit of eating substances such as:

  • Clothes.

  • Dirt.

  • Clay.

  • Paint.

  • Pieces of plastic.

  • Pieces of metal.

  • Cigarette ashes.

  • Coffee grounds.

  • Ice.

  • Hair.

  • Talcum powder.

  • Soap.

  • Toothpaste.

  • Paper.

  • Pebbles.

  • Shampoo.

  • Rubber bands.

  • Small objects or toys.

What Are the Causes of Pica?

There are some etiological factors that suggest that the children with these factors may or may not have the pica disorder, such as:

  • Malnutrition.

  • Nutrition deficiency of zinc, calcium, or iron.

  • Neglect or abuse.

  • Developmental defects such as autism or intellectual defects.

  • Psychological disorders such as obsessive-compulsive disorder.

  • The poverty that triggers stress-induced pica in children.

  • The oral fixations, where the child has a constant urge to put things in the mouth.

What Are the Signs and Symptoms of Pica?

The symptoms related to this disorder solely depend on the consumption of non-food items in children. For instance:

  • Upset Stomach: As the soil may contain many toxins, eating it may cause many health-related issues such as upset stomach and stomach ache in children.

  • Blood in the Feces or Urination: Due to ulcer formation by eating non-food items.

  • Bowel-Related Problems: Such as diarrhea or constipation.

  • Food Poisoning: When a child eats anything that is found on the ground, there are chances of getting food poisoning too.

  • Lead Poisoning: Eating paint chips or other objects or materials that contain lead can cause lead poisoning.

  • Internal Organ Injuries: If the child eats and gulps any small and hard or sharp objects, there are chances of intestinal blockage or tear.

  • Injuries to Teeth: Chewing or biting on hard objects such as pebbles or metal can cause serious injuries to the teeth.

  • Infections: When the child is eating anything and everything, there are chances of him getting a parasite infection in the body causing many health issues.

How to Diagnose Pica?

There are no particular tests for diagnosing the condition. Although, the doctors follow the signs and other symptoms to follow the diagnosis. However, for accurate diagnosis, the parents or caregivers should be very honest with the doctors about the eating habits of their children. Sometimes it is hard for doctors to determine if the child has this disorder, especially if the child has an intellectual disability.

To commence with the diagnosis, the doctor will look for physical complaints such as stomach ache or bowel dysfunction. Secondly, the doctor will proceed by asking about the medical history of the parents to know the details about psychological development and any behavioral changes. If the child shows any concerning signs, the doctor goes with the next step. They proceed with the blood test to determine the nutrition level of the children. It reveals whether the child is deficient in iron, calcium, or zinc. Additionally, radiographic imaging can reveal any foreign objects eaten by a child. It also reveals if that object has caused any damage to the internal organs or not.

These are the steps that doctors usually follow to diagnose this disorder and any complications related to it.

What Are the Complications Associated With Pica?

Eating dirt comes with many internal health-related complications such as:

  • Mineral Deficiency: When a child eats clay or dirt, the process of absorption of iron is slowed down. Moreover, the effect of eating soil can cause iron and zinc deficiencies in the body.

  • Soil Toxicity: The soil may contain bacteria, parasites, human wastes, or heavy metals in it. Eating soil means consuming all of these toxic substances as well, which can cause many health-related issues.

  • Ascariasis: Ascarid worms are a parasite that resides in the soil. When a child eats soil, this parasite can cause problems such as intestinal blockage and other complications.

  • Gastrointestinal Complications: Due to soil and its toxic substances, there are chances of gastric complications such as ulcerations and constipation.

  • Mouth Injury: Sometimes, a child eats sharp objects by mistake, and that can cause mouth injuries.

How to Manage Pica?

When parents see the aforementioned signs, it is best to see a doctor immediately. The doctors check for any physical abnormalities before going further with the diagnosis. Although there are no direct treatments for pica disorder, doctors can start by approaching the complications associated with it. These approaches are:

  • Nutritional Intervention: In most cases, deficiencies are associated with the disorder. Solving this problem and giving dietary supplements can solve this issue.

  • Psychological Intervention: In many cases where a child is addicted to the behavior of eating soil or chewing on some objects, psychological intervention (psychological therapy) is required to remove this addiction.

  • Pharmacological Intervention: If the child is intellectually changed, this line of treatment can help to manage the compulsion to eat soil.

  • Behavioral Intervention: Usually, the child with developmental disabilities, this treatment is used with the help of a psychologist to reduce the addiction to eating dirt or soil.

  • Sensory Intervention: Finding and giving a replacement option for the non-food items can also solve this issue.

Conclusion

Pica is a disorder that resolves with increased age in children. However, if the addiction is too much and it is affecting the health of a child, it is better to seek medical care. Because of the addiction to chewing any object, sometimes this can lead to life-threatening situations and even death. Parents should keep their household very clean to prevent the children from eating or chewing objects or dirt.

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Dr. Patel Bhavesh Ashokkumar
Dr. Patel Bhavesh Ashokkumar

Pediatrics

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