Pica: This Rare Eating Disorder Make Children Crave Non-Food Items Like Clay, Paper, Dirt

Pica in children is often associated with iron and other mineral shortages. It is a worrisome condition as these deficiencies can lead to slowed growth and cognitive issues.

Usually, young children put things in their mouths, including non-food items like grass or toys. While it’s fairly normal as they’re curious about the world around them, in some cases, the habit may indicate serious problem. If your child compulsively eats things that aren’t food, and if this behaviour continues for long, it is likely that s/he is suffering from Pica, a rare eating disorder.

Let’s learn more about this eating disorder from Dr. N. Balamurugan, Consultant Pediatric Neurology, Rainbow Children’s Hospital, Marathahalli, Bangalore.

Who are prone to developing pica?

Pica is a compulsive eating disorder that involves repeatedly and persistently consuming non-food items like chalk, clay, paper, dirt, soap, soil, paste, poop, ash, cloth, paint, ice, pebbles, hair, and more. This condition is often observed in children, pregnant women, individuals undergoing dialysis, and some individuals who have mental health issues such as schizophrenia, autism spectrum disorder, or intellectual disability.

Signs and symptoms that indicate a child has pica?

The main symptom of pica is compulsively eating things that aren’t food or have no nutritional value. The majority crave for a single type of non-food item they eat, and they find it hard to control the urge on their own.

Health risk associated with pica

Pica can have a diverse range of effects depending on what non-food substance(s) a person is eating. Sometimes, it can be harmless but sometimes it can be dangerous when they consume a sharp item, or toxic item, or a dangerous substance. Sometimes, the items that are consumed can cause infection, worm infestation, lead toxicity, and sometimes even block the intestine (especially when someone consumes hair) or rarely even perforate it.

In some people especially in children, pica could be a coping response to deal with situations of stress, anxiety, abuse, or neglect. People with pica are significantly associated with an increased risk of anemia, iron deficiency, zinc deficiency, electrolyte imbalance, and constipation and hence it is important for one to get evaluated by a doctor.

One must also look for any features of autism spectrum disorder, intellectual or learning difficulties, and behavioral problems in people with pica and they must consult a doctor if there is any concern. People with pica can sometimes have mental health effects and they often feel embarrassed about it to share, and they do not seek help or medical attention. It is important for the family members to identify to seek medical attention.

Can pica be cured? How is it treated?

The majority of the time, it is curable. In developmentally normal children and pregnant women, it is usually harmless, and it is not dangerous unless a dangerous item has been consumed. They stop it gradually and they grow out of it on their own usually when we explain and educate them on the hazards and the difference between edible and non-edible things. Keeping dangerous substances out of reach of children and supervision is essential.

For persistent or recurrent pica, treatment includes modification to lifestyle and circumstances along with behavioral therapy. Detailed medical and psychological assessment by a doctor is required in those with persistent or recurrent pica to identify medical complications and any possible contributing factors. If present, medical complications must be properly treated. If a contributing factor (for example, iron deficiency anemia) is identified, addressing the factor (iron supplements) may often lead to the resolution of pica. Even in those with recurrent or persistent pica, it is usually treatable with proper behavioral therapy and they go into remission. Though it can relapse again in a few, people can live their lives happily without difficulty from it with the right medical advice.