Overview
Whilst most people will have heard of eating disorders such as bulimia, anorexia and binge eating few people have heard of pica eating disorder, unless they have heard people referring to it, as the strange cravings that some women can get when they are pregnant.
Whilst it is not as commonly known, and it’s diagnosis is significantly different to that of other eating disorders it is still a mental health condition and can have a negative affect on their physical health and well-being.
Pica is an eating disorder where a person repeatedly craves and eats non-food substances that have little or no nutritional value, and in some instances they can actually be harmful or toxic especially if they are consumed either in large quantities or over an extended period of time.
People who have pica will often continue to eat a normal diet as well as eating the non-food item or variety of items that they crave.
The condition is common amongst children and people with cognitive or intellectual disabilities. It’s should not be confused with normal childhood development, as children have a tendency to put everything in their mouths and sometimes inadvertently swallow none food items.
For this reason, the condition is not diagnosed in children under three and has to have been present for well over a month.
It can also affect adults, male or female and the condition has links to other mental and physical health conditions.
The condition often goes undiagnosed unless physical symptoms occur which will depend on what it is they are eating, for instances items that are not harmful such as ice may not cause any problems.
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Potential causes for developing pica
Because pica often goes unreported unless it causes physical symptoms or is diagnosed alongside an existing physical or mental health related conditions, it’s not known how many people suffer from the condition. It also doesn’t help that some medical professionals and researchers have different criteria for its diagnosis.
There is no single known cause for developing pica but some scientists believe it could have links to the nervous system. It’s believed that environmental, biological and social factors can all contribute to its development, which can include:
· Cultural or learnt behaviours, some types of pica are believed to be acceptable in certain cultures and religions
· Stress and anxiety can be a trigger
· People suffering from vitamin and mineral deficiencies either due to a poor diet or living in poverty which can lead to them being malnourished
· Children who have suffered abuse or neglect
· Pregnant women who have low iron, calcium or zinc levels
· People who have had bariatric surgery and develop low levels of certain vitamins
Factors that could put you at higher risk of its development
You can be at higher risk of developing the condition if you have certain mental health conditions which can include:
· Autism spectrum disorder
· Depression
· Eating disorders
· Schizophrenia
· Developmental disorders
· Anxiety and stress
· Intellectual disabilities
· OCD (obsessive compulsive disorder)
· BFRB’s (body focused repetitive behaviours) including trichotillomania, hair pulling and dermatillomania, skin picking
Certain physical conditions can also result in the condition occurring such as:
· Sickle cell anaemia
· Certain medications
· Nutritional deficiencies
· Pregnancy
Associated health risks of having pica
Eating non-food items can have negative effect on a person’s health and can lead to serious health conditions which can require urgent medical intervention in some cases. Pica can cause:
· An irregular heart rhythm
· Damage to the mouth, gums and teeth
· A serious risk of chocking
· Electrolyte imbalances
· Constipation, diarrhoea or vomiting
· Anaemia caused by low iron levels other mineral and vitamin deficiencies
· Roundworm or other parasitic infections
· Stomach bleeding and ulcers
· Blockages or obstructions in either the small or large intestines
· Fatigue
· Lead poisoning
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Common types of non-food items people with pica can eat
People with pica can eat either only one, or several types of non-food items, some of these can cause them little or no harm and will result in no symptoms, whilst others can have a serious effect on their health and wellbeing and cause severe symptoms. Some of the types of things they might eat can include, but not be restricted to:
· Paper
· Dirt or soil
· Talcum powder
· Chalk
· Hair
· Paint chips
· Faeces
· Cloth
· Pet food
· Sand
· Ice
· String or thread
· Laundry products or starch
· Rubber bands
· Wool
· Eggshells
· Gum
· Pebbles and rocks
· Shampoo or soap
· Coffee grounds
· Small toys or toy parts
· Plants or grass
· Clay
· Cigarette butts
· Ash or charcoal
Diagnosing pica
Often people who have pica are too embarrassed to admit to other people that they eat non food items so rarely tell their doctor unless they develop health problems or their symptoms become severe.
There are no specific tests for pica so your doctor will initially ask you for a list of symptoms. The condition is not usually diagnosed in children under three years old, and symptoms have to have been present consistently for a period of at least a month.
Your doctor can run a variety of tests to account for your symptoms including:
· Blood, stool and urine tests to check for any infections, vitamin deficiency especially zinc or iron, anaemia, electrolyte imbalances, potential poisoning such as lead poisoning or intestinal bleeding
· X-rays, CT scans or MRI’s to rule out any internal blockages
· An ECG to check that there is no problem with your hearts electrical rhythm, which can occur with some electrolyte imbalances or parasitic infections
If they have ruled out any other mental or physical health condition that could be causing your symptoms, and to diagnose pica you need to meet the following criteria:
· In the cases of children, that their behaviour is not part of their normal development and is inappropriate for their age and developmental stage.
· That their desire to eat non-food items is not part of their cultural or religious beliefs and practices
· That they have been consistently ingesting non-food items for at least a month or more even when it is causing them to feel nauseous or ill
Treating Pica
How a person is treated for pica will depend on the severity of their symptoms and the underlying reasons for its development. The most common treatments can include:
· Vitamin and nutritional supplements for any resulting deficiencies
· Appropriate medications for diarrhoea and constipation
· Medications for fungal, bacterial or parasitic infections
· Treatment for stomach ulcers including medication and in extreme cases surgery
· Dental repair to any damage caused to the teeth or replacement of lost teeth
· Surgery for intestinal blockages
· Medication that helps to reduce the urge to eat non-food items
Your doctor could also refer you to other medical professionals to help manage the condition. Children often grow out of pica as they grow older and understand what food is and what non-food item are.
If they have developmental disorders they could benefit from being referred to a paediatrician who specialises in pica in children. Pregnant women will usually stop craving non-food items once they have given birth.
One of the main treatments for pica is therapy and a psychotherapist can use one or a combination of therapies to meet your specific needs. These could include:
· Behavioural therapies can help people to develop coping mechanisms as well as helping them change their negative behaviours
· Differential reinforcement teaches people how to avoid pica behaviours, it does this by getting them to focus on other activities and behaviours
· Mild aversion therapy, this type of therapy consists of teaching people to avoid pica behaviours by using mild aversions or consequences to teach them to avoid non-food items and by positively reinforcing or rewarding healthy eating behaviours
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Outlook for people with pica
Other than in children and pregnant women pica is considered to be an incurable condition. People that stop pica behaviours are considered to be in remission unless their behaviours return.
Most people can have the condition without it causing them serious health problems, and if they see their doctor or therapist to help them manage their symptoms they can ensure that it has a minimal effect on their lives.
Written by Jan, Jeana and Wendy at Barnsley Hypnosis and Counselling (UK). For more free Information click above link.
