Pica can commonly occur with pregnancy, but the disorder may also arise outside this nine-month period. Characteristic symptoms of pica, a type of eating disorder, include the consumption of items that aren’t food — such as ice, paper or chalk. If you’ve heard of pica or wonder why you’ve experienced strange cravings for non-edible items, this comprehensive guide provides details about the causes of pica, pica symptoms, treatments and associated concerns.
What Is Pica Disorder?
Pica occurs when someone eats items that aren’t meant to be consumed, most commonly clay, dirt or paint flakes. Other non-food items often associated with pica include human waste, chalk, glue, cigarette butts or ashes, sand, dirt, hair, buttons, metal fragments, baby powder, charcoal, eggshells, pebbles, pet food, soap or ice. People who have pica experience a compulsion, which means they crave the item they consume and can’t stop themselves from eating it. Children who have pica may also display behavioral problems at home and school.
Pica disorder more commonly affects children younger than 6 rather than adults. However, it’s also common during pregnancy and among people with schizophrenia, obsessive-compulsive disorder, autism spectrum disorder (ASD) and other developmental disorders. A study published in the journal Pediatrics found a pica rate of more than 23% among participants with ASD as compared to 8.4% in a group with other developmental disorders and 3.5% in children with no noted developmental disorders.
Doctors aren’t sure what causes pica, but some research suggests it results from a zinc or iron deficiency. Children sometimes grow out of this compulsive behavior as they get older. Kids who have autism spectrum disorder may struggle to tell the difference between food and non-food items. They may also enjoy the sensory experience of consuming the items.
Pica can be a culturally accepted behavior in some parts of the world. For example, the Cleveland Clinic reports that some religious sects and communities consume dirt or clay.
What Are the Tell-Tale Signs of Pica Disorder?
It’s evident that someone has pica disorder when they consume non-food items and display behavior like chewing paper, so many people self-diagnose with this condition before they see a doctor. Depending on the items they eat, people with pica can have diverse symptoms. They may experience stomach pain, vomiting, nausea, constipation, diarrhea or blood in the stool caused by an internal laceration.
People who rely on extreme diets to lose weight are more likely to develop pica. They may also display signs of malnourishment, such as feeling cold, limited concentration, non-healing wounds, weakness, lack of immunity, weakness, fatigue, and lack of interest in eating and drinking.
Severe stress can also cause symptoms of pica, especially in children. It’s especially noted in children who have experienced poverty, abuse or neglect. Pica may occur in conjunction with other compulsive disorders such as skin picking and hair pulling.
What Does It Feel Like to Have Pica Disorder?
Pica is a compulsive disorder, which means someone who has it can’t control their urge to eat the non-food item even when they try very hard to stop. While pica isn’t inherently dangerous, it can cause health complications. Hard substances such as ice damage the teeth, increasing the risk of cavities and gum disease.
Some people who have pica consume clay or dirt, which can cause them to contract bacterial illness and parasites. For example, roundworm infection can be found with a pica diagnosis.
Some consumed materials, like hair, can cause damage to the internal organs when swallowed. Choking is also a serious health concern, particularly for parents when children have pica. Pica may lead to electrolyte imbalance, which can cause seizures in severe cases.
Many people who have pica hesitate to seek help for this condition. They may feel embarrassed about their behavior, or they may not even realize it poses health concerns.
What Is the Treatment for Pica?
Health care providers specializing in treating pica will determine the right course of action when someone displays these symptoms. The doctor will review any physical symptoms associated with your non-food consumption and ask you how long you’ve been experiencing the compulsive urge to eat the non-food item. They may also run X-rays and blood tests to look for intestinal blockages, signs of infection and nutritional deficiencies such as lack of zinc or iron. Generally, symptoms that last at least four weeks constitute pica.
The approach for treating pica depends on the underlying cause of the illness and the resulting health complications. The provider will address issues like ulcers, infection and digestion concerns. For example, people who develop lead poisoning must have chelation therapy, which involves consuming a medication that carries the lead out of the body. They may also prescribe a special diet or supplement if your pica results from a vitamin deficiency.
Referral to a mental health specialist is necessary when mental health concerns contribute to compulsive behavior. A pediatric mental health specialist may be recommended for children. Adults who have pica can potentially benefit from seeing a psychologist or psychiatrist who specializes in applied behavior analysis, a technique to target and address behavior that you want to change.
Differential reinforcement, another effective treatment methodology for pica, involves replacing unwanted behavior with desirable behaviors and activities. Some people see success with aversion therapy, which focuses on rewards for the intended behavior and consequences for the unwanted actions (in this case, consuming non-food items).
Does Pica Need Lifetime Management or Can it Be ‘Cured’?
If you or a family member shows signs of pica, it’s important to seek treatment from a professional health care provider. Although some cases resolve without medical care (especially in children), the condition can create serious health complications without medical attention. Most people with pica respond well to treatment and find the behavior resolves after a few months of medical care. However, some people develop chronic compulsive pica and may require ongoing mental and physical health care to keep symptoms under control.