Jessica Holttum and Jordan Standlee Present:
What Is Pica?

Definition: the persistent craving and
compulsive eating of nonfood
substances
 Chalk, ice, metal, soil, sponges, soap, paint
Seen especially in children and pregnant
women
 Seen cross-culturally, though most
common in developing countries

 Also areas of low socioeconomic status
What Is Pica?
Image: http://en.wikipedia.org/wiki/File:Glore_Stomach_Display.jpg
What Is Pica?
Name comes from genus name of
magpie
 Very old!

 Romans, Greeks,
Mesopotamians
Pica pica
Image: http://en.wikipedia.org/wiki/File:Pica_pica.jpg
Significance

Fairly common for such an odd disease
 10-32% of children 1-6 years old
Most-affected groups are at high risk for
health problems
 Cause unknown, so treatment difficult

 Physiological or psychological?

Possible evolutionary implications
Gastrointestinal Consequences

Blockages
 “Bezoars”
 Usually caused by eating hair, fibers

Tears and Ruptures
 Leads to internal hemorrhage
 Result of eating nails, other pointed objects
Illness & Infection

Contaminated soil
 E. coli, tetanus,
anthrax
 Also poisoning from
pesticides, other
chemicals

Unclean objects in
mouth
 Coins, nails, sponges
Image: universityofcalifornia.edu
Poisoning

Lead poisoning
common
 Especially in
children who
ingest paint chips
 Prominent in lowincome areas

Potassium toxicity
 Caused by
ingesting burnt
matches
Image: findmeacure.com
Inducible in Animals

Experiment 1: rats given chemotherapy,
variable access to clay
 Those who ate clay were less physically
affected
Inducible in Animals
Image: “Pica as an adaptive
response…” – De Jonghe et al.
Inducible in Animals
Image: “Pica as an adaptive
response…” – De Jonghe et al.
Inducible in Animals

Experiment 2: some rats given motion
sickness, all received clay access
 “Sick” rats ate more clay, less food
Inducible in Animals
Image:"Motion sickness induced pica in
the rat” –Mitchell et al.
Detoxifying Effects

Native American
acorn bread
 Clay absorbs toxic
tannins

Study of inner-city
mothers
 Pica = lower levels of
illicit drugs
Image: mrssurvival.com
Detoxifying Effects
Image: “Pica in an Urban Environment”
–Edwards et al.
Underlying Conditions

Anemia
 Iron deficiency
 Correlated with pica
○ Especially metal or ice cravings
 Can be symptomatic of liver/kidney failure
 Iron replacement therapy often stops pica

Other mineral deficiencies
 Zinc
Underlying Conditions
Conclusion

In the past…
 Yes
○ Good way to self-treat nutrient deficiencies,
combat toxins

In the present…
 Somewhat
○ Can easily be replaced by supplements
○ Valuable as indicator of dietary issues
○ Can cause problems, must be able to stop
References
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http://medical-dictionary.thefreedictionary.com/pica
De Jonghe, Brian C., Maureen P. Lawler, Charles C. Horn, and Michael G. Tordoff. "Pica as an
adaptive response: Kaolin consumption helps rats recover from chemotherapy-induced
illness." Physiology & Behavior 97.1 (2009): n. pag. Web. 21 Apr 2011.
Parry-Jones, B, and WL Parry-Jones. "Pica: symptom or eating disorder? A historical
assessment."British Journal of Psychiatry 160. (1992): 341-354. Web. 21 Apr 2011.
Rose, E. A., J. H. Porcerelli, and A. V. Neale. "Pica: Common but commonly missed." Journal of
the American Board of Family Practice 13.5 (2000): 353-358. Web. 21 Apr 2011.
Singhi, Sunit, R. Ravishanker, Pratibha Singhi, and R. Nath. "Low plasma zinc and iron in
pica." Indian Journal of Pediatrics 70.2 (2003): 139-143. Web. 21 Apr 2011.
Johns, Timothy, and Martin Duquette. "Detoxification and mineral supplementation as functions
of geophagy." American Journal of Clinical Nutrition53.2 (1991): 448-56. Web. 21 Apr 2011.
Mitchell, Denis, J.D. Laycock, and William F. Stephens. "Motion sickness induced pica in the
rat." American Journal of Clinical Nutrition 30. (1977): 147-50. Web. 21 Apr 2011.
Adler, Amanda I., and Adam Olscamp. " Toxic 'Sock' Syndrome Bezoar Formation and
Pancreatitis Associated With Iron Deficiency and Pica." Western Journal of Medicine 163.5
(1995): 480-82. Web. 21 Apr 2011.
http://www.nlm.nih.gov/medlineplus/ency/article/001538.htm
http://en.wikipedia.org/wiki/Pica_(disorder)
http://emedicine.medscape.com/article/914765-overview
References
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Johnson, Bruce E. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston:
Butterworths, 1990. Chapter 148. eBook.
Barton, James C., J. Clayborn Barton, and Luigi F. Bertoli. "Pica associated with iron deficiency or depletion:
clinical and laboratory correlates in 262 non-pregnant adult outpatients." BMC Blood Disorders 10.9 (2010): n.
pag. Web. 21 Apr 2011.
Kahn, Yasir, and Glenn Tisman. "Pica in iron deficiency: a case series." Journal of Medical Case Reports 4.
(2010): n. pag. Web. 21 Apr 2011.
Kawai, Kosuke, Elmar Saathoff, Gretchen Antelman, Gernard Masmanga, and Wafaie W. Fawzi. "Geophagy
(Soil-eating) in Relation to Anemia and Helminth Infection among HIV–Infected Pregnant Women in
Tanzania." American Journal of Tropical Medicine and Hygiene 80.1 (2009): 36-43. Web. 21 Apr 2011.
Young, Sera L., M. Jeffrey Wilson, Dennis Miller, and Stephen Hillier. "Toward a Comprehensive Approach to
the Collection and Analysis of Pica Substances, with Emphasis on Geophagic Materials." PLoS one 3.9 (2008):
n. pag. Web. 21 Apr 2011.
Lynch, Kristin A., Peter G. Feola, and Elisabeth Guenther. "Gastric Trichobezoar: An Important Cause of
Abdominal Pain Presenting to the Pediatric Emergency Department." Pediatric Emergency Care 19.5 (2003):
343-47. Web. 21 Apr 2011.
Hackworth, Samuel R., and Laura L. Williams. "Pica for Foam Rubber in Patients With Sickle Cell Disease:
Case Reports." Southern Medical Journal96.1 (2003): n. pag. Web. 21 Apr 2011.
Kinnell, H. G. "Pica as a feature of autism."British Journal of Psychiatry 147.1 (1985): 80-82. Web. 21 Apr
2011.
Edwards, Cecile H., Allan A. Johnson, Enid M. Knight, Ura Jean Oyemade, O. Jackson Cole, et al. "Pica in an
Urban Environment." Journal of Nutrition 124. (1994): 954S-962S. Web. 21 Apr 2011.
Von Garnier, Cristophe, Holger Stunitz, Michael Decker, Edouard Battegay, and Andreas Zeller. "Pica and
refractory iron deficiency anaemia: a case report." Journal of Medical Case Reports 2.234 (2008): n. pag. Web.
21 Apr 2011.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1951586/pdf/pubhealthreporig00017-0091.pdf
http://www.dhpe.org/infect/Anthrax.html
http://www.ehow.com/about_6729187_harmful-bacteria-soil.html