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Jessica Holttum and Jordan Standlee Present:. Pica. 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
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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 low-income 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
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 • 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, PratibhaSinghi, 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 • 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, ElmarSaathoff, Gretchen Antelman, GernardMasmanga, 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, HolgerStunitz, Michael Decker, EdouardBattegay, 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