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When a person habitually eats or mouths something that is not food, he/she is said to have a condition called pica. This is classified as an eating disorder common to children and some pregnant women but in some people, pica is a manifestation of a coexisting mental disorder such as mental retardation or schizophrenia.

Among the non-food substances ingested by children and adults who have pica are ice, clay, dirt, pebbles, stones, sand, hair, fingernails, feces, laundry starch, plastic, vinyl gloves, pencil erasers, paper, lead, plaster, paint chips, chalk, coal, wood, light bulbs, string, wire, needles, burnt matches, and cigarette butts. It is more common for infants and young children to ingest plaster, paint, string, cloth, and hair. Older children ingest sand, animal droppings, insects, pebbles, cigarette butts, and leaves while teens and adults ingest soil or clay.

The cause of pica is not known, but studies show that it is associated with nutritional deficiencies, low socioeconomic status, cultural factors, and mental disorders. Nutritional deficiencies that have been linked with pica include iron, calcium and zinc deficiency. People who live in underdeveloped areas are more likely to develop pica than those who live in developed areas.

Although pica can resolve spontaneously without treatment in young children or pregnant women, it may persist for long periods in other people. It may be a serious problem because it can lead to a significant medical complication such as lead poisoning, excessive potassium blood levels (hyperkalemia), and intestinal parasitism. There is also a danger of gastrointestinal tract complications from mechanical bowel obstruction, perforation of the bowels, ulceration, and constipation. Other side effects include nutritional deficiencies or excessive calorie intake (from starch). Dental injury is also a common complication of pica.

One of the most serious consequences of pica is lead toxicity, which can further lead to neurologic, hematologic, cardiovascular, renal, and endocrine effects. Lead poisoning can damage the brain, resulting in encephalopathy, which presents as headache, seizures, coma, vomiting, and respiratory arrest. However, studies show that even low levels of lead poisoning can cause intellectual impairment, learning, and behavioral problems.

Treatment and Prevention

The treatment of pica mostly involves behavioral and psychological interventions towards improvement of diet and behavior. However, there is no standard treatment or pharmacological management, so patients must be treated individually. Health problems and complications must be addressed immediately, including any signs of poisoning, infection, gastrointestinal and dental problems.

Although it is not known how pica can be prevented, the best strategy is to educate parents, children and adults about nutrition and health.

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