The pica Is a eating disorder that is characterized by the ingestion of non-food substances without nutritional value persistently and compulsively.
This act is considered inappropriate for the level of development and is usually associated with young children. When it occurs in children who are more than five years old may be indicative of a behavior inappropriate for age.
Eating disorders are very varied and affect a large part of the population. Many people lose years of their lives and these disorders can even become deadly.
Within the medical profession, eating disorders are clinically defined and diagnosed according to specific diagnostic criteria.
Characteristics of the pike
Adults who have pica syndrome often have intellectual disabilities. The disorder is also associated with people who have a Deficiency, such as a lack of iron, and pregnant women or individuals With other mental illnesses.
If you suffer a Obsessive compulsive disorder (OCD) Or an impulsive disorder, you are more likely to be suffering from a related pica disorder. However, just as the Individuals suffering from OCD, people who have pica are often aware of their behavior despite being unhealthy behaviors and Illogical.
Individuals suffering from this disorder often eat substances such as earth, paper, chalk, feces, glass, paper, among other non-food items.
History of the pike
The term"pica"comes from the Latin word that means"magpie", which refers to the strange behavior of the eating habits of this bird. The magpie does not show a preference for food or non-food substances.
In some modern cultures the behavior of pike still occurs in a ritualistic way. In the nineteenth century in the southern United States, this behavior Was common among slaves and this practice is still accepted in some cultures.
It has also been part of religious ceremonies, magical beliefs and attempts at healing. In many cultures the ingestion of clay is used by its Medicinal properties, in some instances to affect the microorganisms in the intestine or to help relieve internal spasms.
In the 1950s and 1960s, this practice was so common that clay bags could be bought alongside bus stops.
Prevalence of pica
It is difficult to establish the prevalence of this disorder due to differences in its definition and the patients' unwillingness to admit this Behavior as well as the embarrassment of communicating strange ingestions and cravings.
It is believed that pica diminishes with age. Above 12 years, only an estimated 10% of the population has this disorder.
If your child has pica symptomatology, you do not have to scare him. It is most commonly seen in children between the second and third year of life. Usually as your child grows, behaviors decrease. But if you are over two and still have pica behaviors, The symptomatology is already considered inappropriate for its level of development.
When it comes to people with mental disabilities, the incidence of pica varies according to age, IQ, medication and manifestations of Behavior and appetite. Research has shown that it occurs more often in individuals who are between 10 and 20 years old.
Risk factor's
If you live in a stressful and chaotic family environment you are more likely to develop this disorder. More factors you should keep in mind for the Development of this disorder include:
Having addictive behaviors or an addiction.
Lack of a social support network.
Maternal deprivation.
Paternal negligence.
Pregnancy.
Having an intellectual disability / developmental disorder.
Epilepsy .
Brain damage.
Culture is another risk factor. In African countries pica is more common among women and children. In a study conducted in Nigeria, the incidence of The pica in adolescents and male children was between 25% and 46%.
Causes of the pica
The cause of the pica is unknown. Some of the hypotheses that exist to explain the development of this disorder include factors of influence Cultural, low socioeconomic status, psychological disorders and other deficiency diseases.
Nutritional Theories
These theories are the most common to explain the occurrence of pica and are attributed to the specific deficiency of minerals in the body, such as Iron and zinc.
Although malnutrition is often diagnosed at the same time as pica, a causal link has not been established.
Sensory and physiological theories
These theories are based on the claims of many patients that they enjoy the taste, texture or odor of the substance they are Ingesting.
Both pica and iron deficiency and more physiological problems have been associated with reduced dopaminergic activity in he brain.
The Dopamine Is a neurotransmitter, or chemical, that helps to transmit messages between cells. It is possible that abnormally low levels of Dopamine in the brain are related to the development of this disorder.
Neuropsychiatric theory
There is evidence that certain brain lesions are associated with abnormal feeding behaviors.
Psychosocial Theories
Another developmental factor of this disorder is a pattern of behavior similar to the anxiety disorders , In which the ingestion of substances Non-food becomes a method to relieve stress.
A study of an adult man with normal IC found that when he experienced a high level of anxiety and then ingested glass, he said he felt a Reduction of anxiety level.
Pica symptoms
The symptoms of pica vary according to the ingested non-food substance, but individuals with pica often experience the same symptoms as a Malnourished anorexic individual. These symptoms include mineral deficiency, nails and unhealthy hair and weight loss.
Below you can see some of the symptoms usually associated with some of the substances ingested:
Sand / soil ingestion - gastric pain and occasional bleeding.
Biting Ice - Abnormal wear on teeth.
Clay ingestion - constipation.
Swallowing metal objects - intestinal perforation.
Ingestion of fecal material - infectious diseases.
Lead ingestion - kidney damage and mental retardation.
Individuals with pica also have a higher risk of developing very serious health problems such as abdominal pain, and intestinal and colon obstruction .
Diagnosis
Often the diagnosis takes place in the emergency room of a hospital, when the child or adolescent already has developed medical symptoms provoked By the ingestion of these substances. But for the disorder to be diagnosed as a psychiatric disorder, it has to meet certain criteria of Diagnosis.
DSM-5 is a diagnostic and statistical manual of mental disorders developed by the American Psychiatric Association. The criteria Diagnoses of the pike are as follows:
Persistent ingestion of non-nutritive and non-food substances for a minimum period of one month.
The ingestion of non-nutritive and non-food substances, which are inappropriate to the degree of development of the individual.
Eating behavior is not part of a culturally accepted or socially normative practice.
If eating behavior occurs in the context of another mental disorder (eg, intellectual disability, Autism, schizophrenia) or medical condition (including pregnancy) is serious enough to justify additional clinical care.
It can be difficult to recognize a person who is suffering from this disorder when there are no external complications that signal these habits of feeding. Individuals may also feel embarrassed about telling these habits to someone, or it may happen that the patient is not aware that their Behavior is inappropriate.
If you suspect that someone you know may have this disorder, this person will require a doctor's assessment where an evaluation should be done Physics. They will have to do blood tests, study the levels of iron, lead, electrolytes and examine the functioning of the liver.
But despite all the clinical evaluations, it is essential for the diagnosis that the patient (or the father) admits their behavior. It is necessary Ask the doctor directly about dietary habits and pica behaviors.
When a parent suspects that their child has a pica, they can make a record of the child's solo play. If there is obsessive or impulsive symptomatology in u N adult or infantile patient, it is recommended to make an evaluation of the symptomatology of the pica.
Treatment for pica
In the case of having a diagnosis of pica, the first intervention can be to educate the patient about nutrition and, in the case that it is due to a Deficiency of minerals, iron therapy or transfusions to restore their levels.
Although pica tends to remit over time, when symptoms persist over time, it will require clinical intervention to treat the disorder.
Pica is a disorder that until today has not received much attention from researchers. The Cognitive-behavioral therapy And family therapy is Commonly used for the treatment of eating disorders.
Behavioral interventions are effective in treating children with a developmental disorder. Parents can be educated about how to Supervise your children during play and to take certain precautions into their home (eg, remove lead-based paints) and Play (eg, collecting feces from a pet).
Applied behavioral therapy is one of the most effective therapies for the treatment of pica and is usually applied in those individuals with Intellectual disabilities or behavioral problems, including individuals with autism and other disorders.
Applied behavioral therapy teaches new behaviors by reinforcing positive behaviors and punishing unwanted behaviors.
Although there are treatments for pica, there is no standard one. Few studies have attempted to examine the efficacy of pharmaceutical treatments, but Is investigating the relationship between pica and very low levels of the neurotransmitter dopamine.
In some cases it is necessary to perform a surgical procedure to remove objects from the digestive tract or to repair tissue damage.
Complications
The complications associated with the pica can be divided into five groups:
Inherent toxicity.
Obstruction.
Excessive calorie intake.
Nutritional deprivation.
Others (parasites and dental damage).
The clinical consequences of pica may have broad and very serious implications. Lead intoxication in children can lead to severe deterioration Of intellectual and physical development. In addition, acute and chronic medical complications can result in surgical emergencies.
Curiosities
Although in most of the Western world pica is considered as a very serious psychiatric disorder, in some cultures it is considered that Symptomatology of the pica is normal and even therapeutic.
In Uganda, for example, soils are available for purchase and ingestion.
It has also been shown that ice intake is more linked to iron deficiency, and is most consistently susceptible to iron therapy.
CONCLUSIONS
If you suspect that you or someone you know has itchy behavior, it is very important that you seek medical attention or talk to them for help.
Diagnosis and treatment on time is very important to avoid some of the serious nutritional and physiological consequences associated with pica.
Pica is a condition little known and sometimes difficult to perceive. If you have a child you should be alert to alert any behavior that could Be indicative of this disorder. Although the sporadic appearance of symptoms in young children may be normal, when it persists in time there are Than to take the appropriate measures.
What is your experience with pica and what have you done to treat it? Your comments will help the readers. Thanks!
References
- Rose, Edward, Porcerelli John, and Neal Anne Victoria. "Pica: Common but Commonly Missed." Journal of the American Board of Medicine 13 (2000): 353-58. Accessed September 11, 2015.