Pica is an exotic name for a mental disorder which is characterized by persistent eating of non food substances such as hair, paint, paper, soil, pencils, metal pins, etc. However, some individuals may eat foods like raw rice, excess salt or sugar, flour, etc. The disorder is quite common and is estimated to occur in 4-25% of the population. A fascinating observation is that the majority will continue to eat only one these non nutritive items during the course of the disorder. Of course, there are others who will eat multiple items.
Pica is most commonly observed in the 1st-3rd decade of life. It may occur early in children but is often mistaken for just children being foolish. To make a diagnosis of Pica, one must persist with these eating habits for more than one month at an age where such a habit would be considered developmentally unsuitable.
Most individuals who develop Pica are healthy individuals. Pica has often been reported during pregnancy where females suddenly develop a taste for bizarre items. The disorder is also seen in wide variety of mental disturbed individuals, esp. those with dementia and some types of schizophrenia.
The majority of healthy individuals eat the non nutritive substances secretly and often are brought to hospital with symptoms of bowel obstruction. Some children eat plaster from the walls and in the past, lead poisoning was a common emergency admission. A number of individuals require surgery because the foreign material may have either blocked the bowel or caused a perforation in the stomach. At surgery, the diagnosis of pica is usually made by the findings of hair, soil or plastic straws, etc.
Once the patient has recovered from surgery, a consultation is made with a psychiatrist to evaluate the individual. Close monitoring of the patient is necessary. Many individuals continue to persist with this bizarre eating habit even after surgery.
While pica is common in childhood and occasionally there may be just one episode, there are developmentally delayed children who do persist with this eating habit. The treatment of pica is behavior management. Close supervision is required of children known to put things in their mouth. Unfortunately developmentally disturbed children fare well with psychotherapy and many require medications. Healthy adults generally recover spontaneously or with some type of behavior management.