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Copyright (C) 1986 National Organization for Rare Disorders, Inc.

214:
Pica

** IMPORTANT **
It is possible the main title of the article (Pica) is not the name you
expected.  Please check the SYNONYMS listing to find the alternate names and
disorder subdivisions covered by this article.

Synonyms

     Eating Disorder
     Pica Eating Disorder

General Discussion

** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only.  It should not be used for diagnostic or treatment
purposes.  If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.


Pica is an eating disorder which is characterized by the repeated eating
of non-nutritive substances over a period of one month or longer.  Patients
may eat non-edible objects such as paint, plaster, dirt, ice, or laundry
starch.  Pica generally affects small children, pregnant women, and people
whose cultural environment is most compatible with the eating of non-food
items.

Symptoms

Onset of Pica is generally between 12 to 24 months of age.  Infants typically
eat paint, plaster, string, hair or cloth.  Older children may eat substances
such as animal droppings, sand, bugs, leaves or pebbles.  Aversion to food is
absent.  Complications of the disorder are lead poisoning (from eating lead-
based paints) and hairball tumors.  Non-food items such as laundry starch,
clay, dirt, stones, chalk and limestone are other substances which may be
craved by Pica patients.  Children usually outgrow Pica.  Rarely adults may
manifest the disorder.  Pregnant women sometimes have a craving for unusual
foods like pickles or ice and rarely non-food items.

For more information on Pica, see the related article in the Prevalent
Health Conditions/Concerns area of NORD Services.

Causes

While a relationship between Pica and iron deficiency has been suggested, a
cause and effect relationship has not yet been proven.  Some substances which
are craved by patients with this disorder interfere with the body's
absorption of iron from food.  Some authorities believe that Pica is a
learned pattern of behavior while others theorize that it is due to other
cultural, psychological and physiological factors or a combination of these
factors.  In many cases, correction of iron or other deficiencies in the
patient may eliminate the abnormal craving which characterizes this disorder.

Affected Population

Pica can begin as early as the age of one year and is usually outgrown by six
or seven years of age, but some cases persist until puberty.  Some adult
women, particularly pregnant women, can suffer from this disorder.  Severely
retarded people often must be monitored to protect them from eating non-edible
substances.

Therapies:  Standard

Treatment of Pica mainly consists of preventing patients from eating the
craved, non-nutritive substances.  Psychiatric counseling aimed at behavior
modification is often recommended.  However, for certain cultural reasons,
some Pica clay and starch eaters may persist in occasionally eating a lump or
two of these items.

When mineral imbalances can be identified in people who have Pica, the
imbalance should be corrected with vitamin and/or mineral supplements.  In
many cases correction of these deficiencies will stop or reduce the craving
for inedible substances.

Therapies:  Investigational

This disease entry is based upon medical information available through
September 1989.  Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate.  Please check with the agencies listed in the Resources section for
the most current information about this disorder.

Resources

For more information on Pica, please contact:

     National Organization for Rare Disorders (NORD)
     P.O. Box 8923
     New Fairfield, CT  06812-1783
     (203) 746-6518

     National Mental Health Association
     1021 Prince St.
     Alexandria, VA  22314
     (703) 684-7722

     National Alliance for the Mentally Ill
     1901 N. Fort Meyer Dr., Suite 500
     Arlington, VA  22209
     (703) 524-7600

     National Mental Health Consumer Self-Help Clearinghouse
     311 S. Juniper St., Rm. 902
     Philadelphia, PA  19107
     (215) 735-2481

     NIH/National Institute of Mental Health (NIMH)
     9000 Rockville Pike
     Bethesda, MD 20205
     (301) 443-4515 or (301) 496-1752
     (800) 421-4211 (24 hrs.)

     National Digestive Diseases Information Clearinghouse
     Box NDDIC
     Bethesda, MD  20892
     (301) 468-6344

     Centers for Disease Control (CDC)
     1600 Clifton Road, NE
     Atlanta, GA  30333
     (404) 639-3534

References

THE MERCK MANUAL 15th ed:  R. Berkow, et al:  eds; Merck, Sharp & Dohme
Research Laboratories, 1987.  P. 1101.

CECIL TEXTBOOK OF MEDICINE, 18th ed.:  James B. Wyngaarden, and Lloyd H.
Smith, Jr., Eds.:  W. B. Saunders Co., 1988.  Pp. 880, 896-7.