Pica

Aka: Pica, Pagophagia, Geophagia, Amylophagia, Trichophagia

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II. Background

  1. Derived from Latin for Magpie
    1. Bird with unusual eating habits

III. Diagnosis: Pica (DSM-V Definition)

  1. Persistent eating of nonnutritive, non-food substances
  2. Eating habits persist for 1 month or more
  3. No associated food aversion
  4. Not appropriate for developmental stage

IV. Symptoms: Voracious consumption of unusual substances

  1. Ice (Pagophagia)
  2. Clay (Geophagia)
  3. Starch (Amylophagia)
  4. Hair (Trichophagia)

V. Associated conditions

  1. Pregnancy
  2. Iron Deficiency Anemia
  3. Obsessive Compulsive Disorder

VI. Complications

  1. Acute or chronic toxicity
    1. Heavy Metal Poisoning (e.g. Lead Poisoning)
  2. Vitamin or Electrolyte deficiency
    1. Hypokalemia
    2. Hyperkalemia
    3. Iron Deficiency Anemia
    4. Zinc Deficiency
  3. Intestinal Obstruction
    1. Bezoar associated with Trichophagia
    2. Foreign Body Ingestion
  4. Malnutrition
    1. Failure to Thrive
    2. Achlorhydria
  5. Dental injury
  6. Parasitic Infection

VII. Labs

  1. Complete Blood Count
  2. Serum Ferritin
  3. Serum Iron
  4. Lead level

VIII. Radiology

  1. Abdominal XRay

IX. Management

  1. General nutrition counseling
  2. Manage associated conditions
    1. Iron Deficiency Anemia
    2. Lead Poisoning
    3. Parasitic Infection
    4. Intestinal Obstruction
  3. Mental health counseling
  4. Selective Serotonin Reuptake Inhibitor (SSRI)

X. References

  1. Rose (2000) J Am Board Fam Pract 13:358-8 [PubMed]

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