Awareness on pica and it's nutritional management

By Dr.Arun

1. AWARENESS ON PICA
~ARUN.VL
SharadaYoga and Naturopathy Medical College

2. PICA( EATING EVERYTHING EXCEPT FOOD)
PICAis an act or habit of eating non-food items such as stone, bricks, chalk, soap, paper, soil etc..[1]
The term is derived from "pica-pica," the Latin wordfor the magpie bird,because of thebird's
indiscriminate gathering and eating a variety of objects for the sake of curiosity.
The American Psychiatric Association'sDiagnostic and Statistical Manual of Mental Disorders,Fifth
Edition(DSM-5) defines pica as eating nonnutritive, nonfood substances over a period of at least one
month.[2]

3. Who usually has it ?
•Normally infants and toddlers .After the age of 2 yrsneeds
investigation
•Pica is common with children and women but affects all age group.
•Pregnant women
•autism
•Even animals like dogs

5. CAUSE OF PICA
Nutritional Deficiency :One of the theories for the cause of pica is patients have a mineral
deficiency owing to improper diet resulting for their bodies to crave for substances that contain
that mineral.
OTHER FACTORS :
•Stress
•Culturalfactors
•Learnedbehaviour
•Lowsocioeconomicstatus
•Underlyingmentalhealthdisorder
•Nutritionaldeficiency
•Childneglect
•Pregnancy
•Epilepsy
•Familialpsychopathology[3]

6. Types of PICA
•Amylophagia(consumption of starch and paste)
•Coprophagia(consumption of excrement)
•Geophagy(consumption of soil, clay, or chalk)
•Consumption of dust or sand has been reported among iron deficient patients
•Hematophagy(ingestion of blood)
•Hyalophagia(consumption of glass)
•Pagophagia(pathological consumption of ice)
•Self-cannibalism(rare condition where body parts may be consumed)
•Trichophagia(consumption of hair or wool)
•Urophagia(consumption of urine)
•Xytopnagia(consumption of ofwood)
•Cautopyreiophagia(ingestion of burnt match heads)

7. DIAGNOSIS OF PICA
•Blood, urine (pee) and stool (poop) tests. These look for signs of
infections, poisoning and electrolyte imbalances.
•Imaging tests. These are looking for any signs of blockage or internal
damage from this condition. These can includex-rays ,CT-scans , MRI,
ultrasound
•Diagnostic tests. These tests look for indications of serious health
problems that can happen with pica. An example of one of these tests
is an electrocardiogram (ECG or EKG), which looks for problems with
your heart’s electrical rhythm that can happen with certain
electrolyte imbalances or parasitic infections.

8. TREATMENT
•Pica rather than a disease should be viewed as a nutritional
aberration that provides opportunities to observe deficiency diseases,
to make nutritional interventions, and to reflect on the factors that
determine food habits.

9. NUTRTIONAL MANAGEMENT OF PICA
AIM:
•To detoxify the body off the previously ingested non food items
•To supply proper nutrition to the subject
•To help deal with the mineral imbalance by diet planning thus
preventing pica

10. REPLACING THE NUTRIENTS IN PICA (PREVENTION)
Eg:
•Clay eaters : deficiency in iron and calcium serum levels
•Chalk eaters: low serum zinc and iron levels in blood
Thus by providing the adequate RDA levels of nutrition for the subject ,one
can reduce their cravings to alternate non food sources of the nutitionlike
clay and chalk

11. DETOXIFICATION OF THE ALREADY INGESTED NON-
FOODS (TREATMENT)
•DIETARY CHANGES: Including more water consumption followed by
addition of green leafy vegetables and fruits increases the water
content in body reducing the toxins in the blood (grapes ,
pomegranate , gourd,andbitter drumsticks)
•HERBAL THERAPY :Herbs like cinnamon ,parsley, flax seeds, primrose
oil actively detoxify the body off the toxins and impurities in body
•EXERCISE:Improves overall metabolism,enhancesdigestion and
improves sweating accelerating the toxins out off the body
•ENEMA AND COLON HYDROTHERAPY: Where water is introduced to
the colon to flush out the toxins out.