Pica
Persistent eating of non-food substances
Quick Facts
- Type: Eating and feeding disorder
- Common items: Dirt, clay, chalk, paint, ice, hair
- Often linked to: Iron or zinc deficiency, pregnancy
- Main risks: Poisoning, blockage, infection
Overview
Pica is an eating disorder in which a person repeatedly eats substances that are not food and provide no nutrition. Commonly eaten items include soil, clay, chalk, paper, soap, cloth, hair, paint chips, and ice. To be considered pica, this behavior usually continues for at least a month and is not part of a normal developmental stage or an accepted cultural practice.
Pica occurs in young children, in people who are pregnant, and in individuals with developmental or intellectual disabilities, as well as in some people with nutritional deficiencies or mental health conditions. While occasionally putting non-food objects in the mouth is normal for infants and toddlers, persistent eating of such items beyond toddlerhood deserves evaluation because it can cause real harm.
Symptoms
The defining feature is the regular eating of non-food substances. Related signs and complications may include:
- Repeatedly seeking out and swallowing specific non-food items
- Strong cravings, sometimes for ice (pagophagia) or earth (geophagia)
- Stomach pain, cramping, or constipation
- Nausea or vomiting
- Signs of poisoning (such as from lead in old paint)
- Symptoms of anemia, like fatigue and pale skin
- Dental damage or mouth injuries
Eating sharp or large objects can cause choking, blockages, or tears in the digestive tract, which may become emergencies.
Causes
Pica does not have a single cause; several factors can contribute:
- Nutritional deficiencies: Low iron or zinc is often associated with pica, and cravings for ice in particular are linked to iron deficiency anemia.
- Pregnancy: Cravings for non-food items can appear during pregnancy.
- Developmental and mental health conditions: Pica is more common in people with intellectual or developmental disabilities, autism, and some psychiatric conditions.
- Hunger or food insecurity: In some settings, lack of food contributes.
- Stress or learned behavior: Emotional factors and habit may play a role.
Risk Factors
- Young age (toddlers and young children)
- Pregnancy
- Intellectual or developmental disability, including autism
- Iron, zinc, or other nutritional deficiencies
- Certain mental health conditions, such as obsessive-compulsive disorder or schizophrenia
- Stressful environments or food insecurity
- A family history of pica
Diagnosis
There is no single test for pica; diagnosis is based on the history of eating non-food substances for at least a month beyond what is developmentally expected. Evaluation often includes:
- Medical history: What is eaten, how often, and for how long.
- Blood tests: To check for iron or zinc deficiency, anemia, and lead exposure.
- Imaging: X-rays or other scans if a blockage or swallowed object is suspected.
- Assessment of mental and developmental health: To identify related conditions.
Treatment
Treatment addresses both the behavior and any underlying cause.
- Correcting deficiencies: Supplementing iron or zinc when low can reduce cravings, especially in pregnancy-related and anemia-related pica.
- Treating complications: Removing swallowed objects, treating lead poisoning, or repairing damage to the digestive tract as needed.
- Behavioral therapy: Strategies that reward eating appropriate foods and discourage eating non-food items are helpful, especially in children and people with developmental disabilities.
- Mental health support: Treating associated conditions such as anxiety or OCD.
- Safe environment: Keeping harmful substances out of reach.
In children, pica often improves with age and treatment of any underlying deficiency.
Prevention
- Ensure a balanced diet to prevent iron and zinc deficiencies
- Supervise young children and keep small or toxic objects out of reach
- Address pica early, before complications develop
- Provide structured support for people with developmental disabilities
- Test homes built before 1978 for lead paint when young children are present
When to See a Doctor
See a doctor if a child or adult regularly eats non-food items, or if you have strong cravings to eat ice, dirt, or similar substances. Seek emergency care right away for signs of a serious complication, such as:
- Choking or trouble breathing after swallowing an object
- Severe abdominal pain, vomiting, or a swollen, hard belly
- Vomiting blood or passing black or bloody stools
- Signs of poisoning, such as confusion, severe vomiting, or seizures
Frequently Asked Questions
What is pica a sign of?
Pica is often a sign of an underlying issue such as iron or zinc deficiency, pregnancy, or a developmental or mental health condition. Identifying and treating the cause, such as anemia, is an important part of management.
Is eating ice a form of pica?
Yes. A strong, persistent craving to chew ice is called pagophagia and is a recognized form of pica. It is frequently linked to iron deficiency anemia, so it is worth checking iron levels with a blood test.
Is pica dangerous?
It can be. Eating non-food items may cause poisoning (for example from lead paint), choking, intestinal blockages, tears in the digestive tract, infections, and dental damage. Some of these are emergencies that need immediate care.
Does pica go away on its own?
In young children, pica often improves with age and once any underlying deficiency is corrected. In people with developmental disabilities or ongoing causes, it may persist and usually benefits from behavioral therapy and medical support.
How is pica treated?
Treatment combines correcting nutritional deficiencies, behavioral therapy, treating any associated mental health condition, and managing complications. Keeping harmful substances out of reach and providing supervision are also important.
References
- Mayo Clinic. Pica.
- MedlinePlus, U.S. National Library of Medicine. Pica.
- American Academy of Pediatrics (AAP). Eating and feeding disorders in children.
- National Eating Disorders Association (NEDA). Pica.