PICAJessica Holttum and Jordan Standlee Present:

What Is Pica? Definition: the persistent craving and

compulsive eating of nonfood substancesChalk, ice, metal, soil, sponges, soap, paint

Seen especially in children and pregnant women

Seen cross-culturally, though most common in developing countriesAlso areas of low socioeconomic status

What Is Pica?

Image: http://en.wikipedia.org/wiki/File:Glore_Stomach_Display.jpg

What Is Pica? Name comes from genus name of

magpie Very old!

Romans, Greeks, Mesopotamians

Pica pica

Image: http://en.wikipedia.org/wiki/File:Pica_pica.jpg

Significance Fairly common for such an odd disease

10-32% of children 1-6 years old Most-affected groups are at high risk for

health problems Cause unknown, so treatment difficult

Physiological or psychological? Possible evolutionary implications

IS PICA BENEFICIAL TO

ONE’S FITNESS?

NO

Gastrointestinal Consequences Blockages

“Bezoars”Usually caused by eating hair, fibers

Tears and RupturesLeads to internal hemorrhageResult of eating nails, other pointed objects

Illness & Infection Contaminated soil

E. coli, tetanus, anthrax

Also poisoning from pesticides, other chemicals

Unclean objects in mouthCoins, nails, sponges

Image: universityofcalifornia.edu

Poisoning Lead poisoning

commonEspecially in

children who ingest paint chips

Prominent in low-income areas

Potassium toxicityCaused by ingesting

burnt matches

Image: findmeacure.com

IS PICA BENEFICIAL TO

ONE’S FITNESS?

YES

Inducible in Animals Experiment 1: rats given chemotherapy,

variable access to clayThose who ate clay were less physically

affected

Inducible in Animals

Image: “Pica as an adaptive response…” – De Jonghe et al.

Inducible in Animals

Image: “Pica as an adaptive response…” – De Jonghe et al.

Inducible in Animals Experiment 2: some rats given motion

sickness, all received clay access“Sick” rats ate more clay, less food

Inducible in Animals

Image:"Motion sickness induced pica in the rat” –Mitchell et al.

Detoxifying Effects Native American

acorn breadClay absorbs toxic

tannins

Study of inner-city mothersPica = lower levels of

illicit drugs

Image: mrssurvival.com

Detoxifying Effects

Image: “Pica in an Urban Environment” –Edwards et al.

Underlying Conditions Anemia

Iron deficiencyCorrelated with pica

○ Especially metal or ice cravingsCan be symptomatic of liver/kidney failureIron replacement therapy often stops pica

Other mineral deficienciesZinc

Underlying Conditions

IS PICA BENEFICIAL TO

ONE’S FITNESS?

Conclusion In the past…

Yes○ Good way to self-treat nutrient deficiencies,

combat toxins In the present…

Somewhat○ Can easily be replaced by supplements○ Valuable as indicator of dietary issues○ Can cause problems, must be able to stop

References http://medical-dictionary.thefreedictionary.com/pica De Jonghe, Brian C., Maureen P. Lawler, Charles C. Horn, and Michael G. Tordoff. "Pica as an

adaptive response: Kaolin consumption helps rats recover from chemotherapy-induced illness." Physiology & Behavior 97.1 (2009): n. pag. Web. 21 Apr 2011.

Parry-Jones, B, and WL Parry-Jones. "Pica: symptom or eating disorder? A historical assessment."British Journal of Psychiatry 160. (1992): 341-354. Web. 21 Apr 2011.

Rose, E. A., J. H. Porcerelli, and A. V. Neale. "Pica: Common but commonly missed." Journal of the American Board of Family Practice 13.5 (2000): 353-358. Web. 21 Apr 2011.

Singhi, Sunit, R. Ravishanker, Pratibha Singhi, and R. Nath. "Low plasma zinc and iron in pica." Indian Journal of Pediatrics 70.2 (2003): 139-143. Web. 21 Apr 2011.

Johns, Timothy, and Martin Duquette. "Detoxification and mineral supplementation as functions of geophagy." American Journal of Clinical Nutrition53.2 (1991): 448-56. Web. 21 Apr 2011.

Mitchell, Denis, J.D. Laycock, and William F. Stephens. "Motion sickness induced pica in the rat." American Journal of Clinical Nutrition 30. (1977): 147-50. Web. 21 Apr 2011.

Adler, Amanda I., and Adam Olscamp. " Toxic 'Sock' Syndrome Bezoar Formation and Pancreatitis Associated With Iron Deficiency and Pica." Western Journal of Medicine 163.5 (1995): 480-82. Web. 21 Apr 2011.

http://www.nlm.nih.gov/medlineplus/ency/article/001538.htm http://en.wikipedia.org/wiki/Pica_(disorder) http://emedicine.medscape.com/article/914765-overview

References Johnson, Bruce E. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston:

Butterworths, 1990. Chapter 148. eBook. Barton, James C., J. Clayborn Barton, and Luigi F. Bertoli. "Pica associated with iron deficiency or depletion: clinical

and laboratory correlates in 262 non-pregnant adult outpatients." BMC Blood Disorders 10.9 (2010): n. pag. Web. 21 Apr 2011.

Kahn, Yasir, and Glenn Tisman. "Pica in iron deficiency: a case series." Journal of Medical Case Reports 4. (2010): n. pag. Web. 21 Apr 2011.

Kawai, Kosuke, Elmar Saathoff, Gretchen Antelman, Gernard Masmanga, and Wafaie W. Fawzi. "Geophagy (Soil-eating) in Relation to Anemia and Helminth Infection among HIV–Infected Pregnant Women in Tanzania." American Journal of Tropical Medicine and Hygiene 80.1 (2009): 36-43. Web. 21 Apr 2011.

Young, Sera L., M. Jeffrey Wilson, Dennis Miller, and Stephen Hillier. "Toward a Comprehensive Approach to the Collection and Analysis of Pica Substances, with Emphasis on Geophagic Materials." PLoS one 3.9 (2008): n. pag. Web. 21 Apr 2011.

Lynch, Kristin A., Peter G. Feola, and Elisabeth Guenther. "Gastric Trichobezoar: An Important Cause of Abdominal Pain Presenting to the Pediatric Emergency Department." Pediatric Emergency Care 19.5 (2003): 343-47. Web. 21 Apr 2011.

Hackworth, Samuel R., and Laura L. Williams. "Pica for Foam Rubber in Patients With Sickle Cell Disease: Case Reports." Southern Medical Journal96.1 (2003): n. pag. Web. 21 Apr 2011.

Kinnell, H. G. "Pica as a feature of autism."British Journal of Psychiatry 147.1 (1985): 80-82. Web. 21 Apr 2011. Edwards, Cecile H., Allan A. Johnson, Enid M. Knight, Ura Jean Oyemade, O. Jackson Cole, et al. "Pica in an Urban

Environment." Journal of Nutrition 124. (1994): 954S-962S. Web. 21 Apr 2011. Von Garnier, Cristophe, Holger Stunitz, Michael Decker, Edouard Battegay, and Andreas Zeller. "Pica and refractory

iron deficiency anaemia: a case report." Journal of Medical Case Reports 2.234 (2008): n. pag. Web. 21 Apr 2011. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1951586/pdf/pubhealthreporig00017-0091.pdf http://www.dhpe.org/infect/Anthrax.html http://www.ehow.com/about_6729187_harmful-bacteria-soil.html