Medical News Today: What to know about pica

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People with pica crave or eat items that are not food.

There is currently no one way to classify this behavior, however. Health professionals need to test for a range of different conditions, including mental health conditions, to try to determine the probable cause.

Pica often develops in people with mental health conditions, but not all people with pica have a mental health condition.

Pica is also more common in children and pregnant women. However, it is difficult to estimate how many people have pica, as they might not report it. Also, children with pica may hide the behavior from parents and caregivers.

Experts believe that some groups have a higher risk of developing pica, including:

• autistic people
• those with other developmental conditions
• pregnant women
• people from nations where dirt eating is common

The primary symptom of pica is eating items that are not food.

Pica is different from normal behaviors of babies and young children who put objects in their mouth. Those with pica will persistently attempt to eat nonfood items. The eating goes beyond sampling or exploring behaviors.

People with pica may also develop a wide range of other symptoms, including:

• broken or damaged teeth
• stomach pain
• bloody stool
• lead poisoning

Some people with pica have nutrient deficits. For example, some people with pica may have low iron, hematocrit, or hemoglobin. Some experts believe that for these people, pica is the body’s way of replacing these missing nutrients.

The most common causes of pica include:

• pregnancy
• developmental conditions, such as autism or intellectual disabilities
• mental health conditions, such as schizophrenia
• cultural norms that view certain nonfood substances as sacred or as having healing properties
• malnourishment, especially iron-deficiency anemia

Eating nonfood items can cause issues such as stomach pain and broken teeth. Treating pica typically begins with addressing these problems first.

Some people develop lead poisoning, infections, or other severe symptoms as a result of pica. Treatment in these cases might include antibiotics or even surgery.

To treat pica itself, a doctor must first identify why the person craves nonfood items. This usually involves assessing their medical history to understand any symptoms or risk factors. They may also use blood tests to check for nutritional deficits.

A doctor might also look at:

• sensory-seeking behaviors, such as chewing nonfood items
• whether or not a person understands that these items are not edible
• cultural beliefs surrounding nonfood items

Addressing these issues may help reduce a person’s cravings.

Some treatment options for pica include:

• occupational therapy
• sensory support, such as providing a safer item to chew on
• medication to treat underlying mental health conditions, if present
• reducing nutrient deficits with supplements, dietary changes, or both

In pregnant women, pica may go away on its own after childbirth.

Sometimes, it can be worth waiting to initiate treatment when the nonfood item is relatively harmless, such as when a person craves ice.

Some forms of pica, such as eating ice, pose few health risks when the overall diet is relatively normal. However, other types of pica can be life-threatening.

For example, a craving for paint chips is dangerous — especially when the paint chips are from older buildings, where the paint may contain lead.

Some potential complications of pica include:

• choking
• poisoning
• damaging the brain from eating lead or other harmful substances
• breaking teeth
• developing ulcers
• harming the digestive system, such as by causing injuries to the throat
• experiencing gastrointestinal problems such as bloody stool, constipation, or diarrhea

Pica can occur during pregnancy, especially in women with nutrient deficits.

Women with unusual cravings during pregnancy should ask their doctor for an iron test. In many cases, taking iron supplements can help reduce these cravings.

It is vital that pregnant women with pica resist the temptation to eat nonfood items to avoid causing harm to the fetus. It can help to find distractions, such as chewing on something else, finding foods with a similar texture to eat, or doing something relaxing.

Parents and caregivers should consult a doctor if they notice children:

• scanning the room for specific nonfood items
• eating the same nonfood items repeatedly, especially over long periods of time
• developing problems with the mouth, such as sores and damage to the teeth
• having bloody stools or stomach problems

Pica can indicate an unbalanced diet. It is important to see a doctor for any unusual cravings that last longer than a few days.

Also, a person should go to the emergency room if they:

• eat anything that may contain lead
• are unable to have a bowel movement
• lose consciousness or act unusually after eating a nonfood item

Adults with pica may realize that their cravings are unhealthful or unusual, but the urge to eat nonfood items can still feel overwhelming. Likewise, children with pica may become frustrated if they are not able to act on these cravings.

The right treatment can help with both the physical and psychological aspects of pica. They can help a person overcome their cravings and return to a normal diet.

Parents and caregivers whose children experience pica should avoid punishing them. It is better to work with a doctor to support the child in changing their behavior.