Pica is a pattern of eating non-food materials, such as dirt or paper.
Pica is seen more in young children than adults. Between 10% and 32% of children ages 1 to 6 have these behaviors. The incidence of intentional consumption of dirt (geophagy) among children, which is a subset of children with pica behavior, is uncertain.
Pica can also occur during pregnancy. In some cases, a lack of certain nutrients, such as iron deficiency anemia and zinc deficiency, may trigger the unusual cravings. Pica may also occur in adults who crave a certain texture in their mouth.
Children and adults with pica may eat:
This pattern of eating must last for at least 1 month to fit the diagnosis of pica.
Exams and Tests
There is no single test for pica. However, because pica can occur in people who have lower-than-normal nutrient levels and poor nutrition (malnutrition), the health care provider may test blood levels of iron and zinc.
Blood tests can also be done to test for anemia. Lead levels should always be checked in children who may have eaten paint or objects covered in lead paint dust to screen for lead poisoning.
The health care provider may also test for infection if the person has been eating contaminated soil or animal waste.
Treatment should first address any missing nutrients or other medical problems, such as lead poisoning.
Treating pica involves behaviors, the environment, and family education. One form of treatment associates the pica behavior with negative consequences or punishment (mild aversion therapy). Then the person gets rewarded for eating normal foods.
Medications may help reduce the abnormal eating behavior if pica is part of a developmental disorder such as intellectual disability.
Treatment success varies. In many cases, the disorder lasts several months and then disappears on its own. In some cases, it may continue into the teen years or adulthood, especially when it occurs with developmental disorders.
Bezoar (a mass of undigestible material trapped inside the body, usually in the stomach)
Katz ER, DeMaso DR. Pica. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 21.2.
Fred K. Berger, MD, Addiction and Forensic Psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.