Geophagy; Lead poisoning - pica DefinitionPica is a pattern of eating non-food materials, such as dirt or paper. CausesPica is seen more in young children than adults. Up to one third of children ages 1 to 6 years have these eating behaviors. It is unclear how many children with pica intentionally consume dirt (geophagy). Pica can also occur during pregnancy. In some cases, a lack of certain nutrients, such as iron and zinc, may trigger the unusual cravings. Pica may also occur in adults who crave a certain texture in their mouth. SymptomsChildren and adults with pica may eat:
This pattern of eating must last for at least 1 month to fit the diagnosis of pica. Depending on what is being eaten and how much, symptoms of other problems may be present, such as:
Exams and TestsThere is no single test for pica. Because pica can occur in people who have certain nutritional deficiencies, your 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. Your provider may also test for infection if contaminated soil or animal waste has been eaten. TreatmentTreatment 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. Medicines may help reduce the abnormal eating behavior if pica is part of a developmental disorder such as intellectual disability. Outlook (Prognosis)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. Possible ComplicationsComplications include:
When to Contact a Medical ProfessionalContact your provider if you notice that your child (or an adult) is eating nonfood materials. PreventionThere is no specific prevention. Getting adequate nutrition may help. ReferencesDeLoughery TG. Microcytic and hypochromic anemias. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 145. Katzman DK, Norris ML. Feeding and eating disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 9. Samsel CB, Walter HJ, DeMaso DR. Rumination and pica. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 36. | |
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Review Date: 5/4/2024 Reviewed By: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. | |
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