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PICA IRON DEFICIENCY SOUR MANUAL

The micronutrient deficiencies most commonly associated with pica are iron and, to a lesser extent, zinc.

It is a nonfunctional epiphenomenon or side effect of a micronutrient deficiency.

It is a functional attempt to increase levels of deficient micronutrients however, this is unlikely to explain much of pica because most substances do not have bioavailable micronutrients.

POSSIBLE ETIOLOGIES - The etiology of pica is unclear.

Course in pregnancy – The course of pica in pregnancy is variable and unpredictable the behavior may decrease or increase.

Geophagy and amylophagy specifically are common during pregnancy in many regions, including sub-Saharan Africa, the Southeastern United States, and the Indian subcontinent. It has been described as more prevalent in Latin American and Black populations. Geographically, pica is most commonly reported among individuals living in or originating from warm, moist climates (ie, tropical or temperate regions). Individuals with some medical disorders, such as iron or zinc deficiency, anemia (of many etiologies), celiac disease, and end-stage kidney disease on dialysis, are also prone to developing pica.

Demographics – Pregnant persons are by far the most likely demographic group to engage in pica, followed by school-age children.

However, studies likely underestimate the true prevalence, given that clinicians often do not ask patients about this behavior and patients may fail to disclose pica because they feel shame or fear chastisement. Prevalence is in the 30 to 40 percent range in most studies among pregnant persons in the United States, but prevalences as low as 8 percent and as high as 77 percent have been reported. In a meta-analysis assessing the worldwide prevalence of pica during pregnancy and the postpartum period, the mean prevalence during pregnancy was much higher in Africa (45 percent) than in either North/South America (23 percent) or Eurasia (18 percent). Prevalence – The prevalence of pica varies across countries and ethnic groups, by health status, and by diagnostic criteria.It can also be made in individuals with amylophagy or pagophagy, although the DSM-5-TR does not allow consumption of "food" items such as flour, raw rice, and ice to be considered pica.

The diagnosis of pica can also be made when the individual reports craving that is provoked by taste, smell, or texture (hapticophagia), but the actual consumption of these substances has not yet occurred.

If the eating behavior occurs in the context of another mental disorder (eg, autism, intellectual disability, or schizophrenia) or general medical condition (including pregnancy), the severity of the eating behavior warrants additional clinical attention.ĭSM-5-TR distinguishes pica from nonsuicidal self-injurious behaviors in which individuals swallow potentially harmful objects (eg, batteries, knives, or needles).

The eating behavior is inappropriate to the individual's developmental level and is not culturally supported or socially normal.Repeated eating of nonfood substances (eg, chalk, clay, cloth, coal, dirt, gum, hair, metal, paint, paper, pebbles, soap, string, or wool) that are not nutritional for at least one month.

PICA IRON DEFICIENCY SOUR MANUAL

Chalk, charcoal, ash, paper, toilet paper, coffee grounds, baby powder, and paint chips are also common choices.ĭIAGNOSIS - The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5-TR) diagnosis of pica requires each of the following : Pagophagy (or pagophagia) – The consumption of large quantities of ice or freezer frost.Įarth, raw starch, and ice are the most commonly consumed pica substances.Amylophagy (or amylophagia) – The consumption of raw starches, including cornstarch, laundry starch, raw rice (ryzophagia), and flour.Geophagy (or sometimes geophagia) – The consumption of earth, including soil or other earth-rich items such as adobe, clay preparations, pottery, or bean stones (clumps of earth among dried beans).TYPES - There are three main types of pica: This topic will provide an overview of pica, focusing on its diagnosis, consequences, and management in pregnant persons. INTRODUCTION - Pica is the craving and intentional consumption of substances not culturally defined as food.