Association of pica with anemia and gastrointestinal distress among pregnant women in Zanzibar, Tanzania. Adult-onset pica leading to acute intestinal obstruction. Agency for Healthcare Research and Quality Web site. Hospitalizations for eating disorder decline, but big increase seen in pica disorder. Agency for Healthcare Research and Quality. Identifying empirically supported treatments for pica in individuals with intellectual disabilities. Assessment, behavioral treatment, and prevention of pica: clinical guidelines and recommendations for practitioners. Issues in the management of challenging behaviours of adults with autism spectrum disorder. Is lead a concern in Canadian autistic children? Paediatr Child Health. Clark B, Vandermeer B, Simonetti A, et al. Pica in pregnancy: new ideas about an old condition. Geophagy during pregnancy in Africa: a literature review. Agency for Toxic Substances and Disease Registry Web site. Summary Report for the ATSDR Soil-Pica Workshop June 2000, Atlanta, Georgia. Agency for Toxic Substances and Disease Registry. Ingested foreign bodies in a patient with pica. Magnetised intragastric foreign body collection and autism: An advice for careers and literature review. A case of severe acute hepatitis due to oral intake of firecrackers. Chalk eating in middle Georgia: a culture-bound syndrome of pica? South Med J. A rare cause of recurrent upper abdominal pain. Cause of life-threatening hyperkalemia in a patient undergoing hemodialysis. Abu-Hamdan DK, Sondheimer JH, Mahajan SK. Amylophagia during pregnancy: some maternal and perinatal correlations. Geophagy and potential health implications: geohelminths, microbes and heavy metals. Kutalek R, Wewalka G, Gundacker C, et al. Geophagy (soil-eating) in relation to anemia and helminth infection among HIV-infected pregnant women in Tanzania. Exposure assessment and risk characterization from trace elements following soil ingestion by children exposed to playgrounds, parks and picnic areas. Paper pica: an unusual cause of colonic ischemia. Spaniolas K, Ou S, Findeis-Hosey J, et al. Prog Neuropsychopharmacol Biol Psychiatry. Adult-onset paper pica in the context of anorexia nervosa with major depressive disorder and a history of childhood geophagia: a case report. Arlington, VA: American Psychiatric Association 2013.ΔΆ. Diagnostic and Statistical Manual of Mental Disorders. Thus whilst we find this behaviour fascinating, we are no clearer in understanding the aetiology of pica for sponge in this small population of children with SCD.1. In six cases the parents found the behaviour so unacceptable that they requested psychological intervention and in four, the behaviour has now stopped. Our children could shed no light on their compulsion. In America it is classified as an eating disorder, in the UK it is considered a behavioural disorder it can also be an obsessive-compulsive disorder, or a manifestation of depression. Therefore, pica can be a response to a nutritional deficit, it can be familial suggesting a learnt behaviour, or developmental and emotional issues may be involved. In our children, four have a positive family history. In one study of pregnant women, 33% with pica had a history of childhood pica and 56% had a positive family history. We wondered whether a craving of an unidentified salt fuels the eating of sponge, or whether the texture of sponge is simply orally stimulating. Natural sponge contains various proteins and minerals, and is often fortified with silica or calcium salts, however, synthetic sponge consists of cellulose alone. There is a recognised association between iron deficiency and pica, leading to debate as to which is cause and which effect. Neurological complications are not uncommon in sickle cell disease (SCD) but none of our children had cognitive impairment. It is also more common in deprived and neglected children. ![]() ![]() Infants place everything in their mouth, and pica occurs in a variety of syndromes associated with brain damage and developmental delay. ![]() We cannot explain the predilection for sponge amongst our patients. However geophagia (soil), pagophagia (ice), and trichophagia (hair) are the commonest substances eaten. Knowing that pica-the compulsive ingestion of non-nutritive substances-is more common in tropical countries where cultural and dietary factors play a role, it may not be a surprising finding. E ditor,-Within our sickle cell population, there are a small number of school aged children who eat sponge.
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