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Date posted: February 22, 2012

Dr Nahida M Mulla.

Pica is a disorder characterized by an appetite for substances largely non-nutritive, e.g. metal, clay, coal, soil, faeces, chalk, paper, soap, ash, gum etc. or an abnormal appetite for some things that may be considered foods such as flour, raw rice, starch, ice cubes, salt. In order for these actions to be considered Pica, they must persist for more than one month at an age where eating such objects is considered developmentally inappropriate (above 18 to 24 months of age).

Pica is seen in all the ages particularly in pregnant women, small children and those with developmental disabilities and mental retardation.

Pica occurs throughout the world predominantly in people who live in poverty and people living in the tropics and in tribe oriented societies.

Pica in children, while common, can be dangerous. Children eating painted plaster containing lead may suffer brain damage from lead poisoning.

Causes:

  1. Mineral deficiency specially iron deficiency
  2. Traumatic events/ stress:
  • Maternal deprivation
  • Parental separation/ neglect
  • Child abuse
  • Disorganized family structure
  • Poor parent-child interaction
  1. Low socio-economic status

Clinical Features:

  1. Child with habit of eating substances like clay, dirt, stones, pebbles, hair, faeces, lead, plastic, pencil, erasers, fingernails, paper, paint chips, coal, chalk, wood, plaster, light bulbs, needles, string, cigarette, wire and burnt matches etc.
  2. A case with history of PICA may present with symptoms of:
    • Constipation
    • Chronic or acute, diffuse or focused abdominal pain
    • Nausea/ vomiting
    • Loss of appetite
  3. On examination findings like :
  • Abdominal distension
  • Pallor
  • Iron deficiency anaemia which could be the cause of PICA
  1. Clinical presentation of PICA is variable and is associated with the specific nature of the resulting medical conditions and the indigested substances.
  2. Parasitic infestations are usually associated with PICA. Ascariasis is commonly seen in children with Pica. 

Examples:

  1. Amylophagia – consumption of starch
  2. Coprophagy – consumption of faeces
  3. Geophagy – consumption of soil, clay or chalk
  4. Hyalophagia – consumption of glass
  5. Pagophagia – pathological consumption of ice
  6. Trichophagia – consumption of hair or wool
  7. Urophagia – consumption of urine
  8. Xylophagia – consumption of wood.

Homoeopathic Management:

  1. Antimonium crudum:
    • Craving for raw food and vegetables
    • Loss of appetite
    • Bloating of abdomen after eating
    • Inability to bear heat of sun, verse from over exertion in the sun and from over-heating
    • Aversion to cold bathing and aggravation therefrom
    • Tendency to grow fat
    • Thick milky white-coated tongue
    • Thirstlessness
    • Craving and intolerance for acids, pickles and bread
    • Peevish, irritable, cannot bear to be touched or looked at
  1. Alumina:
    • Craving for starch, chalk, charcoal, cloves, coffee or tea grounds, raw rice, acids
    • Alumina is one of the chief antidotes for lead poisoning (complication of pica)
    • Thin delicate children
    • Dryness of mucus membranes and skin
    • Constipation, no desire for stools for number of days and soft stool requires great straining
    • Exhausted physically and mentally
    • Aversion to potatoes
    • Mild, cheerful disposition
  1. Calcarea carbonica:
    • Craving for chalk, charcoal, coal and pencils
    • Chilly patient, takes cold easily
    • Fat, fair, flabby
    • Pale, weak, easily tired
    • Head sweats profusely while sleeping
    • Tendency for lymphatic glandular enlargement
    • Desire for eggs, aversion to meat and milk
    • Sour smelling discharges
    • Fearful, shy, timid, slow and sluggish
    • Longing for fresh air
  1. Culcaria phosphorica:
    • Desires lime, slate, pencils, earth, chalk, clay etc
    • Colicky pain in abdomen while eating
    • Distended abdomen
    • Feeble digestion
    • Chilly patient, thin, emaciated, unable to stand, rickety
    • Easy perspiration
    • Slow in learning to walk
    • Aggravation from damp, cold weather, change of weather, mental exertion
    • Desires raw salt and smoked things
    • Restless, dissatisfied, desire to wander
  1. Cicuta virosa:
    • Abnormal appetite for chalk, charcoal, coal, cabbage, which are relished
    • Grinding of teeth
    • Chilly patient
    • Convulsive with tendency to bend backward
    • History of suppressed skin eruptions
    • Stupid, singing, dancing, crazy, makes strange gestures
  1. Natrum muriaticuam:
    • Craving for salt
    • Takes long time for food to digest
    • Worse from eating
    • Hot patient
    • Poorly nourished
    • Great emaciation (marked on neck), losing flesh while eating well
    • Oily, greasy face
    • Aversion to bread and fatty things
  1. Nitricum acidum:
    • Craving for lime, slate, pencil, papers and charcoal
    • Cracks in muco-cutaneous junction especially fissures in rectum and corners of mouth
    • Chilly patient, takes cold easily
    • Thin built, sickly
    • Desires fat and salt
    • Disposed to diarrhoea
    • Strong smelling urine
    • Head-strong, irritable, fearful, vindictive, sensitive to noise and light
  1. Nux vomica:
    • Craving for charcoal, pepper, chalk
    • Chilly patient, thin
    • Craves fats, spicy food
    • Tongue coated yellowish in the posterior part
    • Over sensitive to noise, odors, light or music
    • Nervous disposition
    • Quick, active, zealous and irritable
    • Impatient, spiteful with violent action
  1. Silicea:
    • Craving for lime, sand, raw foods
    • Extremely chilly patient, all symptoms worse by cold except stomach complaints which are better by cold
    • Profuse, offensive discharges
    • Sweats profusely especially on feet
    • Easy suppuration, glandular affinity
    • Large head and distended abdomen
    • Weak ankles, slow in learning to walk
    • Obstinate, head strong, cries when spoken kindly to
    • Nervous, apprehensive, over sensitive, irritable, fearful

Dr Nahida M Mulla.
Principal,Professor of Repertory & PG Guide,
HOD Repertory.HOD Paediatric OPD,A M.Shaikh Homoeopathic Medical College,Hospital & PG Research Centre,
Nehru Nagar, BELGAUM (Karnataka)
E-Mail : drnahida_mulla@yahoo.com

Comments

2 Responses so far.

  1. Dr. Saifuddin Mulla says:

    A good insight view on Pica. Thanx.

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