Posted at 11.15.2018
Pica Disorder is the affliction that triggers people to have a sudden urge to take non-food related items (1). This disorder has baffled scientist for decades, and research has yet to create a clear reason or cause (1). Pica disorder are available in literature as early as Hippocrates, and has been categorised by many ancient scholars during the middle ages and Renaissance times (1). Many explorers, missionaries, and colonist also have written accounts about pica disorder in their journeys (1). Many of these early descriptions located pica disorder as an extreme desire to consume non-food related items, and has been referred to as a cultural phenomenon without physiological cause(1). The term pica comes from the Latin word Pica pica which is the name of the magpie, a bird that is referred to with an erratic desire for food (1). Other brands include cachexia Africana (known as by doctors who took health care of the African slaves), citta, mal d'estomac, and malacia (1).
Pica disorder is prevalent among pregnant women and young children because they are the most natural vulnerable, and can be found in people who are having renal dialysis, have celiac disease, and the ones who have a red blood cell defect such as sickle cell anemia (1). The disorder can cause many different affects on the body with both negative and positive results (1). Some unwanted effects include: steel poisoning, damage to internal organs, and some putting on weight (1). Results can include: providing important micronutrients that your body lacks (Fe, Ca, or Zn), possible relieving stress on the gestational tract, and stopping hazardous pathogens and bacterias from stepping into the bloodstream (1). Several explanations have been provided to clarify what causes pica disorder such as: mental health stress, dyspepsia, general hunger, coverage against poisons and pathogens, and a aspect affect of iron insufficiency which can cause anemia (1).
In medical literature this is of pica is, "the craving and purposive consumption of chemicals that the buyer does not establish as food with symptoms prolonged longer then one month. " (1). This clarification implies that pica cannot be labeled as the accidental ingestion of dirt or other non-food items, and the individual must voluntary take in the element (1). The craving for pica can be set alongside the addiction of tobacco, drugs, or the consumption of alcohol consumption (1). The set of pica chemicals is countless, but some of the major items are the consumption of: mud, organic starch (uncooked pasta), snow, paper, chalk, eggshells, espresso grounds, complements, and in extreme cases fine needles or other distinct directed items (1).
The ingestion of dirt and grime, clay, and chalk for the nutritional value that they could contain is called geophagy (1). This practice is common among women that are pregnant, and in a few communities might reach up to 60% of the populace (1). The garden soil can be prepared by baking or frying, and the quantity of dirt ingested runs from 20-40g, and can range from consuming bits of pottery, or eating beans which may have a high amount of dirt found in them (1). Many of these items include some type of clay in them, which has a compound called kaolin, which is ingredient found in some anti-diarrhea medications (1). Another option to eating dirt or clay is found in the consumption of other non-nutritional foods such as raw starch which is recognized as amylophagy (1). Many of these starches come by means of natural foods such as uncooked rice, pasta, and starchy rubbers (1). The consumption of these starches runs from a couple of grams per day to 1kg (1). One other major form of pica disorder are available in pagophagy which is the intake of snow (1). Unlike the average person that might suck with an ice cube or two, somebody who practices pagophagy consumes several cups of ice per day (1).
There are several hypotheses that explain the environmental factors that may cause the starting point of pica. These hypotheses can be broken down into three sub-categories: food cravings, micronutrient deficit, and coverage against toxin (8). Research workers, however, have found little to no information on the genetic basis or mechanism that is associated with pica disorder. This insufficient data is associated with researchers not having acknowledged that pica disorder is widespread among many populations of the world today, and the belief that pica is merely a mental disorder (8).
The main hypothesis pertaining to pica disorder is the connection between pica and anemia (1). Some experts have hypothesized that pica is an indicator which is developed when one becomes anemic (1). In two different studies, pregnant women were tested for many different variables. In the first study, experts took a group of 823 pregnant women from Turkey and examined their romantic relationship between anemia and pica (5). The second study contains pregnant women found in Tanzania which were examined to see pica's involvement with immunodeficiency diseases (HIV), iron insufficiency, soil transmitted helminth attacks such as malaria, and the danger of an infection of parasites (7). The demand for flat iron in a pregnant girl is much better then your average human because of the increasing amount of bloodstream cells necessary for the mom and the fetus (7). The lack of iron can lead to iron-deficiency anemia, abortions, bogus labors, and multiparity (5). In an internationally research it was found that 20% of most maternal deaths resulted from anemia, and can also lead to early births, underdeveloped newborns, increased infant fatality, and a decrease in fertility (5). In the analysis done in Turkey, analysts were able to find that out of the 823 pregnant women analyzed, 1 out of 10 exhibited pica habit (5). Many of these women were illiterate and were in a lower social course that resulted in less consumption of animal health proteins, and the lack of funds to adopt iron supplements during their pregnancy which led to lacking amount of flat iron, folate, and vitamin supplements B12 throughout their motherhood (5). In the study done in Tanzania, analysts found that 82. 6% of the ladies studied experienced anemia where about 29% ate garden soil on a regular bases (7). Those that consumed ground were 75% more likely to own severe anemia when compared to those that didn't (7). Women that confirmed signs of iron insufficiency (such as a decrease range of hemoglobin) were also much more likely to take pica substances (7). There was no relationship between HIV and geophagy, and women that had malaria didn't consume soil which could be a consequence of soil filled with traces of iron which makes the conditions of malaria worse (7). The quantity of Ascaris lumbricoides (spherical worm) within the pregnant women was higher in those who employed geophagy (7). Geophagy became more prevalent as the pregnancy progressed (7). This could be the body's response of offering more iron to create more hemoglobin (7).
Another purposed hypothesis is that whenever an individual methods in eating non-food related items this may cause anemia (1). This hypothesis says that the consumption of non-nutritional elements does not result in a good consequence or a decrease in this deficiency (1). The mechanism behind this happening is found to be brought on by tissue enzyme deficiency which includes Fe and Zn deficiencies which are likely involved in desire for food regulating brain enzymes (1).
In one review, three subject matter were analyzed that exhibited different types of pica (4). One subjected used at least two super-sized McDonald soda cups filled with ice a day which led to severe bleeding during her menstrual cycle (4). Another subject would drink iced normal water three to four times each day which led to the forming of colonic polyps which triggered bleeding (4). The 3rd and final subject would munch on rubber bands with a specific color and diameter (4). All three of the individuals were mentally stable, and got no history of mental illnesses (4). After cured with flat iron supplementation, one subject matter could stop their pica condition as the other two were still considering treatment (4).
It has been suggested that the key reason why individuals that have developed pica eat glaciers in an unnatural amount is because glossal pain on the tongue can form because of iron insufficiency, and the glaciers actually soothes the pain (4). It has additionally been recommended that stress that is shaped in top of the gastrointestinal tract (such as heartburn or nausea) brings on the craving of eating pica elements (1). This is because some pica elements contain high traces of alkaline which can react a suppressor and reduce the gastric pH in the gastrointestinal organs which would decrease the pain induced by heartburn or nausea (1). This however does not take into account for the individual that chewed on rubber bands (4).
In another circumstance article, a 22-season old African girl was diagnosed to acquire severe anemia (6). The woman got complained of huge tiredness, and it was discovered that she had been consuming a natural stone that was saturated in kaolinite and quartz for the past 15 years (5). After getting rid of traces of the stone in her body and providing flat iron supplements, the girl was able to get over her sever anemia, and a check up 3 months later showed a satisfactory blood count and stable flat iron levels (6). A possible reason to why this stone made the girl develop severe anemia is because of the high degrees of kaolinite within the natural stone (6). Kaolinite is a mixture that can absorb concentrations of Fe2+ and Fe 3+ in the duodenum, which is where iron is utilized by the body (6). This may have brought on her to build up a deficiency in iron which could have led to her having severe anemia (6).
In many conditions of pica, iron deficiency or anemic properties can be found in the average person (1). There have been excellent results that show livestock that have developed iron insufficiency and have involved in pica activity have shown improvement in their iron deficiency (1). However, sodium is the only known nutrient that is craved in humans, and some data shows that most pica substances have little to no flat iron in them except for soil, that your flat iron content of is less known although some acid base exams have been considered which led to some pica substances containing nutritional elements such as Fe, Zn, Cu, and Ca (1). These testing however do not take into account the pH of the intestine, and the website of these nutritional elements such as Fe (1). Overall this hypothesis is an interesting one, but doesn't have any current data that shows that eating pica elements actually help raise iron deficiency or other dietary deficiencies (1)
A recent hypothesis that has appear in the methodical community is that pica chemicals are consumed to protect against harmful chemicals and pathogens (1). Clay is shown to display toxin-binding properties, and kaolin (within some clay) can be an active ingredient within some anti-diarrhea medications (3). These toxins will come from plants, which produce contaminants as a protecting strategy against predators (1). These poisons can cause dizziness, muscle aches and pains, and other negative effects (1). Other chemicals can enter in food via bacteria such as Escherichia coli and Staphylococcus aureus (1). Infections and parasites can also go into the body and cause destruction (1). In a study done with rats, the rats were injected with a chemotherapy agent (cisplatin), and then given doses of kaolin (3). The rats that were given kaolin proved less acute symptoms then the rats which were injected with cisplatin which exhibited a decrease in appetite, and weight loss (3). Kaolin might well have played a role in reducing the anxiety sensed by the rats, and possibly sped up the recovery process (3). The device on how clay and kaolin focus on the body continues to be a puzzle, and does not solidify the hypothesis that pica chemicals are likely involved in elevating pain from toxins or other chemicals (3).
Although pica disorder has been known since the time of Hippocrates, it continues to be a mystery to numerous researchers (1). The next phase to further the data about pica is to take a multidisciplinary approach, and shift the idea of pica just being truly a mental disorder to pica also participating in a physiological role in individuals (8). It isn't fully recognized to whether pica plays a role in the onset of anemic properties or if pica is a side effect of anemia (8). There is also the opportunity that pica can contribute to the avoidance or comfort of toxins and pathogens from joining the blood stream (1). Although pica is not completely realized, it still must be taken seriously, as the consequences are still not fully realized and could cause many problems that can result in suffering for folks that experience pica symptoms (1).