What Is Pica?

Pica is an eating disorder that causes a desire to eat non-food items with no nutritional value, such as dirt, clay, paper, or hair. Pica is most commonly seen in pregnant people and young children but can also affect others with nutritional deficiencies and adults who crave a certain texture in their mouths.

What people with pica eat is often harmless, but sometimes consuming non-food items can cause serious health problems, such as intestinal blockages or poisoning. If you have pica or symptoms of the condition, your healthcare provider can diagnose pica based on your medical history and a thorough evaluation of symptoms. Your specific treatment plan will depend on the underlying cause of your symptoms.

Types of Pica

There are different types of pica and the classifications vary based on the type of non-food item a person eats. The most common types of pica include:

• Geophagia: Consumption of the earth, which can include eating dirt, soil, clay, or sand.
• Pagophagia: Eating ice, freezer frost, or compulsively drinking iced beverages—commonly seen in people with iron-deficiency anemia.
• Amylophagia: Craving starches, such as uncooked rice or pasta, laundry starch, and cornstarch.

Along with the most common forms of pica, there are many other substances people with pica report wanting to eat, such as:

• Charcoal 
• Hair
• Baking soda
• Ashes
• Pencil erasers
• Sand 
• Chalk
• Paper
• Paint chips 

Symptoms

The primary symptom of pica is eating non-food items with no nutritional value. While many substances are benign (meaning harmless), others can cause complications or symptoms, especially when pica is chronic. Most pica symptoms are related to the digestive system because some substances are toxic or poisonous. You might experience one or more of the following symptoms with this condition:

• Abdominal pain 
• Constipation 
• Bloating
• Diarrhea
• Bloody stool
• Nausea 

Causes

The exact cause of pica is not fully understood, but research shows that certain conditions can increase the risk of a person developing pica, including: 

• Malnutrition and nutritional deficiencies (e.g., low in iron or zinc) 
• Intellectual disabilities and developmental disorders, such as autism spectrum disorder
• Mental health disorders, such as schizophrenia and obsessive-compulsive disorder (OCD) 
• Iron-deficiency anemia 
• Stress, particularly in children who have been abused, neglected, or live in poverty 
• Pregnancy, especially among pregnant people who may be low in iron 
  

Cultural practices and traditions can also contribute to developing pica, particularly in parts of the world where eating soil, clay, or other non-food items is culturally acceptable. You may also be at an increased risk of pica if you have symptoms such as trichotillomania (hair pulling) or excoriation (skin picking).

Diagnosis

Healthcare providers can diagnose pica after a medical evaluation, which includes a thorough assessment of your symptoms and learning about your personal and family medical history.

In order to receive a pica diagnosis, your provider will look for the following criteria:

• Persistent eating of non-food items for one month or longer
• Consumption of non-food substances when it is not influenced by cultural or social factors that promote the behavior (e.g., some cultures eat clay for the potential nutritional or digestive benefits) 
• Developmentally inappropriate eating behaviors

If a healthcare provider suspects you have pica, they may order lab tests to identify any underlying medical conditions or nutritional deficiencies that might be contributing to your eating habits. Tests can also check for potential complications of pica, such as an intestinal blockage. 

Your provider may order one or more of the following tests: 

• Blood tests: Check for nutritional deficiencies or underlying medical conditions, such as anemia or lead poisoning.
• Imaging tests: X-rays and other imaging tests can search for signs of an intestinal blockage.
• Stool tests: Looks for a parasitic infection. 
• Psychological evaluation: Assesses the possibility of any underlying mental health disorders contributing to the behavior, such as OCD.

Treatments

Treatment options for pica usually vary. Your exact treatment plan will depend on what's causing your symptoms, which symptoms you're experiencing, and whether you have any pica-related health complications. Treating pica involves addressing nutritional deficiencies, complications, and underlying medical, developmental, or psychiatric conditions. 

Your provider can recommend one or more of the following treatment options:

• Behavioral therapy, such as cognitive behavioral therapy (CBT) 
• Nutritional supplements and counseling to address nutrient deficiencies 
• Counseling for individuals and families to provide education and address emotional needs and stresses 
• Treating underlying conditions and complications
• Antibiotics or antiparasitic medications to treat bacterial or parasitic infections 
• Medication and management of underlying medical or psychological conditions

If pica leads to an intestinal blockage, surgery may be required to remove the item(s). 

How to Prevent Pica 

There is no surefire way to prevent pica. The best way to lower your risk is to eat a nutritious, balanced diet to help ensure your body gets the necessary vitamins and minerals you need to function. If you are a caretaker of a child and may be worried about their risk of pica, you may find it helpful to carefully supervise what a child is putting in their mouth—especially because children under the age of three tend to be curious about non-food items.

Complications

Because pica involves eating non-food items, it is possible to develop complications depending on what you consume. Pica may cause any of the following complications:

• Intestinal blockages
• Stomach ulcers
• Dental problems (e.g., a broken tooth) 
• Bacterial or parasitic infections 
• Lead poisoning (from eating paint chips) 
• Fatigue
• Behavior problems 
• Poor nutrition 
• Constipation 
• Seizures (caused by electrolyte imbalances)
  

Living With Pica

If you suspect you, your child, or a loved one has pica, seeking professional help for appropriate care and treatment is essential. A healthcare provider can identify the cause of your symptoms and guide you in developing an effective treatment plan. 

For many children and pregnant people, pica is a temporary behavior that resolves on its own or with treatment. However, for those with developmental or mental health disorders, pica may be chronic and require ongoing management. Education for yourself, family members, and caregivers can boost understanding and support for your loved one with pica. 

You may find it helpful to seek family or individual counseling with a mental health professional to address any psychological factors contributing to pica and help you develop coping strategies to manage the emotional effects of the condition. Additionally, a nutritionist or dietician can help you address nutritional deficiencies and work with you to create a healthy eating plan.