Pica syndrome causes and treatment netdoctor

Pica syndromeThe
Pica syndrome (Latin "pica": the magpie) is a form of eating disorder in which sufferers ingest things that are not actually suitable for consumption – such as soil, sand, paper or textiles. Pica syndrome usually manifests in young children, but sometimes occurs in adults as well. Read more about the pica syndrome here.

– clay and earth (geophagy) – ice (pagophagy) – starch (amylophagy) – feces (coprophagy) – hair (trichophagy) – wood/paper (xylophagy) – chalk – paint

Sometimes certain nutrient deficiencies can be detected in pica syndrome, for example a zinc deficiency or iron deficiency anemia.

Under certain circumstances, the eating behavior may lead to serious complications such as poisoning, injury to the digestive tract (in the case of sharp or pointed objects), intestinal obstruction or malnutrition. Infections with parasites such as tapeworms are also a possible consequence.

Investigations and diagnosis

The diagnosis of pica syndrome is made by a psychiatrist, psychotherapist, pediatrician, child psychologist or general practitioner. The most important thing is a detailed examination of the patient Medical history, i.e. a conversation with the person affected or – in the case of small children or people with mental disabilities – with a relative.

The physician asks, for example, what exactly the affected person consumes in which situations and in what quantities, and also what the other eating behavior looks like. He also clarifies known physical and psychological previous illnesses, a possible pregnancy and nutrient deficiencies as part of the anamnesis.

If the doctor or psychotherapist suspects another underlying mental illness, he or she may ask further specific questions or have the patient fill out certain questionnaires and tests (such as dementia or schizophrenia tests).

Physical examinations in pica syndrome

First, the doctor gets an idea of whether the person is malnourished or has certain deficiency symptoms. He checks the patient's body weight and watches for various symptoms that indicate nutrient deficiencies, for example, pallor and hair loss.

If the affected person consumes pure starch (amylophagia) on a permanent basis, for example, iron deficiency anemia is possible. Children and adults who ingest paint or other substances containing lead also risk chronic lead poisoning. A Blood test provides certainty about nutrient deficiencies, elevated lead levels and other shifts due to pica syndrome.

Imaging procedures such as a X-ray examination are necessary when the affected person has swallowed indigestible objects (such as nails). Eating hair (trichophagy) is also potentially dangerous, as it often forms indigestible tangles in the intestine – known as bezoars. On the X-ray image, these are only visible with a contrast medium.

The diagnosis “pica syndrome” is made by the treating physician if the disorder occurs over more than one month, the consumed substances have no nutritional value, the behavior does not correspond to the developmental level, no other mental disorder is present and the eating behavior also has nothing to do with the culture of the affected person. In some areas, for example, eating soil is considered normal or curative.

Read more about the examinations

Find out here which examinations may be useful for this condition:


Since the backgrounds of pica syndrome are extremely varied, there is no single therapy for this eating disorder. Treatment depends on the age of the affected person and the individual expression and cause of the symptomatology. Therapies that have been shown to be helpful are:

– In infants over two years of age with pica syndrome, the first measure is an careful supervision. Everything that the child considers potentially edible should be removed from his reach. – When people with pica syndrome have iron or zinc deficiencies, for example, it is important to support therapy by addressing nutrient deficiencies through rich diets and Food supplements to compensate. This is especially true for pregnant women. – target of a Behavioral therapy is for those affected to learn to discard their pathological eating behavior and instead resort, for example, to alternative behaviors or foods. Behavioral therapy is useful in any case for people in whom the pica syndrome has existed for a long time and has taken on a compulsive character. – Children and adults with pica syndrome, who show severe limitations in their intelligence and general development, need according to their needs a curative care – such as in living, school and work areas. – In the case of underlying or concomitant mental illnesses such as depression, schizophrenia or dementia, it is important that these illnesses are treated psychotherapeutically and, if necessary, with medication. In individual cases it has been shown that modern antidepressants (serotonin reuptake inhibitors) can have a positive effect on pica syndrome.

If there is a self-hazard due to the consumed things, the affected person is usually admitted as an inpatient.

If the objects in the digestive tract – such as nails, broken glass or the like – pose a danger to life, the affected person undergoes surgery to remove the objects.


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