Patients with Pica

Patients with Pica Pica is a condition in which there is persistent eating of inedible objects.

Pica is most common among patients that suffer from mental illness and are institutionalized. Therefore, it usually occurs as a result of another condition. The average number ranges up to 26% of those in institutions.

Pica can start at any age, but it most commonly starts in childhood. Adults that suffer from pica often hide their condition from others, and feed into their obsession when in private.

Diagnosis of Pica When a patient is suspected of having pica, a medical evaluation is ordered.

Tests will include a blood work up which will test for anemia, a common side effect of pica patient's. X-rays are done to ensure there are no blockages from objects consumed. There will also be checks and observations done to look for possible infections from contaminants. The doctor will inquire about the eating habits of the patient, and may ask that a daily journal of consumed foods be kept for a week to supply more information. The doctor will look for conditions such as developmental disabilities, obsessive compulsive disorder, that may have an impact on the condition. Usually the doctor will requests food and behavior journals be kept for a month before a complete diagnosis.

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Treatment for Pica There are numerous complications associated with pica. Lead poisoning is a common side effect of pica, as bacterial infections from the consumption of unclean items is also a concern. A physician will closely monitor the patient's health to look for indications of problems from this condition. In most cases a behavior therapist will be introduced into the picture to work closely with the patient, and if the patient is a child, their family as well. For children, positive reinforcements for good behavior, and negative consequences for bad choices may help. Medications that work to control impulses may help, and behavior modification can be used to re-train the mind to avoid eating inedible objects. There is no cure for pica, however, finding the right combination of drugs and therapy may reduce the symptoms by about 50%.

Complications of Pica Because individuals that have pica lack the ability to refuse eating objects, they must be monitored closely. Most pica patients have undergone multiple surgeries to remove objects from their intestines. Because of the convenience, pica sufferers often consume things such as dirt, dust, and

animal feces. There have been cases that a person has swallowed a full size stapler or cell phone. This required surgery to remove the objects, followed by antibiotic treatments to prevent infections. Pica patients that eat feces may need to be on a regimen of antibiotics at all times to avoid infections within the intestines. Individuals with this condition need to be monitored very closely at all times. Even if objects are not available for the patient to swallow, they make create objects, such as peeled paint, nails and screws, wood chips from furniture, virtually anything that can be picked or scraped off. Pica patients may also pick at their own skin to manifest items to eat, or they may remove buttons and snaps from clothing. Even when monitored very closely, it may be difficult to prevent every incident.

Related: Understanding and Preventing Hospital-Acquired Infections There are some options for family members of pica patients. Day service programs that engage the individual, which may provide a distraction from eating, may be a solution. There are also specialized group homes designed with minimal dĂŠcor, to lessen temptations. These homes are staffed with people that receive specialized training to work with pica patients. This enables families to still have contact with the pica sufferer, yet they won't be responsible for 24/7 care.

This condition is very often found in institutions and centers where developmentally delayed individuals attend. The environments are controlled and monitored, yet incidents still occur on a regular basis.

This very unusual medical condition can be extremely difficult for family members. Regular trips to the hospital emergency rooms, followed by surgeries, and recovery times, can make for very complicated lives. One emergency room doctor mentioned a time during his residency that a pica patient swallowed a live grenade. It took hours of preparation, and the alcohol, tobacco and firearm organization to properly suit doctored to perform surgery. The grenade was disarmed, and the patient was ok, however it could have ended quite differently.

This condition can take a life or lead to painful surgeries and lengthy hospital stays. The individuals that suffer from the condition simply do not have the ability to stop. The patient suffers, as well as the patient's family. As a nurse, you may not encounter many Pica cases, but if you do, consider that it is a delicate issue that must be handled with care.

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