Pica is most frequently seen in children and pregnant women. Contributing causes According to DSM-IV, pica is the action of nonnutritive ingestion that is repeated for a period of at least a month and is developmentally inappropriate. In addition, we discuss some of the associated complications as well as current treatment strategies. In this overview of pica, we review its causes and prevalence. In the spectrum of eating disorders, pica may be viewed as a derailment of food selection and a driven, often chaotic, form of ingestive behavior. In addition, acute and chronic medical complications may pose surgical emergencies (intestinal obstruction from bezoars) as well as more subtle encroaching symptoms such as parasitosis, intoxication, and nutritional deficits. The clinical consequences of pica may have broad epidemiological implications as in lead intoxication and geophagia in children, which lead to severe impairment of intellectual and physical development. It is a complex behavior that can present with any number of variations (Table 1), and multiple pica determinants range from demands of tradition and acquired tastes in the cultural context to presumptive neurobiological mechanisms (eg, iron deficiency, CNS neurotransmission, physiological conditioning). We are not asking for herculean efforts, we all know autism families are already plenty overwhelmed, but for small steps that help prevent these daily heartbreaking calamities.Pica is the pathological craving for and eating of a nonnutritive item (eg, clay, coal, paper) or food ingredients (flour, raw potatoes). Please stay tuned - we’ll be on social media, have special podcasts, a featured video, a webinar, and more. This month we undertake our second annual September 26th Project - the annual emergency preparedness reminder for autism families, created in memory of our beloved founding VP Feda Almaliti and her son Muhammed who perished senselessly in a house fire after Feda attempted in vain to get Mu to exit the burning house. I would do anything to end this epidemic of death and damage. Watching her recover, I think I must have been the most relieved and grateful autism mom on the planet.Įvery time I see a story of autism’s ravages, another lost child or lifeless body, following some senseless tragedy wrought by an impulse-driven brain that can’t comprehend even basic dangers, my heart stops. She ate a full breakfast and went to school. Today she woke up with energy and even some smiles, albeit with soreness caused by the procedure and breathing tube. Sophie was wheeled back to her hospital room and gradually emerged from her groggy state, and was discharged. It was too large to be removed through the esophagus whole, but after cutting it into two pieces the doctor was able to extract it. My daughter had swallowed a lemon?! Ahhhhh, we have always had a lemon tree in the backyard, but this possibility had never even occurred to us. This meant the extraction could possibly be performed endoscopically, that is, through the mouth and esophagus, and without more invasive surgery.Ī pediatriac gastroenterologist was assigned to the case, Sophie went under general anesthesia with intubation, and the little endoscopy camera revealed…. We and the medical staff were also happily stunned that she didn’t choke.įortunately this mystery object was apparently a bit too large to travel to the small intestine. We were puzzled - we could not think of any object that fit that description. The radiologist said it seemed harder on the outside and softer on the inside. The CT scan revealed a non-metallic round-ish object, about 3cm x 2.5cm x 2cm at the base of her stomach. Yesterday we landed at the ER again after she stopped eating and drinking, vomited, and continually placed my hand on her tummy, the same alarming clues we saw in January. She underwent surgery in January after she ate a ball-shaped part of a toy, and it lodged in her small intestine, causing a complete blockage that would have killed her but for the miracles of modern imaging and surgery, which was performed laparoscopically at Stanford Hospital. Despite many years of working to reduce this behavior, it continues and only takes a single hand-to-mouth instant to put her life in peril. Sophie is not a runner, but she suffers from another heart-stopping “restricted and repetitive behavior” - she compulsively ingests inedible objects, something that also goes by the name of pica. I spent yesterday in the hospital panic-stricken about my daughter 16 year-old Sophie, our second visit to the ER and emergency surgery this year.
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