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.
Related: What is a Nursing Informaticist?
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.
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 décor, 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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