Pica may take different forms depending on the substance consumed; these include pagophagia
(eating ice), trichophagia (eating hair), xylophagia (eating paper), lithophagia (eating stones), geophagia (eating soil), and metallophagia (eating metals).
Patients with iron deficiencies frequently chew or suck ice (pagophagia
It has a vast clinical presentation ranging from pallor, anorexia, irritability, pagophagia
, breath holding spells9 to febrile seizures10 impaired psychomotor and mental development 1,2,4,8.
Although the one category of ice eating has been changed in the DSM-5 as written above (Hartmann et al., 2012), craving and chewing ice (pagophagia
) is often associated with iron deficiency anemia (American Pregnancy Association, 2011).
ICE CHEWING The practice of compulsively chewing and consuming excessive amounts of ice is called pagophagia
Often associated with pregnancy, iron deficiency anemia, early development, and mental retardation, pica has been observed in post-gastric bypass surgery patients, all of whom presented with pagophagia
(compulsive ice eating), and in one case was associated with a bezoar causing obstruction of the GI tract (1), (2) With the dramatic increase in gastric bypass surgery and the required presurgical mental health evaluation, the consequences of failing to screen patients for pica behaviors can be devastating.
A study by Northwestern Memorial Hospital, Chicago says that compulsive ice eating, called pagophagia
, could be a symptom of iron deficiency anaemia.
Several examples of pica include amylophagia (the consumption of starch), coprophagia (feces), geophagia (soil, clay, or chalk), hyalophagia (glass), pagophagia
(pathological consumption of ice), trichophagia (hair or wool), urophagia (urine) and xylophagia (wood).
(1) reported in the November issue of SAMJ that pagophagia
(pica for ice) was present in 9 out of 16 patients with iron deficiency and some form of pica.
Patients with kidney disease practicing pica most commonly consume clay or dirt (geophagia), laundry starch (amylophagia), or ice (pagophagia
), but the list of potential pica substances can be quite extensive.
The definition can be broadened to encompass any behavior manifested by the eating of a non-food that is unusual in kind or quantity (2) including ice (pagophagia
), hair, plaster, clay or dirt (geophagia), laundry and corn starch (amylophagia), ashes, and cigarette butts.