A 62-year-old man is rushed to the emergency room, complaining of severe stomach pains. At first the doctors aren鈥檛 sure what the problem is, so they X-ray his stomach and find a large mass there, heavy enough to push his stomach downwards. They operate, and are surprised to discover more than 5 kilograms of coins, worth $650 in total.
This isn鈥檛 a joke. It happened just a few years ago in France, and highlights the effects of a strange condition called pica 鈥� the compulsion to swallow non-food items. The word pica comes from the Latin for magpie, a bird famed for eating almost anything it can find. Pica behaviour is normal in infants, who explore the world through their mouths, sometimes swallowing things they shouldn鈥檛. But in older people it is not so cute, and can be life-threatening.
Who suffers from pica? We鈥檝e all heard tales of pregnant women craving, and even eating, coal and clay, but this behaviour turns out to be far from unusual. In fact, expectant mothers in many sub-Saharan African cultures routinely eat soils (a practice called geophagia). Perhaps it鈥檚 due to the heightened sense of smell and taste during pregnancy: in one investigation into geophagia, pregnant women reported that the rich smell of the soil drove them to eat it. A more extreme example of pregnancy pica can be found in last February鈥檚 issue of Obstetrics and Gynecology, where a pregnant woman was admitted to hospital suffering from weakness and muscle pain. Closer investigation revealed the cause of the problem: she was eating almost half a kilogram of baking soda a day.
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Pica is also common in people who have cognitive or psychiatric disorders such as autism and schizophrenia. What can be done to treat their pica habits? Obviously, a compulsion to eat, say, cigarette lighters (as reported in the journal Gastrointestinal Endoscopy last year) will be tricky to treat, but sometimes a simple blood test for mineral deficiencies is the answer. Compulsive consumption of ice (or pagophagia), for example, is often associated with iron deficiency. In another case, a 9-year-old girl who routinely ate cloth and string was helped by taking vitamin supplements.
鈥淚nfants often swallow things they shouldn鈥檛, but in older people it鈥檚 not so cute鈥�
But pica isn鈥檛 necessarily harmful. Though it is rare in western societies, soil-eating is common in many traditional societies. Why? It could be an instinctive way to supplement a diet deficient in trace minerals like iron and zinc. When a team of Canadian scientists analysed the soils eaten by people in China, Zimbabwe and the US they found they contained a host of beneficial nutrients such as iron, calcium and potassium, and the soil from Zimbabwe even contained kaolinite, used to treat diarrhoea (快猫短视频, 18 October, 1997, p 14). Though it may put you at risk from parasitic infections, the researchers鈥� conclusion was that eating soil can be good for you.
