Pica is an unusual craving for and ingestion of either edible or inedible substances. We believe pica is an important sign of iron deficiency that should never be ignored, and the craving for any unusual substance should compel clinicians to search for occult blood loss with secondary iron deficiency. Pica symptoms abated in one of our patients upon iron supplementation, while the other two are currently under treatment as of this writing. None of our patients we describe here, as well as their primary care physicians, were aware of the importance of their pica related symptoms. We have noticed that the younger community of academic and community physicians are not aware of the importance of complaints related to pica. Pica has been practiced for centuries without a clear etiology. All three patients presented with hematological parameters diagnostic for iron deficiency anemia. Lastly, the third patient, a 37-year-old Hispanic woman, presented with dysfunctional uterine bleeding and habitually chewed rubber bands. The second patient is a 62-year-old Caucasian man who presented with bleeding from colonic polyps associated with drinking partially frozen bottled water. The first patient is a 36-year-old Caucasian woman who had dysfunctional uterine bleeding associated with daily ingestion of two super-sized cups of ice as iced tea. We describe three patients who presented with symptoms of pica.
We report three patients with pica, two of them showing evolutionary changes associated with pica and the third demonstrating a peculiar nature of pica, which has yet to be reported. Pica is an unusual condition where patients develop cravings for non-nutritive substances that can cause significant health risks.
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