Abstract:- Pica is a disorder in which children compulsively eat stuffs that have no nutritional value. The causes of pica can be deficiency like – iron, zinc, calcium or any other nutrient associated with it. Symptoms of pica includes abdomen upset/ pain, blood in stool, bowel problems and it can also lead to complications which can be difficult to tackle1. Pica cases generally comes up for treatment when there are other problems associated due to this cause1. Homoeopathy has its effective cure as it deals with mental generals as well as physical generals and particulars and this holistic approach is required to treat the behavior complaints of the children and help them in healthy growing. In this article, a case is explained in which pica is treated with homoeopathic medicine.
Keywords:– Pica, homoeopathy.
Abreviations: – DSM (Diagnostic and statistical manual of mental disorders),
AEBE (air entry both side equal),
H/O (history of), CNS(central nervous system), CVS
cardiovascular system), RS (respiratory system), P/A (per
abdomen), RADAR (rapid aid to drug aimed research), SL (Saccharum
lactis), OPD (outpatient department).
Introduction:– Pica is a disorder in which children compulsively eat stuffs that have no nutritional value, for example, dried flaks of wall paint, dry leave, mud, chalk, metal rust, soap, clay etc. In some cases it can lead to poisoning as if a person is having habit to eat metal rust, then it is harmful. Pica often occurs in individuals who have intellectual disabilities.1 It comes under DSM-V – The American Psychiatric Association’s diagnostic and Statistical Manual of Mental Disorders and is defined as eating non–nutritive, non – food substance for over a period of at least one month.1
The causes of pica may be deficiency of iron, zinc, calcium or any other nutrient associated with it. The unusual cravings may be a sign that body is trying to replenish low nutrient levels. Dieting and malnourishment can lead to pica.1
Symptoms of pica includes:-
- Abdomen upset/ pain
- Blood in stool ( which may be a sign of ulcer from eating non-eatable items)
- Bowel problems (such as constipation and diarrhoea)1.
As such there is no diagnostic tool to check for pica except case taking done by physician. The complications associated with pica are
- Poisoning such as lead poisoning
- Parasitic infections
- Intestinal blockages
- Injuries to teeth (eating glass and bricks)
- Chocking.1
Its treatment generally requires restoring of the required nutrients due to which the child is malnourished. Restoring the nutrients is an easy task but the behavioural problems which come in accepting the this corrected form of eating is a challenge to the physician and also to the parents as child readily doesn’t give up eating the stuffs which he/she is addicted to. This includes many times stubbornness, excessive craving to such indigestible stuffs, negligence on account of parents and many times disobedience and obstinacy shown by children. Pica cases generally comes up for treatment when there are other problems associated due to this cause.
Homoeopathy has its effective cure as it deals with mental generals as well as physical generals and particulars and this holistic approach is required to treat the behaviour complaints of the children and help them in healthy growing. A case is explained in which pica is treated with homoeopathic medicine.
Case history
Preliminary Data:-
Name: AQ
Age: 7 years
Sex: Male
Occupation: Student
Status: Unmarried
Religion: Hindu / Maratha
Chief complaints
Patient was brought by his mother with the complaints of:-
- Frequent abdominal pains,
cramping type, on and off since 1-2
months.
- Constipation, passes stool irregularly sometimes once in 2-3 days.
- Appetite decreased.
- Eats soil, wall paint and putty/ clay, whenever mother scolded him not to eat it, he listened to, but when she was not present, he used to eat it, and when asked, used to lie that he did not eat it.
- He was very obstinate regarding leaving the habit of pica as told by his mother, he listened to her when scolded, otherwise did only what he wanted.
Life space investigations:-
Patient’s father was in service, mother was housewife, and he had one younger sister.
The patient was well dressed, with lax body, having tendency to obesity, was chubby with anxiety on face. His behaviour was agitated but cooperative, changing mood from hilarious to low. He was having good comprehension but paid less attention / concentration.
His memory was poor and forgetful, remembered what was taught but had to memorise a lot.
His judgement was also poor.
Past history:
Blood in stools, although scanty, once 20 -25 days before, but it was treated with home remedies and he became alright.
Physical generals included decreasedappetite, desire for chocolates, sweets, soil, wall paint, and clay/ putty, aversion to chapatti, vegetables, and rice, child only used to eat the above desired food. Stools were irregular, unsatisfactory, once in 2-3 days, urine frequency was 11-12 times a day. The perspiration was profuse, over head and face staining yellow, sleep was unrefreshing. He was thermally a chilly patient.
The built of patient was obese, chubby, with lax musculature. His height was average, nutrition was poor. There was no abnormality detected in pallor, oedema, cyanosis, icterus, or lymphadenopathy.
Systemic examination:-
Respiratory system – AEBE, clear
Investigations:-
Advised blood examination of serum calcium level and serum alkaline phosphatase
Final diagnosis:-pica1
CASE PROCESSING:-
- Analysis of symptoms:-
Mental generals:-
- Poor concentration
- Memory poor/ forgetful.
- Mood changeable from hilarious to low.
- Tells lie ( for eating pica).
- Obstinate.
Physical generals:-
- Appetite decreased.
- Stools – irregular and unsatisfactory
- Perspiration profuse on head and face staining yellow.
- Sleep – unrefreshing
- Desire for soil, chocolate, sweets, wall paint and clay.
- Aversion to vegetables and wheat/ chapattis.
Particulars:–
- Abdominal pain, cramping.
- Constipation.
- Evaluation of symptoms:-
| Sr. No. | Grades | Symptoms | Evaluation | Miasmatic analysis |
| 1. | I Grade | Poor concentration | characteristic mental general | Psora |
| Memory poor/ forgetful | characteristic mental general | Psora/ Sycosis | ||
| Mood changeable from hilarious to low. | characteristic mental general | Sycosis | ||
| Tells lie (for eating pica). | characteristic mental general | Sycosis | ||
| Obstinate. | characteristic mental general | Sycosis | ||
| 2. | II Grade | Desire for soil, chocolate, sweets, wall paint and clay. | characteristic physical general causation | Psora |
| Stools – irregular and unsatisfactory | characteristic physical general | Sycosis | ||
| Perspiration profuse on head and face staining yellow. | characteristic physical general | Sycosis | ||
| Sleep – unrefreshing | characteristic physical general | Sycosis | ||
| Appetite – decreased | characteristic physical general | Sycosis | ||
| Aversion to vegetables and wheat/ chapattis | characteristic physical general | Sycosis | ||
| 3. | III Grade | Abdominal pain – cramping | particular symptom | Psora |
| Constipation | particular symptom | Sycosis |
Process of repertorisation:-total addition process
Software used :- RADAR3
Repertorisation3:-
Probable remedies:-
- Sulphur
- Nux vomica
- Belladonna
- Phosphorus
- Natrum muriaticum
- Calcarea carbonica
Miasmatic analysis:-Fundamental:- Psora
Dominant:- Sycosis
Susceptibility :- Moderate
Remedy selected:- Calcarea carbonica
Prescription on 3/12/2019
Calcarea carbonica 1M/ 1 dose stat
S.L 200/2-2-2/ 15 days
Calcarea phosphorica 6X/ 4-4-4/ 1 month
Justification for selection of remedy:-
- Although Calcarea carbonica didn’t come first in repertorisation but the patient was chilly while Sulphur is a hot patient, so 1st remedy is void.
- Patient had poor memory, obstinate, pica was there along with constipation suggestive of Calcarea carbonica .1,2
- Calcarea carbonica was chilly and patient was more constitutionally obese, chubby and obstinate.2
- Even serum calcium level before treatment was 6.6mg/dl (8.4-10.4 mg/dl), even desire for calcium like non-edible materials suggested Calcarea carbonica.
- Calcarea phosphorica 6X is given as it is for calcium deficiency, and biochemic medicines overcome deficiency disorders immediately in paediatric age group. (Schussler’s Materia Medica).2
Follow up – Patient was on regular follow up till now for other minor complaints.
Follow up:
| Date | Complaints | Remedy | Justification of selection of remedy |
| 3/1/2020 | The constipation was decreased. No abdominal pain. Pica also decreased | Calcarea carbonica 200 1 dose stat and Calcarea phosphorica 6 X, 4-4-4 for 30 days. | Patient was improving so single dose is repeated and susceptibility is also moderate so , dose is repeated so as to cure the further symptoms. Even minimum duration of action of Calcarea carbonica is approximate 25-30 days, so repetition is required, for Calcarea carbonica .4 Calcarea phosphorica was repeated so as to fulfill the calcium defeciency which is evaluated in lab reports and till patient improvement. Apart from from diet rich in calcium inside supplement is also required to patient. |
| 11/2/2020 | Patient was concentrating properly in studies, Pica decreased only 10% was remaining, Patient is less obstinate now and listens to mother. Constipation is also now less observed passes stool regularly daily. | Calcarea carbonica 200 1 dose stat and Calcarea phosphorica 6 X, 4-4-4 for 30 days. | |
| 1/4/2020 | Since March 2020 due to lockdown patient had not himself visited to takes medicine and was continuing till June 2020 for pica. All complaints, i.e. constipation, poor concentration, obstinacy, pica was absent. | Calcarea carbonica 200 1 dose stat and Calcarea phosphorica 6 X, 4-4-4 for 30 days. And advised parents to watch if he still tries to eat such non edible things.Parents counselling regarding proper calcium rich diet was done and patient was doing better. |
Conclusion:-
In cases of pica, constitutional homoeopathic medicine along with diet and biochemic combinations served useful in the above case. Homoeopathy not only cured the pica but also solved the behavioural complaints of the child, thus proving it to be a holistic method.
References:-
- 2005-2021 Healthline Media a Red Ventures Company, Everything you need to know about Picca Medically reviewed by Karen Gill, M.D. — Written by Gretchen Holm — Updated on August 2, 2019, San Francisco Office, The Healthline team, August 2 2019.( www.healthline.com/health/pica )
- Dr. Schussler, Schussler’s Biochemic Pocket Guide with Repertory, 2 nd edition, B.Jain Publishers Pvt. Ltd. , New Delhi, 2018, Page-27-29.
- RADAR 10 software Schroyens F; Repertorium H o m o e o p a t h i c u m Syntheticum; 9th edition; New Delhi; Bjain Publishers Pvt Ltd.
- Boericke W. Boericke’s New Manual of Homoeopathic Materia Medica and Repertory. 9th ed. New Delhi: B. Jain Pvt. Ltd.; 2014.
About Author:
Dr D .G .Bagal, M.D. (Hom)
Professor, Vice-Principal
Dept of Repertory
Y.M.T. H.M.C, Navi Mumbai
Dr Uttara Agale, M.D. (Hom)
Associate Professor
Dept of Repertory
Y.M.T. H.M.C, Navi Mumbai
