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digestive issues

Digestive Issues - Pica

When people chew on or eat things that are not food.

Pica is a condition in which individuals with nutrient deficiency or some other process going on causes them to chew on or ingest non-food products. While present in the neurotypical population pica does appear more often in autistic people. It’s more common in children but pica does appear in adults, particularly those who have had pica as children – it doesn’t always go away.

Sensory-seeking children and adults will sometimes chew on something as a way of meeting a sensory need and then end up swallowing part of the item. Picking at skin, fingernails, threads or fabric can be signs of anxiety and can lead to ingesting those items. Sometimes autistic people can mistake non-food items for food (mistaking a colorful eraser for a gummy bear) and eat them (even if they taste terrible). 

Often a non-food item will pass through the digestive system without causing any physical harm, but toxicity or ingestion of small things over time can create significant health problems.  Dr. Tim Buie, a Pediatric Gastroenterologist at Boston Children’s Hospital experience in treating autistic patients, explains:

What you worry about is what you don't see. Individuals who might be chewing their hair or eating their hair can develop a collection of that hair and develop an intestinal obstruction. Or they're shredding paper or they're shredding clothing, and you think that's just an external behavior. But then they're imbibing that product and they're getting intestinal symptoms or intestinal obstruction because they've eaten those products.

Autistic adults who exhibited pica as children should continue to be monitored for those behaviors, especially when they are under stress. That monitoring should include toileting behaviors, as rectal itching can be a sign that non-food items are being digested.

 Here's an example of a tablet device cover where the vinyl coating became loose at the edge and it was picked away and ingested by an autistic adult.

A black tablet device cover with part of the cover picked away.A black tablet device cover with part of the cover picked away.