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[异食癖:一种鲜为人知的临床病症的写照]

[Pica: the portrait of a little known clinical entity].

作者信息

Viguria Padilla F, Miján de la Torre A

机构信息

Centro Atención Minusválidos Psíquicos (CAMP) Fuentes Blancas, Gerencia Servicios Sociales, Junta Castilla y León, Burgos.

出版信息

Nutr Hosp. 2006 Sep-Oct;21(5):557-66.

Abstract

Pica is a eating disorder, of the eating behavior in childhood. It is defined as the persistent intake of non-nutritional substances for at least one month, in an inappropriate way from an evolutionary perspective, and provided that its practice is not culturally banned. Many animal species, including primates, have this behavior. Documented from antiquity, in most cases it has been considered a symptom of another related disorder rather than as independent condition. Its prevalence is unknown. It is mainly described in mentally disabled people, pregnant women, autism, mentally ill patients, children, and others. The ingestion of earth, ice, starch, ropes, wood, and other products has been observed, although some authors also include the obsessive and reiterative consumption of eatable substances. Geophagia is considered a cultural phenomenon, although sometimes may lead to disease, and an form of paleomedicine or paleonutrition. The etiology of pica is unknown and it has no markers. Sensitive, digestive, nutritional, psychological, and psychiatric factors have been implicated in its origin and maintenance. Although the morbimortality is unknown and difficult to study, we may highlight intoxications, parasitic diseases, and surgical abdomen with serious complications. Finally, as in other eating behavior disorders, the global management of this entity requires a coordinated intervention of different health care professionals.

摘要

异食癖是一种儿童期的饮食行为方面的进食障碍。它被定义为持续摄入非营养物质至少一个月,从进化角度来看这种方式不恰当,并且其行为在文化上未被禁止。许多动物物种,包括灵长类动物,都有这种行为。从古代就有记载,在大多数情况下,它一直被认为是另一种相关障碍的症状,而非一种独立病症。其患病率未知。它主要在智力残疾者、孕妇、自闭症患者、精神病患者、儿童及其他人群中被描述。已观察到有吞食泥土、冰块、淀粉、绳子、木头及其他物品的情况,不过一些作者也将可食用物质的强迫性反复食用纳入其中。食土癖被认为是一种文化现象,尽管有时可能导致疾病,也是古代医学或古代营养学的一种形式。异食癖的病因不明且没有标志物。敏感、消化、营养、心理及精神因素都与其成因及持续存在有关。尽管其病死率未知且难以研究,但我们可以强调中毒、寄生虫病以及伴有严重并发症的急腹症。最后,如果其他饮食行为障碍一样,对这一病症的整体管理需要不同医疗保健专业人员的协同干预。

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