JRSM > Volume 96, Number 11 > Pp. 571-572

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Jumperphagia: a woolly diagnosis

Guy Nash Rachel Evans   Richard Cohen

St Mark's Hospital, Harrow HA1 3UK, UK

Last year in the JRSM, Woywodt and Kiss recorded the history of earth-eating,¹ and Grewal and Fitzgerald² described the case of a learning-disabled man who consumed metal objects and pieces of clothing. Some workers hypothesize that such habits (pica) are related to dietary deficiencies. Here we report some evidence in support.

A woman of 67 was being investigated for longstanding iron deficiency. Upper gastrointestinal endoscopy had been negative, but on colonoscopy the bowel contained several clumps of what appeared to be fabric. A dietary history, taken thereafter, revealed that she was in the habit of consuming whole woollen jumpers at a single sitting; also her iron intake was low. After iron supplementation and nutritional advice, both her urge to eat wool and the anaemia gradually resolved.

Pica has been linked with severe iron-deficiency anaemia in children³ and adults.⁴ The question of cause and effect has not been resolved. In the past the habit has been seen as a manifestation of other disorders rather than an entity.^5,6 Here, cessation of pica after successful treatment of the anaemia indicates that iron deficiency might have contributed to the causation.

REFERENCES

1. Woywodt A, Kiss A. Geophagia: the history of earth-eating. J R Soc Med2002; 9:143 -6

2. Grewal P, Fitzgerald B. Pica with learning disability. J R Soc Med 2002;95:39 -40[Free Full Text]

3. Saloojee H, Pettifor J. Iron deficiency and impaired child development: the relation may be causal, but it may not be a priority for intervention. BMJ2001; 323:1377 -8[Free Full Text]

4. Anderson JE, Akmal M, Kittur DS. Surgical complications of pica: report of a case of intestinal obstruction and a review of the literature. Am Surg1991; 57:663 -7[Medline]

5. Parry-Jones B, Parry-Jones WL. Pica: symptom or eating disorder? A historical assessment. Br J Psychiatry1992; 160:341 -4[Abstract/Free Full Text]

6. McLoughlin IJ. The picas. Br J Hosp Med1987; 37:286 -90[Medline]

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This Article Full Text (PDF) Send a Quick Comment Alert me when this article is cited Alert me when Quick Comments are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nash, G. Articles by Cohen, R. Search for Related Content PubMed PubMed Citation Social Bookmarking                      What's this?