Iron deficiency Although compulsive consumption of ice is frequently associated with a deficiency of iron, the exact etiology of this form of pica is not well-understood. There is one hypothesis that states consumption of ice activates a vasoconstrictive response which causes an increase of blood flow to the brain. Because fatigue is the most common symptom experienced in iron-deficiency anemia due to decreased levels of oxygen delivered to the brain, the increase of blood flow to the brain through consumption of ice is thought to increase alertness and improve the symptoms of fatigue. In support of this hypothesis, individuals with iron-deficient anemia were found to have improved response times on neuropsychological tests than compared to healthy controls when chewing ice. Reports have demonstrated the improvement or resolution of<unk>  when given iron supplementation. People with iron-deficiency anemia who showed symptoms of<unk>  had complete resolution of their symptoms when their iron levels were treated, suggesting the association between serum iron levels and symptoms of<unk> . In another case, an individual who presented with<unk>  was prescribed 325mg tablets of ferrous sulfate twice daily. The individual was also administered 1000mg of low molecular weight dextran over 1 hour and their symptoms of<unk>  were immediately resolved. In another case, a woman with iron-deficiency anemia related to gynecological bleeding was admitted and her dietary screening showed consumption of about 80 ice cubes for day for the past 5 years. She was given iron supplementation and her anemia was treated along with the disappearance of<unk>  within two weeks. One study looked at the relationship between<unk>  and H. pylori infection in those with iron deficiency anemia. It was found that<unk>  does not increase the risk of H. pylori infections in that specific population. In addition, H. pylori infection and<unk>  did not have a synergistic effect on the development of iron absorption abnormalities in the intestines. Calcium deficiency<unk>  has been often reported with calcium deficiency but its pathophysiology is unknown. Psychological and physiological distress In several cases,<unk>  has been associated with certain psychological conditions such as compulsive behavior or depressive disorder where<unk>  was used as a coping mechanism to deal with psychological stress. Some suggestions for other causes of<unk>  include hunger and gastrointestinal distress related to ways the body attempts to ease the stress. Other known risk factors for pica include "stress, cultural factors, learned behavior, low socioeconomic status, underlying mental health disorder, nutritional deficiency, child neglect, pregnancy, epilepsy, and familial psychopathology." In one case report, a 42-year-old lady presented with complaints of freezer frost and eating ice. She developed a habit of eating 10 to 12 ice cubes and freezer frost each day, and eventually increased her consumption to 25 to 30 ice cubes each day. Her medical assessment revealed no past or family history of any chronic psychiatric disorder or physical disorder. Her hemoglobin, serum calcium, and stool examination were normal. One suspected cause of her<unk>  was psychological stress, the stressor being her son's annual examinations. The lady was previously prescribed venlafaxine 50mg and vitamin B-complex for two to six weeks but with no improvement. The doctor initiated fluoxetine 20mg daily for her and the venlafaxine was tapered off. The dose was increased to 30mg after three weeks and counseling and behavioral treatment was given. Her<unk>  resolved after four months. Along with this case, previous reports have shown selective serotonin reuptake inhibitors effective in treating<unk> . Counseling and behavioral strategies such as positive and negative reinforcement should be utilized for people with psychiatric conditions.
Pagophagia
Aerophagia
Caviar tongue
Odynophagia
Pressure of speech
Hypnagogia
Cricopharyngeal spasm
Muscle tension dysphonia