Pica for Uncooked Basmati Rice in Two Women with Iron Deficiency and a Review of Ryzophagia

Abstract

Reports of pica for uncooked rice (ryzophagia) in adults who reside in European and derivative countries are uncommon. We evaluated and treated two nonpregnant women with pica for uncooked basmati rice. Both women reported fatigue, abdominal discomfort after consuming large quantities of uncooked basmati rice, and hair loss. One woman was from India and the other was from Pakistan. Both women were vegetarians. Basmati was the local rice in their native countries and their usual rice in the USA. Both women had tooth damage due to eating uncooked rice and iron deficiency with microcytic anemia attributed to menorrhagia and multiparity. Ryzophagia and other manifestations (except tooth damage) resolved after iron dextran therapy. We review and discuss other reports of ryzophagia associated with iron deficiency, pregnancy, race/ethnicity, geographic origin, and local traditions. We conclude that adults with ryzophagia in European and derivative countries are likely to be non-Europeans.

Uncooked rice consumption: Causes, implications, regulation, and interventions

“…The consumption of uncooked rice may lead to foodborne illness and gastrointestinal problems. Symptoms such as diarrhea, vomiting, nausea, abdominal discomfort or pain, and loss of appetite have been reported in many pica patients who ate uncooked rice (Barton et al, 2016; Golden et al, 2012; Kalita & Dihingia, 2018; Upadhyaya & Sharma, 2012; Young et al, 2010). A common pathogen in rice, Bacillus cereus ( B. cereus ) may be responsible for the foodborne illness symptoms experienced by consumers of uncooked rice.…”

“…Consumers of uncooked rice may suffer from nutrient deprivation because of the constant eating of an unbalanced diet. Some consumers of uncooked white rice had symptoms such as severe anemia, weight loss, glossitis, angular stomatitis, hair loss, skin and conjunctival paleness, lethargy, weakness in lower limbs, decreased growth, and thinning of nails which are indicative of nutrient deficiencies (Barton et al, 2016; Camli et al, 2014; Jyothi, 2015).…”

“…Unlike other side effects of uncooked rice consumption that resolve within a few weeks after treatment, dental issues can be long‐lasting and difficult to manage even after pica is treated. A study by Barton et al (2016) reported tooth damage in two women with pica for uncooked white basmati rice. The first patient was a 39‐year‐old woman, a native of Mumbai, India.…”

“…Her physical examination also revealed moderate pallor and chipped and abraded teeth due to eating of pica materials. Both women were treated with iron dextran therapy (Barton et al, 2016). The ryzophagia/amylophagia and other manifestations resolved after completion of the therapy.…”

Effect of Pica on Some Hematological Parameters in Thi-Qar Province

“…Pica is the eating of a non-nutritional substance as defined by the American psychiatric association and the most widespread of which is eating soil 2 . Pica items are deferent, and vary according to culture, race/ethnicity, and geographic location 3,4 . There are little reports in which noting available at diagnosis of lack iron were evaluated utilized multivariable analyses to recognize possible significant differences between persons who did and did not develop pica.…”