Case of a 31-Year-Old Woman with Unique Eating Habits
The patient: A 31-year-old woman residing in the U.K.
The symptoms: This woman had a medical history that included type 1 diabetes, some learning difficulties, and end-stage kidney failure. To manage her kidney condition, she was undergoing dialysis three times a week.
Dialysis helps filter waste and excess fluid out of the blood, which is crucial since her kidneys were no longer functioning properly. Patients need to manage their fluid and salt intake between sessions to avoid complications like weight gain and stress on the heart.
However, this particular patient was struggling with excessive fluid retention despite various measures taken to control it.
What happened next: Over time, she found it increasingly difficult to handle the lengthy dialysis sessions. She often started and ended her treatments above her target weight due to the fluid accumulation. There were also reports of occasional constipation.
After one session, a nurse noticed that the dialysis chair felt unusually light. On further examination, she discovered that substantial amounts of low-density polyurethane foam were missing from it.
The diagnosis: The medical team concluded that the patient had developed pica, a condition where individuals have a compulsion to ingest non-food items.
The doctors were taken aback to learn that she had been eating the foam, believing it might absorb excess water in her stomach and help alleviate her fluid retention. They noted, “This was evidently not the case,” suggesting her assumption that the foam would act like a sponge was misguided.
Pica is often linked to nutrient deficiencies, which might drive unusual cravings. Some researchers think that people with pica might simply be attracted to the sensory experiences — taste, texture, or even smell — of non-food items. The condition can also occur due to pregnancy, sickle cell disease, mental health issues, or medications.
In this case, thorough testing ruled out nutritional deficiencies or other immediate psychosocial issues. She didn’t have any prior instances of pica either, leading the medical team to consider that her known learning difficulties could be a factor.
The treatment: The woman was informed about the risks of consuming foam and received ongoing support from a dietitian specialized in kidney health. Her family also became more involved in her care. Although behavioral therapies are typically suggested for pica, it’s unclear if these were considered in her treatment plan.
Additionally, she was given a laxative to assist in passing the foam already in her system without causing complications. When the case report was published in 2010, she continued her scheduled dialysis treatments.
What makes the case unique: While pica cases have been observed in kidney patients before, they typically involve cravings for substances like clay, dirt, or ice. The potential effects can vary greatly, with some cases leading to severe complications like dental issues, blockages, or even malnutrition.
While her doctors searched medical literature for instances of kidney patients consuming polyurethane foam, they found none, though some reports existed of others consuming foam without kidney conditions.
“This case underscores a recognized but often overlooked issue in renal patients, known as pica,” her doctors remarked. “What sets this case apart is the patient’s choice to eat foam from her dialysis chair.”
