She was discharged home on iron supplements and laxatives. The patient received intravenous iron therapy and was evaluated by psychiatry. Gastrograffin enema was then performed twice with resulting bowel movements. Flexible sigmoidoscopy was performed for mechanical disimpaction using endoscopic accessories was unsuccessful. The abdominal x-ray showed radiopaque material opacifying the lumen of the colon with nonobstructive bowel gas pattern. Laboratory tests revealed iron deficiency anemia but normal calcium and vitamin D level. Physical exam was pertinent for abdominal distention and tenderness. Her cravings for chalk increased with worsening anemia.
She ate 5 lbs of chalk with each meal for the previous 10 years, like her mother. CASE DESCRIPTION/METHODS:Ī 35-year-old black female from Augusta Georgia with iron deficiency anemia and depression presented with worsening abdominal pain, distention and constipation with the last bowel movement 2 weeks prior to presentation. We present a case of a young black female from Georgia who presented with a partial bowel obstruction from eating chalk. Kaolin ingestion in the form of chalk, white dirt or white clay, is a lesser known form of pica but a common occurrence in Central Georgia. Pica is the persistent intake of nonnutritive and nonfood substances seen commonly in children, pregnant women, institutionalized persons, patients with developmental disabilities and iron deficiency.
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