- With Mayo Clinic hematologist
Ruben A. Mesa, M.D.
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Ruben A. Mesa, M.D.
Ruben A. Mesa, M.D.
Dr. Ruben Mesa is board certified in internal medicine, hematology and medical oncology and is director of the Acute and Chronic Leukemias Program in the Division of Hematology-Oncology at Mayo Clinic in Arizona. Dr. Mesa is also a professor of medicine.
The Chicago-area native's primary field of interest is hematology with special interests in both acute and chronic leukemias — specifically the chronic myeloproliferative disorders (MPDs).
"I believe patients' understanding of their disease is a critical first step in the healing process," he says. "I believe that the Internet, carefully used, is a phenomenal resource for patients to be able to access high-quality and valuable information to understand both their diseases and various treatments."
Dr. Mesa has been with Mayo Clinic throughout his training since 1991 and is a graduate of Mayo Medical School. He is a member of the American Society of Hematology, the American Society of Clinical Oncology and the American College of Physicians.
His scholarship has focused on advancing the understanding and therapy of the chronic myeloproliferative disorders. In these disorders, he has been active in evaluating novel therapeutics, implementing clinical trials, and working with quality of life studies. He also works with national patient groups.
He has been principal investigator or co-principal investigator in 20 clinical trials for patients with myeloproliferative neoplasms or other myeloid disorders. He is committed to improving the therapy and quality of life in MPD patients. He has lectured both nationally and internationally on these disorders.
Dr. Mesa founded the biennial Mayo Clinic Living With a Blood Disease Symposium for patients with hematologic diseases. He sits on the editorial board of the journal Blood, and several other journals.
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Question
Craving and chewing ice: A sign of anemia?
Is constantly craving and chewing ice a sign of anemia?
Answer
from Ruben A. Mesa, M.D.
Possibly. Doctors use the term "pica" to describe craving and chewing substances that have no nutritional value — such as ice, clay, cornstarch or paper. Transient pica is very common in normal children. On the other hand, craving and chewing ice (pagophagia) is often associated with iron deficiency anemia — although it may be associated with other nutritional problems as well.
It's not known why some people with iron deficiency anemia crave and chew ice. Results from one study suggest it may be because of ice's pain-relieving properties, since some people with iron deficiency anemia experience tongue pain and inflammation (glossitis). The same researchers found that ice has a new and better taste to some people who are iron deficient.
In some individuals, pica is a sign of emotional problems, such as stress, obsessive-compulsive disorder or a developmental disorder.
A thorough medical evaluation can help determine if pica is due to an underlying medical condition. If the cause of pica is an emotional or developmental issue, cognitive behavioral therapy may be helpful.
- Schrier SL, et al. Causes and diagnosis of anemia due to iron deficiency. http://www.uptodate.com/home/index.html. Accessed Jan. 7, 2010.
- Kettaneh A, et al. Pica and food craving in patients with iron-deficiency anemia: A case-control study in France. The American Journal of Medicine. 2005;118:185.
- Pica. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://psychiatryonline.com. Accessed Jan. 14, 2010.
- Ursano AM, et al. Disorders usually first diagnosed in infancy, childhood, or adolescence. In: Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. Arlington, Va.: American Psychiatric Association; 2008. http://psychiatryonline.com/resourceToc.aspx?resourceID=5. Accessed Jan. 14 2010.
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