by Aiman Fayaz
SRINAGAR: On October 21, a deeply unsettling case surfaced on the outskirts of Shopian when a two-and-a-half-year-old girl arrived at the District Hospital suffering from severe abdominal pain. Her parents, visibly distressed, shared that their daughter had been experiencing sharp, unremitting discomfort. After an extended wait in the crowded emergency paediatric unit, Dr Shafi Ahmad Naikoo was finally able to examine the young patient.
During the physical assessment, Dr Naikoo detected something unusual – a hardened mass lodged in the child’s abdomen. Recognising the gravity of the situation, he ordered an X-ray without delay. The scan revealed a bewildering sight: the child’s large intestine was markedly swollen, densely filled with a multitude of small, round pebbles.
“I was completely taken aback by what I saw,” Dr Naikoo recounted. “Her entire large intestine was packed with pebbles. I had never encountered anything like this in my career.”
The gravity of the situation demanded prompt and decisive intervention. Dr Naikoo and his team swiftly referred the toddler to the general surgery department for further assessment and care. Instead of an invasive procedure, the medical team opted for a cautious, non-invasive approach. They administered a proctoclysis enema to gently irrigate the bowel and provided oral laxatives to aid the natural expulsion of the foreign objects.
Over the ensuing 48 hours, the child remained under vigilant observation in the hospital. Throughout this period, the team monitored her condition attentively as the pebbles gradually began to pass through her system. To the astonishment of everyone involved, the toddler ultimately passed nearly a thousand pebbles, weighing close to one kilogram.
While talking with Kashmir Life, reflecting on the case, Dr Naikoo said, “When I first examined the X-ray, I realised we were dealing with something extraordinary. I advised the parents to continue feeding her as usual and to collect her stool in a container. Over two days, she relieved herself numerous times, and we accounted for nearly a thousand pebbles.”
The case left the medical community in shock and raised urgent questions about the child’s environment and how she could have ingested such a large number of pebbles undetected. The girl’s parents were equally bewildered, unable to explain when or how she might have swallowed the stones.
Though the child was fortunate to have expelled the pebbles without surgery, her large intestine had endured considerable strain. “The fact that she avoided serious complications was a stroke of luck,” Dr Naikoo observed, noting that any delay in medical intervention could have led to a much more severe outcome.
When questioned about the potential impact of the pebbles on the young girl’s health, Dr Naikoo clarified that not all foreign objects entering the body pose significant harm. “In this instance, the pebbles were small and round, which prevented the situation from becoming more complicated,” he explained. “Had the objects been sharp or pointed, they could have caused serious injury, potentially tearing the oesophagus or damaging other parts of the digestive tract.”
Dr Naikoo also shed light on the body’s response to foreign objects. “The human body reacts swiftly to anything unnatural, which was what triggered the severe abdominal pain in this case. Her system was essentially trying to reject the pebbles, leading to the discomfort she experienced.”
Though the girl’s condition was ultimately managed without major complications, Dr Naikoo underscored the risks involved. Had the objects differed in shape or size, he noted, the outcome could have been far more perilous.
The Medical Superintendent of Shopian’s District Hospital, in conversation with Kashmir Life, voiced concerns about the circumstances that had led to the young girl’s condition. He pointed to inadequate parental supervision as a likely factor. “This situation arose due to a lack of attentiveness on the part of her parents,” he remarked. “The family already has five or six children, and, in such cases, parents often feel a sense of relief when their children play on their own. It can ease their sense of stress and responsibility.”
He emphasised the risks associated with such neglect, particularly for very young children. “Leaving a two-year-old unsupervised in an open area, without monitoring what she might eat or play with, is deeply concerning,” he stated. “In this instance, the toddler had been left alone to play in a nearby field, with no one watching over her. Over several days, she ingested pebbles repeatedly, until her body could no longer tolerate them and began to reject them.”
The Medical Superintendent underscored the critical role of vigilant parenting, particularly for the youngest children. He urged parents to stay attentive and observe their little ones closely, especially those too young to express discomfort. “A baby who cannot speak is unable to tell their parents what is wrong, and this can sometimes lead to severe health issues if not addressed in time,” he cautioned.
Dr Naikoo shared a disturbing case from his practice involving a 26-year-old woman who engaged in behaviour most people would find unsettling. “She would pull out hair from her head and eat it every day,” he recounted. “Over time, a large ball of hair formed inside her stomach, and unlike other foreign objects, it could not pass naturally.”
The situation became severe enough to require surgery, during which doctors removed the massive hairball from her stomach. Post-surgery counselling revealed that this behaviour had become her way of coping with anxiety. “She admitted she felt relief when she did it—it was her method of managing stress,” Dr Naikoo explained.
He further elaborated on the psychological roots of such behaviours. “It becomes part of their psyche. Children and even adults dealing with stress, anxiety, or certain disorders often adopt unusual or harmful habits as a means of coping,” he said.
Dr Asma, a psychiatrist based in Srinagar, described how it is not uncommon to encounter cases of children or adults consuming non-edible items. “In many cases, adults compulsively eat things like chalk, clay, or even coal to satisfy their cravings. For them, it acts almost like a drug. They feel they cannot start their day without it. It provides them with temporary relief from stress, much like substances do,” she explained.
Dr Asma pointed out that such behaviours often stem from underlying mental health conditions, particularly severe anxiety and depression. “Patients experiencing high levels of anxiety or depression are more likely to engage in these behaviours. Stress from parental disputes, work pressures, academic demands, or other life challenges can drive individuals toward these coping mechanisms,” she added.
She identified this condition as Pica, an eating disorder where individuals compulsively consume non-food items with no nutritional value. “Depending on the context, Pica can sometimes be harmless,” she remarked. “However, when someone ingests something toxic or hazardous, it can lead to serious health complications.”
Dr Asma outlined several health risks associated with Pica, including anaemia (low iron levels), ascariasis (roundworm infection), constipation, irregular heart rhythms (arrhythmias), lead poisoning, and obstructions in the small or large intestine.
She emphasised the importance of early diagnosis and intervention, as well as the role of a supportive environment in helping individuals manage this condition. “With proper counselling and emotional support, it is possible to address the root causes of Pica. Creating a positive, stress-free environment around the individual is key to helping them overcome the disorder,” Dr Asma concluded.
