A Patient Presenting With Hematochezia Found to Have Geophagia-Induced Electrolyte Derangements

Geophagia is the deliberate practice of eating earth or other soil-like substances. Although associated with nutritional deficiency, it may occur as a culturally sanctioned practice outside the context of illness. A patient with kidney failure on home hemodialysis presented with hematochezia, myalgias, and fatigue. She was found to have constipation with radiopacities in the gastrointestinal tract, symptomatic hypokalemia, hypocalcemia, and relative hypophosphatemia in the setting of end-stage kidney disease. History revealed significant geophagia and intake of bentonite clay, which is primarily composed of aluminum, a phosphorus binder, and silica, a potassium binder. Her electrolyte abnormalities resolved with clay discontinuation.