Hiccups
(Singultus)
Definition
Hiccups are an episode of repeated, uncontrollable spasms of the diaphragm muscle. This results in an odd, sometimes uncomfortable gasping sensation and sound with each hiccup.
Diaphragm
Causes
Everyone experiences hiccups at one time or another. Some unusual medical conditions result in hiccups that persist for long periods of time and may be very difficult to control.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors for hiccups include:
- Sex: men
- General anesthesia
- Having surgery
- Irritation to the nerve that stimulates the diaphragm (phrenic nerve)
- Certain medical disorders of the central nervous system or kidneys
Phrenic Nerve and Diaphragm
Symptoms
Symptoms include:
- Repeated, uncontrollable spasms of the diaphragm muscle
- Uncomfortable gasping sensation and sound with each hiccup
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam. If you have the hiccups, they will be evident during the exam. If the doctor is concerned that the hiccups may be caused by some underlying illness, you may need tests. These tests might include:
- Blood tests
- Liver function tests
- Chest x-ray —a test that uses radiation to take a picture of structures inside the body
- CT scan of the head , chest, and/or abdomen —a type of x-ray that uses a computer to make pictures of the inside of the body
- Echocardiogram —a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
- Bronchoscopy —a thin, lighted tube inserted into the bronchial tubes to examine the lungs and air passages
- Upper endoscopy —a thin, lighted tube inserted down the throat to examine the stomach and intestine
Treatment
Many treatments for hiccups involve stimulating various nerves that may be involved. This can be done by:
- Eating granulated sugar
- Valsalva maneuver—holding your breath and bearing down, as you might when having a bowel movement
- Breathing into a bag
- Pulling on your tongue
- Lifting the uvula (the tissue hanging down in the back of your throat) with a spoon
- Assuming a knees-to-chest position
- Belching
- Purposefully gasping
- Complete relaxation with slow controlled breathing
-
Some drugs may help resolve particularly troublesome hiccups, including:
- Chlorpromazine
- Seizure medications
- Benzodiazepines
- Metoclopramide
- Baclofen
- General anesthesia
Prevention
It is not known why some people get hiccups and others don't. There are no sure ways to prevent developing this condition. However, if you're prone to hiccups, you might want to avoid:
- Overfilling your stomach
- Carbonated beverages
- Sudden changes in temperature
- Alcohol
- Overexcitement (including stress, intense emotion, heavy laughing, or crying)
RESOURCES:
American Academy of Family Physicians
http://www.aafp.org/
National Library of Medicine
http://www.nlm.nih.gov/
CANADIAN RESOURCES:
Canada Health Portal
http://chp-pcs.gc.ca/
Canadian Institutes of Health Research
http://www.cihr-irsc.gc.ca/
References:
Current Medical Diagnosis and Treatment. Lange Medical Books; 2001.
Ferri's Clinical Advisor . Mosby; 2000.
Last reviewed November 2009 by Robert E. Leach, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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