Materiały źródłowe

• #1 Hiccups – UpToDate

  https://www.uptodate.com/contents/hiccups

  Hiccups are a common and usually transient condition affecting almost everyone during their lifetime. A hiccup is also known as a „hiccough” and as a „singultus” from the Latin „singult,” meaning a „gasp” or „sob.” […] This topic will discuss the pathophysiology, etiology, evaluation, and treatment of hiccups. […] While brief bouts of hiccups lasting less than 48 hours are common, little is known about the overall incidence and prevalence of prolonged hiccups in the general population. […] However, among patients with advanced cancer, a systematic review found that 1 to 9 percent had persistent or intractable hiccups. […] A hiccup occurs due to an involuntary, intermittent, spasmodic contraction of the diaphragm and intercostal muscles. This causes sudden inspiration that ends with abrupt closure of the glottis, generating the „hic” sound. […] Hiccups often occur at a frequency of 4 to 60 per minute; the frequency remains relatively constant in a given individual.

• #2 Hiccups – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/symptoms-causes/syc-20352613

  Spasms of your diaphragm that you can’t control cause hiccups. The diaphragm is the muscle that separates your chest from your stomach area and plays an important role in breathing. This spasm causes your vocal cords to close briefly, producing a „hic” sound. […] Hiccups are repeated spasms or sudden movements of the diaphragm that you can’t control. […] Eating a large meal, drinking alcoholic or carbonated beverages, or getting excited suddenly may cause hiccups. In some cases, hiccups may be a sign of an underlying medical issue. For most people, hiccups usually last only a few minutes. Rarely, hiccups may continue for months. When they last that long, they can result in weight loss and extreme tiredness. […] Make an appointment to see your health care provider if your hiccups last more than 48 hours or if they’re so severe that they cause issues with eating, sleeping or breathing.

• #3 Hiccups: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hiccups-care-instructions.abk7514

  Hiccups occur when a spasm contracts the diaphragm. This is a large sheet of muscle that separates the chest cavity from the abdominal cavity. The spasm causes an intake of breath that is suddenly stopped by the closing of the vocal cords. This closure causes the „hiccup” sound. […] Most hiccups go away on their own within a few minutes to a few hours and don’t require any treatment. […] Hiccups that last longer than 48 hours are called persistent hiccups. Hiccups that last longer than a month are called intractable hiccups. Both kinds of hiccups may be a sign of a more serious health problem. Tests may be needed to help find the cause. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #4

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk7510

  Hiccups occur when a spasm contracts the diaphragm. This is a large sheet of muscle that separates the chest cavity from the abdominal cavity. The spasm causes an intake of breath that is suddenly stopped by the closing of the vocal cords. This closure causes the „hiccup” sound. […] Most hiccups go away on their own within a few minutes to a few hours and don’t require any treatment. […] Hiccups that last longer than 48 hours are called persistent hiccups. Hiccups that last longer than a month are called intractable hiccups. Both kinds of hiccups may be a sign of a more serious health problem. Tests may be needed to help find the cause. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It’s also a good idea to know your child’s test results and keep a list of the medicines your child takes.

• #5 Hiccups – UpToDate

  https://www.uptodate.com/contents/hiccups

  Hiccups are a common and usually transient condition affecting almost everyone during their lifetime. A hiccup is also known as a „hiccough” and as a „singultus” from the Latin „singult,” meaning a „gasp” or „sob.” […] This topic will discuss the pathophysiology, etiology, evaluation, and treatment of hiccups. […] While brief bouts of hiccups lasting less than 48 hours are common, little is known about the overall incidence and prevalence of prolonged hiccups in the general population. […] However, among patients with advanced cancer, a systematic review found that 1 to 9 percent had persistent or intractable hiccups. […] A hiccup occurs due to an involuntary, intermittent, spasmodic contraction of the diaphragm and intercostal muscles. This causes sudden inspiration that ends with abrupt closure of the glottis, generating the „hic” sound. […] Hiccups often occur at a frequency of 4 to 60 per minute; the frequency remains relatively constant in a given individual.

• #6 What Causes Hiccups: How to Make Them Stop and More

  https://www.healthline.com/health/hiccups

  Hiccups can occur at any age. They can even occur while a fetus is still in the womb. […] Hiccups are also normal in newborns, are rarely bothersome for them, and dont typically require home remedies or treatment. […] Contact a doctor if you have hiccups that last longer than 2 days. The doctor can determine the severity of your hiccups in relation to your overall health and other conditions. […] Treating any underlying causes of your hiccups will usually make them go away. […] If your hiccups last for a while and have no obvious cause, a doctor may recommend several anti-hiccup medications. […] A doctor may perform a carotid sinus massage to help stop long lasting hiccups. […] There are also more invasive options, which can be used to end extreme cases of hiccups. […] Hiccups that last longer than 48 hours are considered persistent. Hiccups that last longer than 2 months are considered intractable, or difficult to manage.

• #7 Diagnostics: Intractable Hiccups — Taming the SRU

  https://www.tamingthesru.com/blog/diagnostics/intractable-hiccups

  Hiccups are one of the most common human reflexes and fascinatingly occur in adults, children, neonates and in utero! The official medical term for hiccups is singultus which is derived from the Latin root word singult and means to catch ones breath while sobbing. […] In most cases, hiccups are a benign, self-limited, albeit annoying phenomenon. However, as hiccups become increasingly frequent or persistent, they can be distressing for patients and can be a sign of underlying disease. Prolonged hiccups can also cause a myriad of negative health consequences including sleep deprivation, exhaustion, malnutrition, dehydration, and depression. […] The physiology, etiology, and evaluation/management strategy of intractable hiccups remains poorly understood. As emergency medicine physicians, it is our job to discern concerning symptoms from the benign and recognize the subtle differences between them to guide appropriate therapy and disposition. This approach can be applied to the chief complaint of hiccups as it represents a largely benign process that can harbor underlying disease when persistent or intractable. This blog post will attempt to serve as a resource to assist in the evaluation of persistent/intractable hiccups and cover the physiology, classification, associated disease processes, evaluation and management strategies of hiccups in the emergency department. […] Persistent or intractable hiccups without explanation warrant additional workup.

• #8 Singultus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538225/

  Hiccups can be acute, lasting less than 48 hours, persistent, lasting over 2 days, or intractable, lasting more than one month. […] This activity stresses the role of the interprofessional team in the care of affected patients. […] Explain a well-coordinated interprofessional team approach to provide effective care to patients affected by persistent or intractable hiccups. […] Hiccups are often caused by gastrointestinal disorders such as gastroesophageal reflux. […] Acute hiccups can be uncomfortable, and a brief annoyance, however persistent and intractable hiccups have a significant impact on quality of life by interfering with eating, sleeping, speaking, and social activities, and can be a harbinger of serious medical pathology. […] Important steps in the treatment of persistent and intractable hiccups are, first, to assess whether the patient is using a medication known to induce hiccups, and second, to determine whether hiccups are associated with GERD.

• #9 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  Persistent hiccups are those that last more than 48 hours, whereas intractable hiccups are those that last more than one month (Lewis, 1985). […] Common causes of hiccups in terminal disease include gastric distension, gastro-oesophageal reflux, diaphragmatic irritation, phrenic nerve irritation, toxicity and central nervous system tumour (Twycross and Wilcock, 2001). […] Intractable hiccups are occasionally seen in patients with a terminal disease, and can be a distressing symptom for some. It is important to elicit from the patient how a symptom affects them as an individual, in order to be able to plan care that effectively improves their quality of life. […] A review of the literature shows that the effective management of hiccups depends on the patient and how they respond to a particular pharmacological approach.

• #10 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  Hiccups are usually self-limiting and benign but can be distressing when they become persistent or intractable and produce significant morbidity. […] In the intubated patients in neurocritical care, persistent hiccups may cause respiratory alkalosis and are also associated with an increased incidence of ventilator-associated pneumonia. […] Several pharmacological and nonpharmacological strategies have been devised for the treatment of persistent and intractable hiccups. […] An accurate estimate of the burden of hiccups in the neuro-intensive care unit (ICU) leading to unfavorable outcomes and morbidity is unknown. […] Though persistent hiccups which are intractable and of neurogenic origin can result in hyperventilation and respiratory alkalosis, and are a risk factor for ventilator associated pneumonia in intubated and mechanically ventilated patients.

• #11 Hiccup: Mystery, Nature and Treatment

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm.2012.18.2.123

  Hiccup is the sudden onset of erratic diaphragmatic and intercostal muscle contraction and immediately followed by laryngeal closure. […] Hiccup is usually a self-limited disorder; however, when it is prolonged beyond 48 hours, it is considered persistent whereas episodes longer than 2 months are called intractable. […] An effective treatment of persistent hiccup may be established upon the correct diagnosis of lesion responsible for the serious event. […] The pharmacotherapy of hiccup includes chlorpromazine, gabapentin, baclofen, serotonergic agonists, prokinetics and lidocaine. […] Non-pharmacological approaches such as nerve blockade, pacing, acupuncture and measures to hold breathing are also successful. […] In conclusions, hiccup is likely to result from lesions involving the hiccup reflex arc.

• #12 Treatment of Lung Cancer-Related Intractable Hiccups Using Pulsed Radiofrequency: Clinical Experience

  https://www.e-jhpc.org/journal/view.html?doi=10.14475/kjhpc.2018.21.3.104

  While most benign hiccups can be controlled with empirical therapy, intractable hiccups lasting longer than one month tend to have significant adverse effects with obscure etiology. Treatment strategies for intractable hiccups have not been established. Only a few sporadic cases of bilateral phrenic nerve blockage have been reported. […] An intractable hiccup, defined as a persistent hiccup for more than one month, is a rare disorder that causes significant morbidity in patients with advanced cancers. […] Because intractable hiccup is very difficult to be treated by conventional methods, such as holding a breath and drinking cold water, variable pharmacologic treatments have been researched, including anticonvulsants, dopamine antagonists, and methylphenidate or serotonin receptor agonists.

• #13 Hiccups: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hiccups-care-instructions.abk7514

  Hiccups occur when a spasm contracts the diaphragm. This is a large sheet of muscle that separates the chest cavity from the abdominal cavity. The spasm causes an intake of breath that is suddenly stopped by the closing of the vocal cords. This closure causes the „hiccup” sound. […] Most hiccups go away on their own within a few minutes to a few hours and don’t require any treatment. […] Hiccups that last longer than 48 hours are called persistent hiccups. Hiccups that last longer than a month are called intractable hiccups. Both kinds of hiccups may be a sign of a more serious health problem. Tests may be needed to help find the cause. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #14 Singultus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538225/

  Hiccups can be acute, lasting less than 48 hours, persistent, lasting over 2 days, or intractable, lasting more than one month. […] This activity stresses the role of the interprofessional team in the care of affected patients. […] Explain a well-coordinated interprofessional team approach to provide effective care to patients affected by persistent or intractable hiccups. […] Hiccups are often caused by gastrointestinal disorders such as gastroesophageal reflux. […] Acute hiccups can be uncomfortable, and a brief annoyance, however persistent and intractable hiccups have a significant impact on quality of life by interfering with eating, sleeping, speaking, and social activities, and can be a harbinger of serious medical pathology. […] Important steps in the treatment of persistent and intractable hiccups are, first, to assess whether the patient is using a medication known to induce hiccups, and second, to determine whether hiccups are associated with GERD.

• #15 Hiccups – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/symptoms-causes/syc-20352613

  Issues that may cause hiccups to last more than 48 hours include nerve damage or irritation, central nervous system disorders, metabolic issues, and certain drug and alcohol problems. […] A cause of long-term hiccups is damage to, or irritation of, the vagus nerves or phrenic nerves. These nerves supply the diaphragm muscle. […] Ongoing hiccups may interfere with eating, drinking, sleeping and speaking. Hiccups also can worsen pain.

• #16 Hiccups: Causes, Serious Signs, Treatment, Home Remedies and More

  https://www.medicinenet.com/hiccups/article.htm

  If your child’s hiccups worsen or they seem to upset him, contact your pediatrician. […] Hiccups are usually harmless and last for a short duration. […] Because most cases of hiccups resolve themselves either spontaneously or with self-administered treatment, complications are extremely rare. […] Hiccups cannot always be prevented. Avoiding overeating, eating too quickly, or drinking too much can help prevent hiccups.

• #17 Stopping and preventing hiccups | OSF HealthCare

  https://www.osfhealthcare.org/blog/stopping-and-preventing-hiccups/

  See your primary care provider. […] Hiccups are an involuntary retraction of the diaphragm, which helps control your breathing. […] Lots of things can trigger a contraction of your diaphragm: carbonated beverages, alcohol, emotional stress, swallowing air. […] If you do have hiccups consistently, for more than a few days at a time, that can be a sign of something more sinister. […] If your hiccups persist more than two weeks, it could be an early warning sign of something you don’t want to miss. See a primary care provider.

• #18 Can Stress Cause Hiccups? | Hackensack Meridian Health

  https://www.hackensackmeridianhealth.org/en/healthu/2022/03/10/can-stress-cause-hiccups

  Hiccups can be an annoying disruption to your day, especially if youre interrupted by an embarrassing hic when youre talking to someone important. […] If this happens to you, its not your imagination; stress can cause hiccups in some people. […] Both children and adults may occasionally experience bouts of hiccups in response to stressful events. […] A stressful event, manifested as sudden excitement, nervousness, fear or shock may act as a trigger, causing the diaphragm to begin to spasm. […] Hiccups that can be linked to an emotional reaction are typically short-lived, lasting less than 48 hours. […] In most cases, the hiccups should go away on their own, or with your intervention, within a few minutes.

• #19 Stopping and preventing hiccups | OSF HealthCare

  https://www.osfhealthcare.org/blog/stopping-and-preventing-hiccups/

  See your primary care provider. […] Hiccups are an involuntary retraction of the diaphragm, which helps control your breathing. […] Lots of things can trigger a contraction of your diaphragm: carbonated beverages, alcohol, emotional stress, swallowing air. […] If you do have hiccups consistently, for more than a few days at a time, that can be a sign of something more sinister. […] If your hiccups persist more than two weeks, it could be an early warning sign of something you don’t want to miss. See a primary care provider.

• #20 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Hiccups are often nothing more than a nuisance. […] In such cases, you may need treatment to help get rid of your hiccups and manage the underlying cause. […] You should call a healthcare provider if your hiccups last longer than two days. This could be a sign of a more serious condition that needs medical attention. […] Various medical conditions can cause persistent hiccups, including: gastrointestinal diseases, like GERD or gastritis; conditions affecting your central nervous system, like stroke, Parkinson’s disease or multiple sclerosis; lung conditions, like pneumonia, pulmonary embolism or pleurisy; tumors or lesions, like mediastinal tumors, esophageal cancer or pancreatic cancer; conditions that disrupt your metabolism and related nerve signaling, like uremia or hypocalcemia; certain infections, like flu, shingles and herpes simplex.

• #21 Singultus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538225/

  Hiccups can be acute, lasting less than 48 hours, persistent, lasting over 2 days, or intractable, lasting more than one month. […] This activity stresses the role of the interprofessional team in the care of affected patients. […] Explain a well-coordinated interprofessional team approach to provide effective care to patients affected by persistent or intractable hiccups. […] Hiccups are often caused by gastrointestinal disorders such as gastroesophageal reflux. […] Acute hiccups can be uncomfortable, and a brief annoyance, however persistent and intractable hiccups have a significant impact on quality of life by interfering with eating, sleeping, speaking, and social activities, and can be a harbinger of serious medical pathology. […] Important steps in the treatment of persistent and intractable hiccups are, first, to assess whether the patient is using a medication known to induce hiccups, and second, to determine whether hiccups are associated with GERD.

• #22 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Hiccups are often nothing more than a nuisance. […] In such cases, you may need treatment to help get rid of your hiccups and manage the underlying cause. […] You should call a healthcare provider if your hiccups last longer than two days. This could be a sign of a more serious condition that needs medical attention. […] Various medical conditions can cause persistent hiccups, including: gastrointestinal diseases, like GERD or gastritis; conditions affecting your central nervous system, like stroke, Parkinson’s disease or multiple sclerosis; lung conditions, like pneumonia, pulmonary embolism or pleurisy; tumors or lesions, like mediastinal tumors, esophageal cancer or pancreatic cancer; conditions that disrupt your metabolism and related nerve signaling, like uremia or hypocalcemia; certain infections, like flu, shingles and herpes simplex.

• #23 What to Do About Hiccups That Won’t QuitCalifornia Consumer Privacy Act (CCPA) Opt-Out Icon

  https://health.usnews.com/health-care/patient-advice/articles/2018-09-11/what-to-do-about-hiccups-that-wont-quit

  Persistent and intractable hiccups are commonly caused by an underlying health issue. […] Research finds that persistent and intractable hiccups tend to be linked to an underlying medical condition or disease. […] In either case, it’s worth taking a closer look when hiccups persist past 48 hours, experts say. […] Just as it’s worth undergoing a medical evaluation to try to determine the underlying causes for persistent and intractable hiccups – when that’s not already known – experts say there’s reason to consider treating these long-lasting hiccups. […] Patients with intractable hiccups may experience issues including difficulty being able to eat or drink, Rizzo says. […] Of course if you can’t get it done in the bedroom – or otherwise get rid of persistent and intractable hiccups at home – experts say it’s worth talking to a doctor about it.

• #24 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Hiccups are often nothing more than a nuisance. […] In such cases, you may need treatment to help get rid of your hiccups and manage the underlying cause. […] You should call a healthcare provider if your hiccups last longer than two days. This could be a sign of a more serious condition that needs medical attention. […] Various medical conditions can cause persistent hiccups, including: gastrointestinal diseases, like GERD or gastritis; conditions affecting your central nervous system, like stroke, Parkinson’s disease or multiple sclerosis; lung conditions, like pneumonia, pulmonary embolism or pleurisy; tumors or lesions, like mediastinal tumors, esophageal cancer or pancreatic cancer; conditions that disrupt your metabolism and related nerve signaling, like uremia or hypocalcemia; certain infections, like flu, shingles and herpes simplex.

• #25 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Hiccups are often nothing more than a nuisance. […] In such cases, you may need treatment to help get rid of your hiccups and manage the underlying cause. […] You should call a healthcare provider if your hiccups last longer than two days. This could be a sign of a more serious condition that needs medical attention. […] Various medical conditions can cause persistent hiccups, including: gastrointestinal diseases, like GERD or gastritis; conditions affecting your central nervous system, like stroke, Parkinson’s disease or multiple sclerosis; lung conditions, like pneumonia, pulmonary embolism or pleurisy; tumors or lesions, like mediastinal tumors, esophageal cancer or pancreatic cancer; conditions that disrupt your metabolism and related nerve signaling, like uremia or hypocalcemia; certain infections, like flu, shingles and herpes simplex.

• #26 Prone to hiccups? Here’s what you need to know | UCLA Health

  https://www.uclahealth.org/news/article/prone-hiccups-heres-what-you-need-know

  Hiccups can be more than just an annoyance. When they happen often or dont go away quickly, they can affect important parts of your life, such as sleeping, eating and socializing. In some cases, hiccups can be a sign of a more serious condition. […] Treatment for hiccups depends on the type of hiccups youre experiencing: […] Having hiccups around the clock for multiple days, weeks or months may cause issues with: Eating, Drinking, Sleeping, Socializing, Working. […] If your hiccups last longer than two days or interrupt your ability to sleep or eat, contact your primary care physician (PCP). […] Chronic hiccups can be a side effect of some medications. They can also occur after surgery or an endoscopic procedure. […] In rare cases, persistent or intractable hiccups can indicate an underlying condition. If they do, youll typically have other symptoms of that condition, too. Hiccups may be a sign of: Cardiovascular disorders, such as aortic aneurism or pericarditis, Central nervous system conditions, with 20% of people with Parkinsons disease reporting recurrent hiccups, Ear, nose and throat disorders, including laryngitis and neoplasms (abnormal tissue growth), Esophageal tumors, which involve persistent hiccups in 25% of cases, Gastrointestinal disorders, including GERD and pancreatitis. […] Your PCP should always be your first call if you have concerns. They can evaluate your hiccups and general health to get you the care you need.

• #27 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Hiccups are often nothing more than a nuisance. […] In such cases, you may need treatment to help get rid of your hiccups and manage the underlying cause. […] You should call a healthcare provider if your hiccups last longer than two days. This could be a sign of a more serious condition that needs medical attention. […] Various medical conditions can cause persistent hiccups, including: gastrointestinal diseases, like GERD or gastritis; conditions affecting your central nervous system, like stroke, Parkinson’s disease or multiple sclerosis; lung conditions, like pneumonia, pulmonary embolism or pleurisy; tumors or lesions, like mediastinal tumors, esophageal cancer or pancreatic cancer; conditions that disrupt your metabolism and related nerve signaling, like uremia or hypocalcemia; certain infections, like flu, shingles and herpes simplex.

• #28 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Hiccups are often nothing more than a nuisance. […] In such cases, you may need treatment to help get rid of your hiccups and manage the underlying cause. […] You should call a healthcare provider if your hiccups last longer than two days. This could be a sign of a more serious condition that needs medical attention. […] Various medical conditions can cause persistent hiccups, including: gastrointestinal diseases, like GERD or gastritis; conditions affecting your central nervous system, like stroke, Parkinson’s disease or multiple sclerosis; lung conditions, like pneumonia, pulmonary embolism or pleurisy; tumors or lesions, like mediastinal tumors, esophageal cancer or pancreatic cancer; conditions that disrupt your metabolism and related nerve signaling, like uremia or hypocalcemia; certain infections, like flu, shingles and herpes simplex.

• #29  When are hiccups serious? | Ohio State Health & Discovery

  https://health.osu.edu/health/general-health/when-are-hiccups-serious

  Hiccups. They can be annoying or embarrassing, but we typically dont think of them as concerning. Theyre usually short-lived, although in rare cases, they can persist. When they last more than a couple of days, or if other symptoms occur at their onset, they can be a sign of a more serious medical condition. […] Prolonged hiccups, though, could be caused by direct post-surgical irritation of the phrenic nerve, which is the nerve that helps the diaphragm muscle to fire, or the vagus nerve, which is part of the autonomic nervous system that controls the heart rate and breathing. […] First, if hiccups persist more than a couple of days, you should seek care with your primary care provider. This is important especially if the hiccups are preventing you from sleeping. Your provider can rule out other medical causes and may prescribe medications if more traditional methods of stopping your hiccups arent working.

• #30 What Causes Hiccups: How to Make Them Stop and More

  https://www.healthline.com/health/hiccups

  The majority of persistent hiccups are caused by injury or irritation to either the vagus or phrenic nerve. […] If the cause of your hiccups is unclear, a doctor may recommend tests. These can help detect any underlying disease or condition. […] A long-term episode of hiccups can be uncomfortable and even harmful to your health. If left untreated, prolonged hiccups can disturb your sleeping and eating patterns, leading to: sleeplessness, exhaustion, malnutrition, weight loss, dehydration. […] Theres no proven method for preventing hiccups. However, if you experience hiccups frequently, you can try to reduce your exposure to known triggers.

• #31 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Some medications can also cause persistent hiccups. […] Persistent hiccups may also happen after certain surgeries or procedures, including those that require general anesthesia. […] Hiccups that last longer than two days are more than just a nuisance. They can interfere with your quality of life and lead to trouble with basic needs like eating or sleeping. […] Possible medications a healthcare provider may prescribe for you include: Chlorpromazine; Proton pump inhibitor (medicines that reduce stomach acid); Metoclopramide; Baclofen; Gabapentin. […] If another medication you’re taking is causing your hiccups, your provider may tell you to stop taking it and take another instead. […] Call your healthcare provider if your hiccups last longer than two days. […] Persistent hiccups can greatly affect your quality of life. If this happens to you, don’t hesitate to talk to your healthcare provider. They’ll find the cause and recommend treatment so you can start feeling better.

• #32 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Some medications can also cause persistent hiccups. […] Persistent hiccups may also happen after certain surgeries or procedures, including those that require general anesthesia. […] Hiccups that last longer than two days are more than just a nuisance. They can interfere with your quality of life and lead to trouble with basic needs like eating or sleeping. […] Possible medications a healthcare provider may prescribe for you include: Chlorpromazine; Proton pump inhibitor (medicines that reduce stomach acid); Metoclopramide; Baclofen; Gabapentin. […] If another medication you’re taking is causing your hiccups, your provider may tell you to stop taking it and take another instead. […] Call your healthcare provider if your hiccups last longer than two days. […] Persistent hiccups can greatly affect your quality of life. If this happens to you, don’t hesitate to talk to your healthcare provider. They’ll find the cause and recommend treatment so you can start feeling better.

• #33 Persistent Postoperative Hiccups – Greater Philadelphia Anesthesia Services

  https://philadelphiaanesthesiaservices.com/persistent-postoperative-hiccups/

  Hiccups are a common transient ailment that affects most people at least once in their lifetime. […] In rare situations, persistent hiccups can occur in the postoperative period. […] Persistent hiccups last 48 hours 1 month while intractable hiccups last greater than 1 month. […] Few studies have elucidated the frequency and pathophysiology of postoperative hiccups. […] Initial management of persistent hiccups include physical maneuvers such as breath holding as tolerated, the Valsalva maneuver for 5 seconds, and pulling on the tongue, which may have varying efficacy depending on the individual. […] New researchers at the University of Texas have developed a forced inspiratory suction and swallow tool (FISST) patented as HiccAway which induces diaphragmatic contraction and epiglottic closure.

• #34 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Some medications can also cause persistent hiccups. […] Persistent hiccups may also happen after certain surgeries or procedures, including those that require general anesthesia. […] Hiccups that last longer than two days are more than just a nuisance. They can interfere with your quality of life and lead to trouble with basic needs like eating or sleeping. […] Possible medications a healthcare provider may prescribe for you include: Chlorpromazine; Proton pump inhibitor (medicines that reduce stomach acid); Metoclopramide; Baclofen; Gabapentin. […] If another medication you’re taking is causing your hiccups, your provider may tell you to stop taking it and take another instead. […] Call your healthcare provider if your hiccups last longer than two days. […] Persistent hiccups can greatly affect your quality of life. If this happens to you, don’t hesitate to talk to your healthcare provider. They’ll find the cause and recommend treatment so you can start feeling better.

• #35 Management of hiccups in palliative care patients | BMJ Supportive & Palliative Care

  https://spcare.bmj.com/content/8/1/1

  Persistent hiccups are a frustrating experience for palliative care patients, and can have a profound impact on their quality of life. […] The management of persistent hiccups still presents an ongoing clinical challenge however, requiring further research on pathophysiology and treatment strategies. […] This literature review aims to provide guidelines for the treatment of persistent or intractable hiccups in the palliative care setting. […] The treatment of hiccups should generally be guided by the nature of the underlying cause. […] If non-pharmacological manoeuvres and pharmacological interventions are not successful, procedural or surgical interventions should be considered to control intractable hiccups. […] Persistent or intractable hiccups remain a diagnostic and therapeutic challenge, and can affect a significant minority of palliative care patients.

• #36 Hiccups – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/symptoms-causes/syc-20352613

  Issues that may cause hiccups to last more than 48 hours include nerve damage or irritation, central nervous system disorders, metabolic issues, and certain drug and alcohol problems. […] A cause of long-term hiccups is damage to, or irritation of, the vagus nerves or phrenic nerves. These nerves supply the diaphragm muscle. […] Ongoing hiccups may interfere with eating, drinking, sleeping and speaking. Hiccups also can worsen pain.

• #37 What Causes Hiccups: How to Make Them Stop and More

  https://www.healthline.com/health/hiccups

  The majority of persistent hiccups are caused by injury or irritation to either the vagus or phrenic nerve. […] If the cause of your hiccups is unclear, a doctor may recommend tests. These can help detect any underlying disease or condition. […] A long-term episode of hiccups can be uncomfortable and even harmful to your health. If left untreated, prolonged hiccups can disturb your sleeping and eating patterns, leading to: sleeplessness, exhaustion, malnutrition, weight loss, dehydration. […] Theres no proven method for preventing hiccups. However, if you experience hiccups frequently, you can try to reduce your exposure to known triggers.

• #38 Prone to hiccups? Here’s what you need to know | UCLA Health

  https://www.uclahealth.org/news/article/prone-hiccups-heres-what-you-need-know

  Hiccups can be more than just an annoyance. When they happen often or dont go away quickly, they can affect important parts of your life, such as sleeping, eating and socializing. In some cases, hiccups can be a sign of a more serious condition. […] Treatment for hiccups depends on the type of hiccups youre experiencing: […] Having hiccups around the clock for multiple days, weeks or months may cause issues with: Eating, Drinking, Sleeping, Socializing, Working. […] If your hiccups last longer than two days or interrupt your ability to sleep or eat, contact your primary care physician (PCP). […] Chronic hiccups can be a side effect of some medications. They can also occur after surgery or an endoscopic procedure. […] In rare cases, persistent or intractable hiccups can indicate an underlying condition. If they do, youll typically have other symptoms of that condition, too. Hiccups may be a sign of: Cardiovascular disorders, such as aortic aneurism or pericarditis, Central nervous system conditions, with 20% of people with Parkinsons disease reporting recurrent hiccups, Ear, nose and throat disorders, including laryngitis and neoplasms (abnormal tissue growth), Esophageal tumors, which involve persistent hiccups in 25% of cases, Gastrointestinal disorders, including GERD and pancreatitis. […] Your PCP should always be your first call if you have concerns. They can evaluate your hiccups and general health to get you the care you need.

• #39 What Causes Hiccups: How to Make Them Stop and More

  https://www.healthline.com/health/hiccups

  The majority of persistent hiccups are caused by injury or irritation to either the vagus or phrenic nerve. […] If the cause of your hiccups is unclear, a doctor may recommend tests. These can help detect any underlying disease or condition. […] A long-term episode of hiccups can be uncomfortable and even harmful to your health. If left untreated, prolonged hiccups can disturb your sleeping and eating patterns, leading to: sleeplessness, exhaustion, malnutrition, weight loss, dehydration. […] Theres no proven method for preventing hiccups. However, if you experience hiccups frequently, you can try to reduce your exposure to known triggers.

• #40 What Causes Hiccups: How to Make Them Stop and More

  https://www.healthline.com/health/hiccups

  The majority of persistent hiccups are caused by injury or irritation to either the vagus or phrenic nerve. […] If the cause of your hiccups is unclear, a doctor may recommend tests. These can help detect any underlying disease or condition. […] A long-term episode of hiccups can be uncomfortable and even harmful to your health. If left untreated, prolonged hiccups can disturb your sleeping and eating patterns, leading to: sleeplessness, exhaustion, malnutrition, weight loss, dehydration. […] Theres no proven method for preventing hiccups. However, if you experience hiccups frequently, you can try to reduce your exposure to known triggers.

• #41 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  Metoclopramide and baclofen aim to relieve gastric distension by improving gastric emptying and relaxing the diaphragm. […] They are also important to assess the patients bowel functioning and to treat constipation, if indicated, as this may be contributing to the gastric distension. […] If the hiccups are not resolved by this, haloperidol and chlorpromazine could be used with the aim of suppressing the hiccup reflex. […] Hiccups can often cause severe distress and they can consequently affect the quality of life for some terminally ill patients. Indeed, persistent hiccups can effect the way patients talk, sleep, eat and drink, and in some can lead to weight loss, exhaustion, anxiety and depression (Wilcock and Twycross, 1996). […] The levels of anxiety and emotional distress suffered by a patient may contribute to hiccups. In palliative care, understanding the patients perception of the impact of the symptom on his/her quality of life is essential in order to alleviate distress and promote comfort.

• #42 Hiccups – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/symptoms-causes/syc-20352613

  Spasms of your diaphragm that you can’t control cause hiccups. The diaphragm is the muscle that separates your chest from your stomach area and plays an important role in breathing. This spasm causes your vocal cords to close briefly, producing a „hic” sound. […] Hiccups are repeated spasms or sudden movements of the diaphragm that you can’t control. […] Eating a large meal, drinking alcoholic or carbonated beverages, or getting excited suddenly may cause hiccups. In some cases, hiccups may be a sign of an underlying medical issue. For most people, hiccups usually last only a few minutes. Rarely, hiccups may continue for months. When they last that long, they can result in weight loss and extreme tiredness. […] Make an appointment to see your health care provider if your hiccups last more than 48 hours or if they’re so severe that they cause issues with eating, sleeping or breathing.

• #43 Hiccups Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/775746-clinical

  No medical training is required to diagnose hiccups. For brief episodes that self-terminate or that respond to simple maneuvers, no investigation or follow-up care is necessary. In contrast, persistent and intractable hiccups frequently are associated with an underlying pathological process and may induce significant morbidity. The focus of the history, examination, and investigation is on identifying these causes and effects. A full systemic inquiry, surgical history, and comprehensive drug history may identify one of the many possible causes. […] Hiccups that abate with sleep and temporally relate to stressful circumstances commonly are psychogenic in origin. Arrhythmia-induced syncope has been reported as both the cause and the effect of hiccups. Gastroesophageal reflux also may either cause or result from hiccups. Weight loss, insomnia, and emotional distress may complicate prolonged episodes. Alcoholism and acute alcohol ingestion may contribute to the development of hiccups.

• #44 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  Hiccups are usually self-limiting and benign but can be distressing when they become persistent or intractable and produce significant morbidity. […] In the intubated patients in neurocritical care, persistent hiccups may cause respiratory alkalosis and are also associated with an increased incidence of ventilator-associated pneumonia. […] Several pharmacological and nonpharmacological strategies have been devised for the treatment of persistent and intractable hiccups. […] An accurate estimate of the burden of hiccups in the neuro-intensive care unit (ICU) leading to unfavorable outcomes and morbidity is unknown. […] Though persistent hiccups which are intractable and of neurogenic origin can result in hyperventilation and respiratory alkalosis, and are a risk factor for ventilator associated pneumonia in intubated and mechanically ventilated patients.

• #45 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  Hiccups (also referred to as “hiccoughs”) are usually a transient condition that affects almost everyone in their lifetime. However, persistent and intractable hiccups are the types which are often linked with unfavorable outcomes and can also result in respiratory alkalosis in the intubated patients. […] The most commonly witnessed hiccups in the neuro-ICU are intractable and neurogenic in nature. […] In this communication, we discuss the strategy of respiratory care and pharmacological management of hiccups in an adult male post decompressive craniotomy in view of unilateral basal ganglion bleed. […] It seems that persistent and intractable hiccups as a risk factor for ventilator-associated pneumonia in patients who are intubated and mechanically ventilated should be given due attention.

• #46 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  Metoclopramide and baclofen aim to relieve gastric distension by improving gastric emptying and relaxing the diaphragm. […] They are also important to assess the patients bowel functioning and to treat constipation, if indicated, as this may be contributing to the gastric distension. […] If the hiccups are not resolved by this, haloperidol and chlorpromazine could be used with the aim of suppressing the hiccup reflex. […] Hiccups can often cause severe distress and they can consequently affect the quality of life for some terminally ill patients. Indeed, persistent hiccups can effect the way patients talk, sleep, eat and drink, and in some can lead to weight loss, exhaustion, anxiety and depression (Wilcock and Twycross, 1996). […] The levels of anxiety and emotional distress suffered by a patient may contribute to hiccups. In palliative care, understanding the patients perception of the impact of the symptom on his/her quality of life is essential in order to alleviate distress and promote comfort.

• #47

  https://jhoponline.com/issue-archive/2014-issues/december-vol-4-no-4/16296-hiccups

  Hiccups are an underreported respiratory complication that can significantly impair an individuals quality of life. Responsible for at least 4000 hospital admissions annually, they often are not considered significant in the need to care for a patients other pressing comorbidities such as malignancy. […] When diagnosing intractable hiccups, a careful physical and laboratory review should be performed to evaluate the myriad of possible causes. Intractable hiccups can result in anxiety, increased depression, sleep loss, impaired nutrition and fluid intake, aspiration, and induction of cardiac arrhythmias via activation of underlying cardiac pathology. This may result in significant impairment, and more rarely, death of the patient. […] Self-limited hiccups do not require intervention as they will generally resolve without causing significant distress. Although there is little scientific evidence to support their use, it is common for people to try a variety of nonpharmacologic interventions to resolve their hiccups.

• #48 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  Metoclopramide and baclofen aim to relieve gastric distension by improving gastric emptying and relaxing the diaphragm. […] They are also important to assess the patients bowel functioning and to treat constipation, if indicated, as this may be contributing to the gastric distension. […] If the hiccups are not resolved by this, haloperidol and chlorpromazine could be used with the aim of suppressing the hiccup reflex. […] Hiccups can often cause severe distress and they can consequently affect the quality of life for some terminally ill patients. Indeed, persistent hiccups can effect the way patients talk, sleep, eat and drink, and in some can lead to weight loss, exhaustion, anxiety and depression (Wilcock and Twycross, 1996). […] The levels of anxiety and emotional distress suffered by a patient may contribute to hiccups. In palliative care, understanding the patients perception of the impact of the symptom on his/her quality of life is essential in order to alleviate distress and promote comfort.

• #49 Hiccups and Heartburn | Cancer-related Side Effects | American Cancer Society

  https://www.cancer.org/cancer/managing-cancer/side-effects/eating-problems/hiccups-and-heartburn.html

  Hiccups (or hiccoughs) are spasms that affect a muscle between your lungs and stomach that is used when you breathe, called the diaphragm. […] Hiccups can be caused by irritation of the phrenic nerve that controls the diaphragm. Several things can irritate this nerve such as: Some cancer medicines, such as certain chemotherapy and targeted drug therapies […] Hiccups are more common in people with advanced cancer. […] Hiccups usually stop on their own in minutes to hours. But hiccups that continue can cause other problems. They can make it hard for people to eat, drink, sleep, and talk to other people. This can lead to being tired, depressed, and having other mood changes. […] If someone has persistent or intractable hiccups, they may need medical treatment. […] Your doctor or cancer care team might prescribe some different medicines for you to help control your hiccups. Each works in a different way so you may need to try more than one before your symptoms are relieved.

• #50 Prone to hiccups? Here’s what you need to know | UCLA Health

  https://www.uclahealth.org/news/article/prone-hiccups-heres-what-you-need-know

  Hiccups can be more than just an annoyance. When they happen often or dont go away quickly, they can affect important parts of your life, such as sleeping, eating and socializing. In some cases, hiccups can be a sign of a more serious condition. […] Treatment for hiccups depends on the type of hiccups youre experiencing: […] Having hiccups around the clock for multiple days, weeks or months may cause issues with: Eating, Drinking, Sleeping, Socializing, Working. […] If your hiccups last longer than two days or interrupt your ability to sleep or eat, contact your primary care physician (PCP). […] Chronic hiccups can be a side effect of some medications. They can also occur after surgery or an endoscopic procedure. […] In rare cases, persistent or intractable hiccups can indicate an underlying condition. If they do, youll typically have other symptoms of that condition, too. Hiccups may be a sign of: Cardiovascular disorders, such as aortic aneurism or pericarditis, Central nervous system conditions, with 20% of people with Parkinsons disease reporting recurrent hiccups, Ear, nose and throat disorders, including laryngitis and neoplasms (abnormal tissue growth), Esophageal tumors, which involve persistent hiccups in 25% of cases, Gastrointestinal disorders, including GERD and pancreatitis. […] Your PCP should always be your first call if you have concerns. They can evaluate your hiccups and general health to get you the care you need.

• #51 Hiccups: What Are They, and How Can We Stop Them?

  https://www.contemporaryclinic.com/view/hiccups-what-are-they-and-how-can-we-stop-them-

  Hiccups are generally harmless but can cause distress and inconvenience. Obtaining knowledge on the science behind and causes of hiccups provide insight on how to treat this peculiar occurrence. […] Pharmacotherapy may be considered for intractable and persistent hiccups. The drug choice will be based on the underlying cause, and because this can vary among patient, the medication chosen will also vary. […] Hiccups are brief, involuntary, and irregular bursts of air that are really 2 different events causing 1 hiccup. First, there is an involuntary contraction of the diaphragm, the muscle at the base of the lungs. The second event is the closing of the glottis. It is here that the vocal cords are located, causing the „hic” sound. […] The effects of hiccups can include inconveniences in communicating, drinking, eating, and sleeping.

• #52

  https://www.nursingcenter.com/journalarticle?Article_ID=2580469&Journal_ID=260877&Issue_ID=2580420

  There is insufficient evidence to guide the treatment of persistent or intractable hiccups; to date, no studies have involved advanced neuro-oncological patients who have experienced persistent hiccups with the aim of understanding their experience, gaining insights, and contributing to knowledge in the field. […] Persistent hiccups have a negative impact on patients’ and families’ quality of life, leading to extreme anguish and to a feeling of powerlessness when it becomes clear that there is no useful pharmacological therapy.

• #53 Managing Hiccups at End of Life – Enclara Pharmacia

  https://enclarapharmacia.com/palliative-pearls/managing-hiccups-at-end-of-life

  Hiccups can become a significant source of distress in hospice settings, impacting the quality of life of patients and their caregivers. […] Untreated hiccups can interfere with critical aspects of daily life, such as eating, sleeping, and breathing, potentially leading to exhaustion. This is particularly concerning for terminally ill patients, for whom the focus is on comfort and quality of life. […] Effective management of hiccups begins with a thorough assessment of modifiable causes. […] Symptom relief should be the focus of hiccup management in hospice and palliative care, since the exact cause of hiccups in these patients can be elusive. […] Pharmacologic treatment should be considered when hiccups are persistent or intractable, especially if non-pharmacologic interventions have failed to provide relief.

• #54

  https://jhoponline.com/issue-archive/2014-issues/december-vol-4-no-4/16296-hiccups

  Hiccups are an underreported respiratory complication that can significantly impair an individuals quality of life. Responsible for at least 4000 hospital admissions annually, they often are not considered significant in the need to care for a patients other pressing comorbidities such as malignancy. […] When diagnosing intractable hiccups, a careful physical and laboratory review should be performed to evaluate the myriad of possible causes. Intractable hiccups can result in anxiety, increased depression, sleep loss, impaired nutrition and fluid intake, aspiration, and induction of cardiac arrhythmias via activation of underlying cardiac pathology. This may result in significant impairment, and more rarely, death of the patient. […] Self-limited hiccups do not require intervention as they will generally resolve without causing significant distress. Although there is little scientific evidence to support their use, it is common for people to try a variety of nonpharmacologic interventions to resolve their hiccups.

• #55 Remedies for Prolonged Hiccups | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0501/p1684.html

  Hiccups are an annoyance to nearly everyone at one time or another. Fortunately, they are also usually self-limited and benign. It is unusual for persons to seek care for hiccups unless the episode is particularly prolonged. Prolonged hiccups, however, can be debilitating and may be a sign of serious underlying disease. Thus, when patients do present with hiccups for medical attention, it is important to evaluate for potentially serious underlying causes. […] Hiccups lasting longer than two days are termed persistent and those lasting longer than one month are considered intractable. Intractable hiccups will frequently be a sign of underlying organic disease; therefore, obtaining a thorough history and performing a physical examination is important to evaluate for potentially serious causes.

• #56 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  Hence, meticulous evaluation and treatment of persistent or intractable hiccups (IH) in neuro-ICU patients is important, in a stepwise and protocolized manner which comprise of physical maneuvers first followed by pharmacological measures in failed or resistant cases. […] Recently U.S. Food and Drug Administration (FDA) revoked the approval of chlorpromazine, citing its serious side effects in treating hiccups. […] A thorough and detailed history is warranted focusing on trigger factors for chronic hiccups along with frequency, duration, progression, and aggravating and relieving factors. […] The treatment approach of persistent hiccups is mostly based on observational reports and case series, and clear-cut guidelines are lacking. […] The treatment is mainly directed at treating the underlying cause when the illness causing hiccups has been identified.

• #57 Hiccups Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/775746-clinical

  No medical training is required to diagnose hiccups. For brief episodes that self-terminate or that respond to simple maneuvers, no investigation or follow-up care is necessary. In contrast, persistent and intractable hiccups frequently are associated with an underlying pathological process and may induce significant morbidity. The focus of the history, examination, and investigation is on identifying these causes and effects. A full systemic inquiry, surgical history, and comprehensive drug history may identify one of the many possible causes. […] Hiccups that abate with sleep and temporally relate to stressful circumstances commonly are psychogenic in origin. Arrhythmia-induced syncope has been reported as both the cause and the effect of hiccups. Gastroesophageal reflux also may either cause or result from hiccups. Weight loss, insomnia, and emotional distress may complicate prolonged episodes. Alcoholism and acute alcohol ingestion may contribute to the development of hiccups.

• #58 Hiccups Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/775746-clinical

  In view of the wide range of differentials, a full physical examination is necessary. A complete and focused physical examination may yield evidence of the following: Head (including ears, eyes, and the entire scalp): Foreign body or aberrant hair adjacent to tympanic membrane; glaucoma; Mouth: Pharyngitis; Neck: Inflammation (including laryngitis); mass lesions; goiter; voice abnormalities (recurrent laryngeal nerve); stiffness (possibly indicating tumors or infection); Chest: Tumors; pneumonia; asthma; Cardiovascular system: Arrhythmias; myocardial infarction (MI); pericarditis; unequal pulses (thoracic aortic aneurysm); Abdomen: Gastric atony (succussion splash); organomegaly; subphrenic abscess; cholecystitis; appendicitis; abdominal aortic aneurysm (AAA); pancreatitis; peritonitis; Rectum: Mass lesions; Nervous system: Focal lesions; disordered higher mental function; indications of multiple sclerosis.

• #59 FF #81 Management of Hiccups | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/management-of-hiccups/

  Hiccups (singultus) are an involuntary reflex involving the respiratory muscles of the chest and diaphragm, mediated by the phrenic and vagus nerves and a central (brainstem) reflex center. A single episode can last for a few seconds to as long as several days. When they last longer than 48 hours, hiccups are termed persistent; longer than one month, intractable. Persistent and intractable hiccups can be very distressing to patients and families and diminish quality of life. Etiologies range in seriousness from stress/excitement, gastric or esophageal distention, corticosteroids, idiopathic, post-surgical, chemotherapy, cancer, myocardial infarction, liver disease, uremia, and CNS lesions. Irritation of the vagus nerve or diaphragm is a common pathophysiologic mechanism. […] Once hiccups have lasted beyond a time-limited annoyance, deciding on therapeutic intervention should be based on a thorough clinical assessment and, if possible, treatment directed at the underlying cause. A thorough history, review of medications, focused review of systems, and physical exam may help guide initial choice of treatment. Many drug and non-drug treatments have been used, but there is little evidence of any one superior approach to management. The patient’s prognosis, current level of function, and potential adverse effects from any proposed treatment should be considered.

• #60 When Is a Hiccup Not Just a Hiccup? – SHM Abstracts | Society of Hospital Medicine

  https://shmabstracts.mystagingwebsite.com/abstract/when-is-a-hiccup-not-just-a-hiccup/

  A 67yearold man presented to the emergency department with a complaint of a presyncopal episode associated with persistent hiccupping and vomiting for 3 weeks. […] Hiccup, or singulitis, is a sudden contraction of the inspiratory muscles terminated by closure of the glottis. Persistent (greater than 48 hours) and intractable hiccups (greater than 1 month) are an uncommon presenting symptom of CNS lesions, toxicmetabolic disorders, or abdominal disorders with irritation of the diaphragm or vagus nerve. […] Hiccups, although nonspecific, may be a presenting symptom of a serious underlying medical condition warranting further investigation. Hospitalists should be aware of the potentially serious diagnosis that can present with hiccups.

• #61 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  We encourage clinical trials in this area of critical care medicine and should also encourage more studies to analyse the effectiveness of non-pharmacological methods. […] The neurogenic type occurs because of the involvement of the medulla oblongata and they might lead to respiratory irregularities resulting in a fatal respiratory arrest. […] During the stay in the ICU, the patient had persistent hiccups responding to SOS Metachlorpromide 10mg Intravenously. […] All the steps were undertaken to stop any involuntary spasms of the diaphragm to alleviate the persistent hiccups. […] Appropriate ventilator settings should be strongly promoted in the treatment of hiccups in patients who are mechanically ventilated. […] We encourage clinical trials in this area of critical care medicine. Also, non pharmacological treatment methods such as acupuncture, respiratory monitoring, chest physiotherapy and use of non sedative drugs should be studied and considered to manage patients with persistent hiccups in the ICU.

• #62 Hiccups: What Are They, and How Can We Stop Them?

  https://www.contemporaryclinic.com/view/hiccups-what-are-they-and-how-can-we-stop-them-

  Below are a few examples of risk factors that cause hiccups. Additionally, a thorough assessment and physical examination can help determine the cause. […] We have all heard of or even tried home remedies, some reportedly successful. Some fun examples you might have heard of include eating a spoonful of sugar, receiving a sudden or fright, or singing a song. […] Some physical maneuvers that reportedly get rid of hiccups include drinking water, holding ones breath, and pulling the knees to the chest.

• #63 How to Get Rid of Hiccups: Home Remedies, Causes & Symptoms

  https://www.emedicinehealth.com/hiccups/article_em.htm

  A person should see a doctor if the hiccups become chronic and persistent (if they last more than 3 hours), or if they affect sleeping patterns, interfere with eating, or cause reflux of food or vomiting. […] Diagnosis is based on physical evaluation. Laboratory testing is rarely necessary unless the hiccups are suspected to be a symptom of an associated medical condition. […] There are a variety of home remedies to resolve hiccups, which include holding your breath to drinking a glass of water quickly. […] Medical care is rarely needed to cure hiccups. If a person has hiccups for more than two days, they should seek medical care. […] Treatment for getting rid of the hiccups depends on how severe the hiccups are. […] For more severe, persistent hiccups (usually lasting over to 2 days), the doctor may try medications to manage the patient’s hiccups. Chlorpromazine (Thorazine) is usually the first prescription medication tried for hiccups, although drugs such as baclofen (Lioresal) and medications for convulsions such as phenytoin (Dilantin) have also been successful. […] Anesthesia to block the phrenic nerve and surgical implantation of an electronic stimulator to the vagus nerve has been effective. Surgery to disable the phrenic nerve (the nerve that controls the diaphragm) is often the treatment of last resort.

• #64 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  Metoclopramide and baclofen aim to relieve gastric distension by improving gastric emptying and relaxing the diaphragm. […] They are also important to assess the patients bowel functioning and to treat constipation, if indicated, as this may be contributing to the gastric distension. […] If the hiccups are not resolved by this, haloperidol and chlorpromazine could be used with the aim of suppressing the hiccup reflex. […] Hiccups can often cause severe distress and they can consequently affect the quality of life for some terminally ill patients. Indeed, persistent hiccups can effect the way patients talk, sleep, eat and drink, and in some can lead to weight loss, exhaustion, anxiety and depression (Wilcock and Twycross, 1996). […] The levels of anxiety and emotional distress suffered by a patient may contribute to hiccups. In palliative care, understanding the patients perception of the impact of the symptom on his/her quality of life is essential in order to alleviate distress and promote comfort.

• #65 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  The effective management of symptoms (hiccups being an example) is dependent not only on a number of clinical approaches but also on the support offered by the multidisciplinary team. Listening to the patients feelings and fears may help them to put the symptom into context and help them to view their quality of life with new hope and meaning.

• #66 FF #81 Management of Hiccups | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/management-of-hiccups/

  Hiccups (singultus) are an involuntary reflex involving the respiratory muscles of the chest and diaphragm, mediated by the phrenic and vagus nerves and a central (brainstem) reflex center. A single episode can last for a few seconds to as long as several days. When they last longer than 48 hours, hiccups are termed persistent; longer than one month, intractable. Persistent and intractable hiccups can be very distressing to patients and families and diminish quality of life. Etiologies range in seriousness from stress/excitement, gastric or esophageal distention, corticosteroids, idiopathic, post-surgical, chemotherapy, cancer, myocardial infarction, liver disease, uremia, and CNS lesions. Irritation of the vagus nerve or diaphragm is a common pathophysiologic mechanism. […] Once hiccups have lasted beyond a time-limited annoyance, deciding on therapeutic intervention should be based on a thorough clinical assessment and, if possible, treatment directed at the underlying cause. A thorough history, review of medications, focused review of systems, and physical exam may help guide initial choice of treatment. Many drug and non-drug treatments have been used, but there is little evidence of any one superior approach to management. The patient’s prognosis, current level of function, and potential adverse effects from any proposed treatment should be considered.

• #67 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  Metoclopramide and baclofen aim to relieve gastric distension by improving gastric emptying and relaxing the diaphragm. […] They are also important to assess the patients bowel functioning and to treat constipation, if indicated, as this may be contributing to the gastric distension. […] If the hiccups are not resolved by this, haloperidol and chlorpromazine could be used with the aim of suppressing the hiccup reflex. […] Hiccups can often cause severe distress and they can consequently affect the quality of life for some terminally ill patients. Indeed, persistent hiccups can effect the way patients talk, sleep, eat and drink, and in some can lead to weight loss, exhaustion, anxiety and depression (Wilcock and Twycross, 1996). […] The levels of anxiety and emotional distress suffered by a patient may contribute to hiccups. In palliative care, understanding the patients perception of the impact of the symptom on his/her quality of life is essential in order to alleviate distress and promote comfort.

• #68

  https://www.nursingcenter.com/journalarticle?Article_ID=2580469&Journal_ID=260877&Issue_ID=2580420

  There is insufficient evidence to guide the treatment of persistent or intractable hiccups; to date, no studies have involved advanced neuro-oncological patients who have experienced persistent hiccups with the aim of understanding their experience, gaining insights, and contributing to knowledge in the field. […] Persistent hiccups have a negative impact on patients’ and families’ quality of life, leading to extreme anguish and to a feeling of powerlessness when it becomes clear that there is no useful pharmacological therapy.

• #69 FF #81 Management of Hiccups | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/management-of-hiccups/

  Hiccups (singultus) are an involuntary reflex involving the respiratory muscles of the chest and diaphragm, mediated by the phrenic and vagus nerves and a central (brainstem) reflex center. A single episode can last for a few seconds to as long as several days. When they last longer than 48 hours, hiccups are termed persistent; longer than one month, intractable. Persistent and intractable hiccups can be very distressing to patients and families and diminish quality of life. Etiologies range in seriousness from stress/excitement, gastric or esophageal distention, corticosteroids, idiopathic, post-surgical, chemotherapy, cancer, myocardial infarction, liver disease, uremia, and CNS lesions. Irritation of the vagus nerve or diaphragm is a common pathophysiologic mechanism. […] Once hiccups have lasted beyond a time-limited annoyance, deciding on therapeutic intervention should be based on a thorough clinical assessment and, if possible, treatment directed at the underlying cause. A thorough history, review of medications, focused review of systems, and physical exam may help guide initial choice of treatment. Many drug and non-drug treatments have been used, but there is little evidence of any one superior approach to management. The patient’s prognosis, current level of function, and potential adverse effects from any proposed treatment should be considered.

• #70 FF #81 Management of Hiccups | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/management-of-hiccups/

  In most clinical scenarios, it is best to start with non-pharmacologic therapy and resort to pharmacologic options for refractory cases. There are many time-honored home remedies — gargling with water, biting a lemon, swallowing sugar, or producing a fright response — which are low risk even if they are lacking in evidence. Other non-pharmacologic options include: […] Once hiccups have lasted beyond a time-limited annoyance, deciding on therapeutic intervention should be based on a thorough clinical assessment and, if possible, treatment directed at the underlying cause. […] Interventions: Acupuncture, diaphragmatic pacing electrodes, or surgical ablation of the reflex arc can be considered when other treatments fail.

• #71 How to get rid of the hiccups? – General Nursing Support

  https://allnurses.com/how-get-rid-hiccups-t10424/

  Many simple measures may be tried: increasing PaCO2 and inhibiting diaphragmatic activity by a series of deep breath-holdings or by rebreathing deeply into a paper bag. […] Vagal stimulation may work: drinking a glass of water rapidly, swallowing dry bread or crushed ice, inducing vomiting, or applying traction on the tongue or pressure on the eyeballs. […] Strong digital pressure may be applied over the phrenic nerves behind the sternoclavicular joints. […] Drugs that control persistent hiccup include scopolamine, amphetamine, prochlorperazine, chlorpromazine, phenobarbital, and narcotics. […] Metoclopramide 10 mg po bid to qid appears to help some patients. […] Nevertheless, successful treatment with drugs is often elusive.

• #72 How to get rid of the hiccups? – General Nursing Support

  https://allnurses.com/how-get-rid-hiccups-t10424/

  Many simple measures may be tried: increasing PaCO2 and inhibiting diaphragmatic activity by a series of deep breath-holdings or by rebreathing deeply into a paper bag. […] Vagal stimulation may work: drinking a glass of water rapidly, swallowing dry bread or crushed ice, inducing vomiting, or applying traction on the tongue or pressure on the eyeballs. […] Strong digital pressure may be applied over the phrenic nerves behind the sternoclavicular joints. […] Drugs that control persistent hiccup include scopolamine, amphetamine, prochlorperazine, chlorpromazine, phenobarbital, and narcotics. […] Metoclopramide 10 mg po bid to qid appears to help some patients. […] Nevertheless, successful treatment with drugs is often elusive.

• #73

  https://news.miami.edu/stories/2024/01/do-you-get-hiccups.html

  Hiccups are mostly harmless, but if the condition persists, doctors recommend seeing a medical professional. […] There is no way to prevent hiccups because it is some nerve that triggers your diaphragm to spasm, she said. […] But she does believe that there is a method to help in getting rid of them. […] Honestly if you look at all the remedies to try to stop hiccups, they all have to do with disturbing the breathing pattern, she said. […] That is also true of the advice to hold your breath or holding your breath and swallowing 10 times, she said. These measures help you to focus on different muscle groups and stop the spasms, she said.

• #74 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  In majority of the cases, no cause is found and the treatment is mainly empirical to ameliorate the symptoms. […] Physical maneuvers such as interrupting normal respiratory function (e.g., breath holding, Valsalva maneuver), stimulating nasopharynx or uvula (e.g., sipping cold water, gargling with water, swallowing a teaspoon of dry sugar), increasing vagal stimulation (e.g., pressing on the eyeballs), and countering irritation of the diaphragm (e.g., pulling knees to chest, leaning forward to compress the chest) are first-line treatments for hiccups. […] Drug therapy should be reserved for treatment of hiccups when physical maneuvers have failed. […] The pharmacological treatment is summarized in Table 3.

• #75

  https://www.allinahealth.org/healthysetgo/care/how-to-get-rid-of-hiccups

  Hiccups are caused by involuntary muscle spasms. […] Acupressure points may help to relieve hiccups. […] Hiccups are usually temporary and tend to go away on their own. […] Those looking for a treatment for hiccups that doesn’t include eating, drinking or breath work can self-treat with acupressure. […] In Traditional East Asian Medicine, acupressure stimulates your body’s own healing response to relieve pain, nausea, stress, headaches, insomnia and help with digestive issues such as constipation and hiccups. […] To remedy a bout of hiccups, you can practice using gentle or firm physical pressure on certain points of your body to restore balance to your mind, body and spirit. […] The following acupressure points may help to relieve hiccups.

• #76 Hiccups: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hiccups-care-instructions.abk7514

  Try these safe and easy home remedies if your hiccups are making you uncomfortable. […] If your doctor prescribed medicine, take it as directed. Call your doctor if you think you are having a problem with your medicine. […] Call your doctor now or seek immediate medical care if: […] Watch closely for changes in your health, and be sure to contact your doctor if:

• #77

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk7514

  Try these safe and easy home remedies if your hiccups are making you uncomfortable. […] If your doctor prescribed medicine, take it as directed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. […] Call your doctor or nurse advice line now or seek immediate medical care if: […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:

• #78 How to get rid of the hiccups? – General Nursing Support

  https://allnurses.com/how-get-rid-hiccups-t10424/

  Many simple measures may be tried: increasing PaCO2 and inhibiting diaphragmatic activity by a series of deep breath-holdings or by rebreathing deeply into a paper bag. […] Vagal stimulation may work: drinking a glass of water rapidly, swallowing dry bread or crushed ice, inducing vomiting, or applying traction on the tongue or pressure on the eyeballs. […] Strong digital pressure may be applied over the phrenic nerves behind the sternoclavicular joints. […] Drugs that control persistent hiccup include scopolamine, amphetamine, prochlorperazine, chlorpromazine, phenobarbital, and narcotics. […] Metoclopramide 10 mg po bid to qid appears to help some patients. […] Nevertheless, successful treatment with drugs is often elusive.

• #79

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk7514

  Try these safe and easy home remedies if your hiccups are making you uncomfortable. […] If your doctor prescribed medicine, take it as directed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. […] Call your doctor or nurse advice line now or seek immediate medical care if: […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:

• #80 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  We encourage clinical trials in this area of critical care medicine and should also encourage more studies to analyse the effectiveness of non-pharmacological methods. […] The neurogenic type occurs because of the involvement of the medulla oblongata and they might lead to respiratory irregularities resulting in a fatal respiratory arrest. […] During the stay in the ICU, the patient had persistent hiccups responding to SOS Metachlorpromide 10mg Intravenously. […] All the steps were undertaken to stop any involuntary spasms of the diaphragm to alleviate the persistent hiccups. […] Appropriate ventilator settings should be strongly promoted in the treatment of hiccups in patients who are mechanically ventilated. […] We encourage clinical trials in this area of critical care medicine. Also, non pharmacological treatment methods such as acupuncture, respiratory monitoring, chest physiotherapy and use of non sedative drugs should be studied and considered to manage patients with persistent hiccups in the ICU.

• #81 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  We encourage clinical trials in this area of critical care medicine and should also encourage more studies to analyse the effectiveness of non-pharmacological methods. […] The neurogenic type occurs because of the involvement of the medulla oblongata and they might lead to respiratory irregularities resulting in a fatal respiratory arrest. […] During the stay in the ICU, the patient had persistent hiccups responding to SOS Metachlorpromide 10mg Intravenously. […] All the steps were undertaken to stop any involuntary spasms of the diaphragm to alleviate the persistent hiccups. […] Appropriate ventilator settings should be strongly promoted in the treatment of hiccups in patients who are mechanically ventilated. […] We encourage clinical trials in this area of critical care medicine. Also, non pharmacological treatment methods such as acupuncture, respiratory monitoring, chest physiotherapy and use of non sedative drugs should be studied and considered to manage patients with persistent hiccups in the ICU.

• #82 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  Hiccups are usually self-limiting and benign but can be distressing when they become persistent or intractable and produce significant morbidity. […] In the intubated patients in neurocritical care, persistent hiccups may cause respiratory alkalosis and are also associated with an increased incidence of ventilator-associated pneumonia. […] Several pharmacological and nonpharmacological strategies have been devised for the treatment of persistent and intractable hiccups. […] An accurate estimate of the burden of hiccups in the neuro-intensive care unit (ICU) leading to unfavorable outcomes and morbidity is unknown. […] Though persistent hiccups which are intractable and of neurogenic origin can result in hyperventilation and respiratory alkalosis, and are a risk factor for ventilator associated pneumonia in intubated and mechanically ventilated patients.

• #83 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  We encourage clinical trials in this area of critical care medicine and should also encourage more studies to analyse the effectiveness of non-pharmacological methods. […] The neurogenic type occurs because of the involvement of the medulla oblongata and they might lead to respiratory irregularities resulting in a fatal respiratory arrest. […] During the stay in the ICU, the patient had persistent hiccups responding to SOS Metachlorpromide 10mg Intravenously. […] All the steps were undertaken to stop any involuntary spasms of the diaphragm to alleviate the persistent hiccups. […] Appropriate ventilator settings should be strongly promoted in the treatment of hiccups in patients who are mechanically ventilated. […] We encourage clinical trials in this area of critical care medicine. Also, non pharmacological treatment methods such as acupuncture, respiratory monitoring, chest physiotherapy and use of non sedative drugs should be studied and considered to manage patients with persistent hiccups in the ICU.

• #84 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  Hiccups (also referred to as “hiccoughs”) are usually a transient condition that affects almost everyone in their lifetime. However, persistent and intractable hiccups are the types which are often linked with unfavorable outcomes and can also result in respiratory alkalosis in the intubated patients. […] The most commonly witnessed hiccups in the neuro-ICU are intractable and neurogenic in nature. […] In this communication, we discuss the strategy of respiratory care and pharmacological management of hiccups in an adult male post decompressive craniotomy in view of unilateral basal ganglion bleed. […] It seems that persistent and intractable hiccups as a risk factor for ventilator-associated pneumonia in patients who are intubated and mechanically ventilated should be given due attention.

• #85 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  The effective management of symptoms (hiccups being an example) is dependent not only on a number of clinical approaches but also on the support offered by the multidisciplinary team. Listening to the patients feelings and fears may help them to put the symptom into context and help them to view their quality of life with new hope and meaning.

• #86 Hiccups: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hiccups-care-instructions.abk7514

  Hiccups occur when a spasm contracts the diaphragm. This is a large sheet of muscle that separates the chest cavity from the abdominal cavity. The spasm causes an intake of breath that is suddenly stopped by the closing of the vocal cords. This closure causes the „hiccup” sound. […] Most hiccups go away on their own within a few minutes to a few hours and don’t require any treatment. […] Hiccups that last longer than 48 hours are called persistent hiccups. Hiccups that last longer than a month are called intractable hiccups. Both kinds of hiccups may be a sign of a more serious health problem. Tests may be needed to help find the cause. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #87 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  Metoclopramide and baclofen aim to relieve gastric distension by improving gastric emptying and relaxing the diaphragm. […] They are also important to assess the patients bowel functioning and to treat constipation, if indicated, as this may be contributing to the gastric distension. […] If the hiccups are not resolved by this, haloperidol and chlorpromazine could be used with the aim of suppressing the hiccup reflex. […] Hiccups can often cause severe distress and they can consequently affect the quality of life for some terminally ill patients. Indeed, persistent hiccups can effect the way patients talk, sleep, eat and drink, and in some can lead to weight loss, exhaustion, anxiety and depression (Wilcock and Twycross, 1996). […] The levels of anxiety and emotional distress suffered by a patient may contribute to hiccups. In palliative care, understanding the patients perception of the impact of the symptom on his/her quality of life is essential in order to alleviate distress and promote comfort.

• #88 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  The effective management of symptoms (hiccups being an example) is dependent not only on a number of clinical approaches but also on the support offered by the multidisciplinary team. Listening to the patients feelings and fears may help them to put the symptom into context and help them to view their quality of life with new hope and meaning.

• #89 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  The effective management of symptoms (hiccups being an example) is dependent not only on a number of clinical approaches but also on the support offered by the multidisciplinary team. Listening to the patients feelings and fears may help them to put the symptom into context and help them to view their quality of life with new hope and meaning.

• #90 Hiccups – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/diagnosis-treatment/drc-20352618

  Most cases of hiccups go away on their own without medical treatment. If an underlying medical condition is causing your hiccups, treating that condition may stop the hiccups. […] If your hiccups last longer than two days, medicines or certain procedures may be needed. […] Drugs used to treat long-term hiccups include baclofen, chlorpromazine and metoclopramide. […] If less invasive treatments aren’t effective, your health care provider may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups. […] Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it also has helped control long-term hiccups.

• #91 Hiccups

  https://www.nhs.uk/conditions/hiccups/

  Most people get hiccups sometimes. They should only last a few minutes. You can usually wait for them to go away or treat them yourself without seeing a GP. […] A GP will want to find out if your hiccups are caused by a health condition or medicine you’re taking. […] Treating the condition or changing your medicine should stop your hiccups. […] If there’s no obvious cause, they might be able to prescribe a medicine called chlorpromazine to treat your hiccups. This does not work for everyone.

• #92 Hiccups: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hiccups-care-instructions.abk7514

  Hiccups occur when a spasm contracts the diaphragm. This is a large sheet of muscle that separates the chest cavity from the abdominal cavity. The spasm causes an intake of breath that is suddenly stopped by the closing of the vocal cords. This closure causes the „hiccup” sound. […] Most hiccups go away on their own within a few minutes to a few hours and don’t require any treatment. […] Hiccups that last longer than 48 hours are called persistent hiccups. Hiccups that last longer than a month are called intractable hiccups. Both kinds of hiccups may be a sign of a more serious health problem. Tests may be needed to help find the cause. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #93

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk7514

  Hiccups occur when a spasm contracts the diaphragm. This is a large sheet of muscle that separates the chest cavity from the abdominal cavity. The spasm causes an intake of breath that is suddenly stopped by the closing of the vocal cords. This closure causes the „hiccup” sound. […] Most hiccups go away on their own within a few minutes to a few hours and don’t require any treatment. […] Hiccups that last longer than 48 hours are called persistent hiccups. Hiccups that last longer than a month are called intractable hiccups. Both kinds of hiccups may be a sign of a more serious health problem. Tests may be needed to help find the cause. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems.

• #94 Hiccups: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hiccups-care-instructions.abk7514

  Try these safe and easy home remedies if your hiccups are making you uncomfortable. […] If your doctor prescribed medicine, take it as directed. Call your doctor if you think you are having a problem with your medicine. […] Call your doctor now or seek immediate medical care if: […] Watch closely for changes in your health, and be sure to contact your doctor if:

• #95

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk7510

  Try these safe and easy home remedies if hiccups are making your child uncomfortable. Have your child: Hold their breath and count slowly to 10. Quickly drink a glass of cold water. Eat a teaspoon of sugar. […] Be safe with medicines. If the doctor prescribed medicine for your child, give it as directed. Call your doctor or nurse advice line if you think your child is having a problem with any medicine. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if: Your child has hiccups for more than 2 days. Your child does not get better as expected.

• #96

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk7510

  Try these safe and easy home remedies if hiccups are making your child uncomfortable. Have your child: Hold their breath and count slowly to 10. Quickly drink a glass of cold water. Eat a teaspoon of sugar. […] Be safe with medicines. If the doctor prescribed medicine for your child, give it as directed. Call your doctor or nurse advice line if you think your child is having a problem with any medicine. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if: Your child has hiccups for more than 2 days. Your child does not get better as expected.

• #97

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk7510

  Try these safe and easy home remedies if hiccups are making your child uncomfortable. Have your child: Hold their breath and count slowly to 10. Quickly drink a glass of cold water. Eat a teaspoon of sugar. […] Be safe with medicines. If the doctor prescribed medicine for your child, give it as directed. Call your doctor or nurse advice line if you think your child is having a problem with any medicine. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if: Your child has hiccups for more than 2 days. Your child does not get better as expected.

• #98 How to get rid of the hiccups? – General Nursing Support

  https://allnurses.com/how-get-rid-hiccups-t10424/

  Does anyone have any good suggestions to get rid of the hiccups? […] The best remedy I have found for the hiccups (that works every time for me) is to eat a teaspoon of table sugar. […] I think it works, b/c you are concentrating so hard on not dumping the water down the front of your shirt. […] BTW hiccups are caused by a stimulation of the phrenic nerve that runs through the diaphragm. Ex: drinking too quickly swallowing too much air can be just enough to stimulate the phrenic nerve. […] Hiccups follow irritation of afferent or efferent nerves or of medullary centers that control the respiratory muscles, particularly the diaphragm. […] Afferent nerves may be stimulated by swallowing hot or irritating substances. […] High blood CO2 inhibits hiccups; low CO2 accentuates them. […] Hiccups are more common in men and often accompany diaphragmatic pleurisy, pneumonia, uremia, alcoholism, or abdominal surgery.

• #99 How to get rid of the hiccups? – General Nursing Support

  https://allnurses.com/how-get-rid-hiccups-t10424/

  Many simple measures may be tried: increasing PaCO2 and inhibiting diaphragmatic activity by a series of deep breath-holdings or by rebreathing deeply into a paper bag. […] Vagal stimulation may work: drinking a glass of water rapidly, swallowing dry bread or crushed ice, inducing vomiting, or applying traction on the tongue or pressure on the eyeballs. […] Strong digital pressure may be applied over the phrenic nerves behind the sternoclavicular joints. […] Drugs that control persistent hiccup include scopolamine, amphetamine, prochlorperazine, chlorpromazine, phenobarbital, and narcotics. […] Metoclopramide 10 mg po bid to qid appears to help some patients. […] Nevertheless, successful treatment with drugs is often elusive.

• #100 Hiccups – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/diagnosis-treatment/drc-20352618

  Most cases of hiccups go away on their own without medical treatment. If an underlying medical condition is causing your hiccups, treating that condition may stop the hiccups. […] If your hiccups last longer than two days, medicines or certain procedures may be needed. […] Drugs used to treat long-term hiccups include baclofen, chlorpromazine and metoclopramide. […] If less invasive treatments aren’t effective, your health care provider may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups. […] Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it also has helped control long-term hiccups.

• #101 Hiccups

  https://www.nhs.uk/conditions/hiccups/

  Most people get hiccups sometimes. They should only last a few minutes. You can usually wait for them to go away or treat them yourself without seeing a GP. […] A GP will want to find out if your hiccups are caused by a health condition or medicine you’re taking. […] Treating the condition or changing your medicine should stop your hiccups. […] If there’s no obvious cause, they might be able to prescribe a medicine called chlorpromazine to treat your hiccups. This does not work for everyone.

• #102 Hiccups – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/diagnosis-treatment/drc-20352618

  Most cases of hiccups go away on their own without medical treatment. If an underlying medical condition is causing your hiccups, treating that condition may stop the hiccups. […] If your hiccups last longer than two days, medicines or certain procedures may be needed. […] Drugs used to treat long-term hiccups include baclofen, chlorpromazine and metoclopramide. […] If less invasive treatments aren’t effective, your health care provider may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups. […] Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it also has helped control long-term hiccups.

• #103 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Some medications can also cause persistent hiccups. […] Persistent hiccups may also happen after certain surgeries or procedures, including those that require general anesthesia. […] Hiccups that last longer than two days are more than just a nuisance. They can interfere with your quality of life and lead to trouble with basic needs like eating or sleeping. […] Possible medications a healthcare provider may prescribe for you include: Chlorpromazine; Proton pump inhibitor (medicines that reduce stomach acid); Metoclopramide; Baclofen; Gabapentin. […] If another medication you’re taking is causing your hiccups, your provider may tell you to stop taking it and take another instead. […] Call your healthcare provider if your hiccups last longer than two days. […] Persistent hiccups can greatly affect your quality of life. If this happens to you, don’t hesitate to talk to your healthcare provider. They’ll find the cause and recommend treatment so you can start feeling better.

• #104 Hiccups Treatment & Management: Approach Considerations, Pharmacologic Therapy, Nonpharmacologic Therapy

  https://emedicine.medscape.com/article/775746-treatment

  Generations of physicians have failed to discover a definitive cure for hiccups. Supportive care is administered as indicated by the causative pathology (eg, oxygen for the patient whose hiccups may be secondary to pneumonia). Therapy is directed first toward at the cause of the hiccups (if identified) and then toward the hiccups themselves (if necessary). Treatment may be pharmacologic or nonpharmacologic. Chlorpromazine remains the only agent approved by the US Food and Drug Administration (FDA) for the treatment of intractable hiccups. Surgical phrenic nerve ablation has been advocated for intractable cases that are unresponsive to other treatment. A Cochrane review concluded that the available evidence was insufficient to guide treatment of persistent or intractable hiccups by either pharmacologic or nonpharmacologic means.

• #105 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  Hence, meticulous evaluation and treatment of persistent or intractable hiccups (IH) in neuro-ICU patients is important, in a stepwise and protocolized manner which comprise of physical maneuvers first followed by pharmacological measures in failed or resistant cases. […] Recently U.S. Food and Drug Administration (FDA) revoked the approval of chlorpromazine, citing its serious side effects in treating hiccups. […] A thorough and detailed history is warranted focusing on trigger factors for chronic hiccups along with frequency, duration, progression, and aggravating and relieving factors. […] The treatment approach of persistent hiccups is mostly based on observational reports and case series, and clear-cut guidelines are lacking. […] The treatment is mainly directed at treating the underlying cause when the illness causing hiccups has been identified.

• #106 Hiccups – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/diagnosis-treatment/drc-20352618

  Most cases of hiccups go away on their own without medical treatment. If an underlying medical condition is causing your hiccups, treating that condition may stop the hiccups. […] If your hiccups last longer than two days, medicines or certain procedures may be needed. […] Drugs used to treat long-term hiccups include baclofen, chlorpromazine and metoclopramide. […] If less invasive treatments aren’t effective, your health care provider may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups. […] Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it also has helped control long-term hiccups.

• #107 Hiccups Treatment & Management: Approach Considerations, Pharmacologic Therapy, Nonpharmacologic Therapy

  https://emedicine.medscape.com/article/775746-treatment

  Various agents have been reported to cure hiccups. Gabapentin, baclofen, and metoclopramide appear to show promise for persistent hiccups alone, in combination with other drugs, including proton-pump inhibitors, or as conjoined therapy. […] Chlorpromazine is the most thoroughly studied medication, is FDA-approved for intractable hiccups, and appears to be the drug of choice in many reports. […] Several anticonvulsant agents have been used to treat intractable hiccups. Phenytoin, valproic acid, and carbamazepine have all been effective when used in typical anticonvulsant doses. Gabapentin has been shown to be effective in patients with central nervous system (CNS) lesions and in some other etiologic groups. […] The final and most drastic treatment for hiccups is phrenic nerve ablation. All other treatments must be explored before this step is embarked on.

• #108 Hiccups – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/diagnosis-treatment/drc-20352618

  Most cases of hiccups go away on their own without medical treatment. If an underlying medical condition is causing your hiccups, treating that condition may stop the hiccups. […] If your hiccups last longer than two days, medicines or certain procedures may be needed. […] Drugs used to treat long-term hiccups include baclofen, chlorpromazine and metoclopramide. […] If less invasive treatments aren’t effective, your health care provider may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups. […] Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it also has helped control long-term hiccups.

• #109 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  Metoclopramide and baclofen aim to relieve gastric distension by improving gastric emptying and relaxing the diaphragm. […] They are also important to assess the patients bowel functioning and to treat constipation, if indicated, as this may be contributing to the gastric distension. […] If the hiccups are not resolved by this, haloperidol and chlorpromazine could be used with the aim of suppressing the hiccup reflex. […] Hiccups can often cause severe distress and they can consequently affect the quality of life for some terminally ill patients. Indeed, persistent hiccups can effect the way patients talk, sleep, eat and drink, and in some can lead to weight loss, exhaustion, anxiety and depression (Wilcock and Twycross, 1996). […] The levels of anxiety and emotional distress suffered by a patient may contribute to hiccups. In palliative care, understanding the patients perception of the impact of the symptom on his/her quality of life is essential in order to alleviate distress and promote comfort.

• #110 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Some medications can also cause persistent hiccups. […] Persistent hiccups may also happen after certain surgeries or procedures, including those that require general anesthesia. […] Hiccups that last longer than two days are more than just a nuisance. They can interfere with your quality of life and lead to trouble with basic needs like eating or sleeping. […] Possible medications a healthcare provider may prescribe for you include: Chlorpromazine; Proton pump inhibitor (medicines that reduce stomach acid); Metoclopramide; Baclofen; Gabapentin. […] If another medication you’re taking is causing your hiccups, your provider may tell you to stop taking it and take another instead. […] Call your healthcare provider if your hiccups last longer than two days. […] Persistent hiccups can greatly affect your quality of life. If this happens to you, don’t hesitate to talk to your healthcare provider. They’ll find the cause and recommend treatment so you can start feeling better.

• #111 Hiccups Treatment & Management: Approach Considerations, Pharmacologic Therapy, Nonpharmacologic Therapy

  https://emedicine.medscape.com/article/775746-treatment

  Various agents have been reported to cure hiccups. Gabapentin, baclofen, and metoclopramide appear to show promise for persistent hiccups alone, in combination with other drugs, including proton-pump inhibitors, or as conjoined therapy. […] Chlorpromazine is the most thoroughly studied medication, is FDA-approved for intractable hiccups, and appears to be the drug of choice in many reports. […] Several anticonvulsant agents have been used to treat intractable hiccups. Phenytoin, valproic acid, and carbamazepine have all been effective when used in typical anticonvulsant doses. Gabapentin has been shown to be effective in patients with central nervous system (CNS) lesions and in some other etiologic groups. […] The final and most drastic treatment for hiccups is phrenic nerve ablation. All other treatments must be explored before this step is embarked on.

• #112 Hiccup: Mystery, Nature and Treatment

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm.2012.18.2.123

  The effective hiccup treatment is exactly established upon a correct diagnosis of lesion responsible for the serious event. […] For example, after effective measures were undertaken to CNS lesions such as vascular ischemia and tumors, hiccup episodes subsided. […] Similarly, some peripheral lesions related hiccups responded well after these lesions were ablated. […] Apart from the well-known chlorpromazine approved to treat hiccups, many other drugs have been tested and recommended. […] Gabapentin, an alpha-2-delta ligand with structural similarity to GABA and the ability to block voltage-operated calcium channels to reduce release of several neurotransmitters including glutamate and substance P and finally to modulate the diaphragmatic activity, was promising and safe to treat intractable hiccups.

• #113 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Some medications can also cause persistent hiccups. […] Persistent hiccups may also happen after certain surgeries or procedures, including those that require general anesthesia. […] Hiccups that last longer than two days are more than just a nuisance. They can interfere with your quality of life and lead to trouble with basic needs like eating or sleeping. […] Possible medications a healthcare provider may prescribe for you include: Chlorpromazine; Proton pump inhibitor (medicines that reduce stomach acid); Metoclopramide; Baclofen; Gabapentin. […] If another medication you’re taking is causing your hiccups, your provider may tell you to stop taking it and take another instead. […] Call your healthcare provider if your hiccups last longer than two days. […] Persistent hiccups can greatly affect your quality of life. If this happens to you, don’t hesitate to talk to your healthcare provider. They’ll find the cause and recommend treatment so you can start feeling better.

• #114 Singultus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538225/

  Hiccups can be acute, lasting less than 48 hours, persistent, lasting over 2 days, or intractable, lasting more than one month. […] This activity stresses the role of the interprofessional team in the care of affected patients. […] Explain a well-coordinated interprofessional team approach to provide effective care to patients affected by persistent or intractable hiccups. […] Hiccups are often caused by gastrointestinal disorders such as gastroesophageal reflux. […] Acute hiccups can be uncomfortable, and a brief annoyance, however persistent and intractable hiccups have a significant impact on quality of life by interfering with eating, sleeping, speaking, and social activities, and can be a harbinger of serious medical pathology. […] Important steps in the treatment of persistent and intractable hiccups are, first, to assess whether the patient is using a medication known to induce hiccups, and second, to determine whether hiccups are associated with GERD.

• #115 Hiccups Treatment & Management: Approach Considerations, Pharmacologic Therapy, Nonpharmacologic Therapy

  https://emedicine.medscape.com/article/775746-treatment

  Various agents have been reported to cure hiccups. Gabapentin, baclofen, and metoclopramide appear to show promise for persistent hiccups alone, in combination with other drugs, including proton-pump inhibitors, or as conjoined therapy. […] Chlorpromazine is the most thoroughly studied medication, is FDA-approved for intractable hiccups, and appears to be the drug of choice in many reports. […] Several anticonvulsant agents have been used to treat intractable hiccups. Phenytoin, valproic acid, and carbamazepine have all been effective when used in typical anticonvulsant doses. Gabapentin has been shown to be effective in patients with central nervous system (CNS) lesions and in some other etiologic groups. […] The final and most drastic treatment for hiccups is phrenic nerve ablation. All other treatments must be explored before this step is embarked on.

• #116 Remedies for Prolonged Hiccups | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0501/p1684.html

  Many pharmacologic and nonpharmacologic remedies have been used to try to abort hiccups. Medications that have been reported to be effective include chlorpromazine (Thorazine), nifedipine (Procardia), haloperidol (Haldol), phenytoin (Dilantin), metoclopramide (Reglan), baclofen (Lioresal) and gabapentin (Neurontin). […] Surgical management has included such techniques as phrenic nerve interruption or placement of diaphragmatic pacemakers. […] When you are seeing a patient with severe hiccups or (more commonly) when you or someone you know needs relief from hiccups, there are many (mostly anecdotal) effective methods you can try.

• #117 Remedies for Prolonged Hiccups | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0501/p1684.html

  Many pharmacologic and nonpharmacologic remedies have been used to try to abort hiccups. Medications that have been reported to be effective include chlorpromazine (Thorazine), nifedipine (Procardia), haloperidol (Haldol), phenytoin (Dilantin), metoclopramide (Reglan), baclofen (Lioresal) and gabapentin (Neurontin). […] Surgical management has included such techniques as phrenic nerve interruption or placement of diaphragmatic pacemakers. […] When you are seeing a patient with severe hiccups or (more commonly) when you or someone you know needs relief from hiccups, there are many (mostly anecdotal) effective methods you can try.

• #118 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  Metoclopramide and baclofen aim to relieve gastric distension by improving gastric emptying and relaxing the diaphragm. […] They are also important to assess the patients bowel functioning and to treat constipation, if indicated, as this may be contributing to the gastric distension. […] If the hiccups are not resolved by this, haloperidol and chlorpromazine could be used with the aim of suppressing the hiccup reflex. […] Hiccups can often cause severe distress and they can consequently affect the quality of life for some terminally ill patients. Indeed, persistent hiccups can effect the way patients talk, sleep, eat and drink, and in some can lead to weight loss, exhaustion, anxiety and depression (Wilcock and Twycross, 1996). […] The levels of anxiety and emotional distress suffered by a patient may contribute to hiccups. In palliative care, understanding the patients perception of the impact of the symptom on his/her quality of life is essential in order to alleviate distress and promote comfort.

• #119 Remedies for Prolonged Hiccups | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0501/p1684.html

  Many pharmacologic and nonpharmacologic remedies have been used to try to abort hiccups. Medications that have been reported to be effective include chlorpromazine (Thorazine), nifedipine (Procardia), haloperidol (Haldol), phenytoin (Dilantin), metoclopramide (Reglan), baclofen (Lioresal) and gabapentin (Neurontin). […] Surgical management has included such techniques as phrenic nerve interruption or placement of diaphragmatic pacemakers. […] When you are seeing a patient with severe hiccups or (more commonly) when you or someone you know needs relief from hiccups, there are many (mostly anecdotal) effective methods you can try.

• #120 FF #81 Management of Hiccups | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/management-of-hiccups/

  Hiccups (singultus) are an involuntary reflex involving the respiratory muscles of the chest and diaphragm, mediated by the phrenic and vagus nerves and a central (brainstem) reflex center. A single episode can last for a few seconds to as long as several days. When they last longer than 48 hours, hiccups are termed persistent; longer than one month, intractable. Persistent and intractable hiccups can be very distressing to patients and families and diminish quality of life. Etiologies range in seriousness from stress/excitement, gastric or esophageal distention, corticosteroids, idiopathic, post-surgical, chemotherapy, cancer, myocardial infarction, liver disease, uremia, and CNS lesions. Irritation of the vagus nerve or diaphragm is a common pathophysiologic mechanism. […] Once hiccups have lasted beyond a time-limited annoyance, deciding on therapeutic intervention should be based on a thorough clinical assessment and, if possible, treatment directed at the underlying cause. A thorough history, review of medications, focused review of systems, and physical exam may help guide initial choice of treatment. Many drug and non-drug treatments have been used, but there is little evidence of any one superior approach to management. The patient’s prognosis, current level of function, and potential adverse effects from any proposed treatment should be considered.

• #121

  https://jhoponline.com/issue-archive/2014-issues/december-vol-4-no-4/16296-hiccups

  Patients with persistent or intractable hiccups often require pharmacologic intervention to alleviate the condition or complications. The only US Food and Drug Administrationapproved hiccup remedy is chlorpromazine, which may not be useful in many patients because of its associated side effects. […] Currently, there is little guidance on which agent should be used initially for hiccups of different etiologies. Because of the larger body of literature, most practitioners use chlorpromazine, metoclopramide, or baclofen as the initial treatment modality; a trial of multiple single agents or combinations of agents is also common. […] In conclusion, although there are many reports of agents that help with the management of intractable hiccups, little current evidence exists regarding which agent, at what dose, and for which etiology should be used initially in patients. Agent and dose selection should be based on individual patient risks and comorbidities to achieve the best effect with minimal adverse consequences.

• #122 Hiccups – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/diagnosis-treatment/drc-20352618

  Most cases of hiccups go away on their own without medical treatment. If an underlying medical condition is causing your hiccups, treating that condition may stop the hiccups. […] If your hiccups last longer than two days, medicines or certain procedures may be needed. […] Drugs used to treat long-term hiccups include baclofen, chlorpromazine and metoclopramide. […] If less invasive treatments aren’t effective, your health care provider may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups. […] Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it also has helped control long-term hiccups.

• #123 Hiccups – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/diagnosis-treatment/drc-20352618

  Most cases of hiccups go away on their own without medical treatment. If an underlying medical condition is causing your hiccups, treating that condition may stop the hiccups. […] If your hiccups last longer than two days, medicines or certain procedures may be needed. […] Drugs used to treat long-term hiccups include baclofen, chlorpromazine and metoclopramide. […] If less invasive treatments aren’t effective, your health care provider may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups. […] Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it also has helped control long-term hiccups.

• #124 Hiccups – UF Health

  https://ufhealth.org/conditions-and-treatments/hiccups

  Hiccups are common and normal in newborns and infants. […] Contact your health care provider if hiccups go on for more than a few days. […] To treat hiccups that do not go away, the provider may perform gastric lavage or massage of the carotid sinus in the neck. DO NOT try carotid massage by yourself. This must be done by a provider. […] If hiccups continue, medicines may help. Tube insertion into the stomach (nasogastric intubation) may also help. […] In very rare cases, if medicines or other methods do not work, treatment such as phrenic nerve block may be tried. The phrenic nerve controls the diaphragm.

• #125 Treatment of Lung Cancer-Related Intractable Hiccups Using Pulsed Radiofrequency: Clinical Experience

  https://www.e-jhpc.org/journal/view.html?doi=10.14475/kjhpc.2018.21.3.104

  Treatments for hiccup include non-pharmacological therapy, pharmacological therapy, and nerve block. Non-pharmacological therapy is used to inhibit afferent pathway of vagus nerve, such as holding a breath, drinking cold water, and carotid sinus massage. […] If these efforts are ineffective, other therapeutic approaches, such as acupuncture and phrenic nerve block can be tried. […] A nerve block guided by ultrasonography is a beneficial tool to directly look at the nerve and its surrounding anatomy. […] The mechanism of PRFT is by inhibiting evoked synaptic activity of excitatory C-fiber in response to repetitive, burst-like stimulation of A -fiber, and changed structure of nerve tissue. […] In summary, evaluations on underlying diseases or causal facts should precede before treating intractable hiccup. If the etiology of the intractable hiccup is highly suspected to be associated with lung cancer near the diaphragm, a phrenic nerve PRFT guided by ultrasonography can be an alternative procedure to treat the intractable hiccup. The procedure can be performed simply and unilaterally that might provide effect and safe management for the hiccup.

• #126 Hiccups – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/diagnosis-treatment/drc-20352618

  Most cases of hiccups go away on their own without medical treatment. If an underlying medical condition is causing your hiccups, treating that condition may stop the hiccups. […] If your hiccups last longer than two days, medicines or certain procedures may be needed. […] Drugs used to treat long-term hiccups include baclofen, chlorpromazine and metoclopramide. […] If less invasive treatments aren’t effective, your health care provider may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups. […] Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it also has helped control long-term hiccups.

• #127 Persistent Postoperative Hiccups – Greater Philadelphia Anesthesia Services

  https://philadelphiaanesthesiaservices.com/persistent-postoperative-hiccups/

  For persistent and intractable hiccups, workup should include looking for underlying causes, such as a structural issue or medication side effect. […] If physical maneuvers do not work for eliminating hiccups, pharmacotherapy is the next step to consider. […] Treatment includes medications such as baclofen or metoclopramide depending on the etiology of the hiccups. […] Lee et al. reported success in treating 3 patients who developed postoperative hiccups with a stellate ganglion block. […] Similarly, phrenic nerve blocks stop hiccups in refractory cases. […] Hiccups are a symptom that are associated with a wide range of underlying causes. […] Treatment will depend on severity and duration of hiccups. […] For more serious types of hiccups, there are a wide range of treatment options, though they lack systematic study.

• #128 Hiccups Treatment & Management: Approach Considerations, Pharmacologic Therapy, Nonpharmacologic Therapy

  https://emedicine.medscape.com/article/775746-treatment

  Various agents have been reported to cure hiccups. Gabapentin, baclofen, and metoclopramide appear to show promise for persistent hiccups alone, in combination with other drugs, including proton-pump inhibitors, or as conjoined therapy. […] Chlorpromazine is the most thoroughly studied medication, is FDA-approved for intractable hiccups, and appears to be the drug of choice in many reports. […] Several anticonvulsant agents have been used to treat intractable hiccups. Phenytoin, valproic acid, and carbamazepine have all been effective when used in typical anticonvulsant doses. Gabapentin has been shown to be effective in patients with central nervous system (CNS) lesions and in some other etiologic groups. […] The final and most drastic treatment for hiccups is phrenic nerve ablation. All other treatments must be explored before this step is embarked on.

• #129 Remedies for Prolonged Hiccups | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0501/p1684.html

  Many pharmacologic and nonpharmacologic remedies have been used to try to abort hiccups. Medications that have been reported to be effective include chlorpromazine (Thorazine), nifedipine (Procardia), haloperidol (Haldol), phenytoin (Dilantin), metoclopramide (Reglan), baclofen (Lioresal) and gabapentin (Neurontin). […] Surgical management has included such techniques as phrenic nerve interruption or placement of diaphragmatic pacemakers. […] When you are seeing a patient with severe hiccups or (more commonly) when you or someone you know needs relief from hiccups, there are many (mostly anecdotal) effective methods you can try.

• #130 Hiccup: Mystery, Nature and Treatment

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm.2012.18.2.123

  Overall, the response rates of gabapentin ranged from 66.7% to 88.4%. […] Phrenic nerve blockades such as ultrasound guided blocking of efferent limbs, trans-esophageal diaphragmatic pacing and nerve stimulator to confirm the effective blocking were successfully used to treat persistent post-operative and lung cancer related hiccups. […] Acupuncture has been employed to treat serious hiccups among patients with myocardial infarction and metastatic liver tumor. […] Hiccup usually results from a lesion involving the hiccup reflex arc. […] Among patients with persistent or intractable hiccup, attempt to identify the lesion causing it is needed since serious or lethal disorder may exist.

• #131 Hiccups and Heartburn | Cancer-related Side Effects | American Cancer Society

  https://www.cancer.org/cancer/managing-cancer/side-effects/eating-problems/hiccups-and-heartburn.html

  Acupuncture has also been shown to help some people with intractable hiccups. […] A surgical nerve block might be done to prevent the nerve signals that can cause hiccups if medicines dont stop the hiccups. […] A tube might be placed through your nose into your stomach to remove excess gas or fluid in your belly that is causing hiccups.

• #132 Hiccup: Mystery, Nature and Treatment

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm.2012.18.2.123

  Overall, the response rates of gabapentin ranged from 66.7% to 88.4%. […] Phrenic nerve blockades such as ultrasound guided blocking of efferent limbs, trans-esophageal diaphragmatic pacing and nerve stimulator to confirm the effective blocking were successfully used to treat persistent post-operative and lung cancer related hiccups. […] Acupuncture has been employed to treat serious hiccups among patients with myocardial infarction and metastatic liver tumor. […] Hiccup usually results from a lesion involving the hiccup reflex arc. […] Among patients with persistent or intractable hiccup, attempt to identify the lesion causing it is needed since serious or lethal disorder may exist.

• #133 Treatment of Lung Cancer-Related Intractable Hiccups Using Pulsed Radiofrequency: Clinical Experience

  https://www.e-jhpc.org/journal/view.html?doi=10.14475/kjhpc.2018.21.3.104

  Treatments for hiccup include non-pharmacological therapy, pharmacological therapy, and nerve block. Non-pharmacological therapy is used to inhibit afferent pathway of vagus nerve, such as holding a breath, drinking cold water, and carotid sinus massage. […] If these efforts are ineffective, other therapeutic approaches, such as acupuncture and phrenic nerve block can be tried. […] A nerve block guided by ultrasonography is a beneficial tool to directly look at the nerve and its surrounding anatomy. […] The mechanism of PRFT is by inhibiting evoked synaptic activity of excitatory C-fiber in response to repetitive, burst-like stimulation of A -fiber, and changed structure of nerve tissue. […] In summary, evaluations on underlying diseases or causal facts should precede before treating intractable hiccup. If the etiology of the intractable hiccup is highly suspected to be associated with lung cancer near the diaphragm, a phrenic nerve PRFT guided by ultrasonography can be an alternative procedure to treat the intractable hiccup. The procedure can be performed simply and unilaterally that might provide effect and safe management for the hiccup.

• #134 Palliative care – hiccups | Healthify

  https://healthify.nz/health-a-z/p/palliative-care-hiccups/

  Hiccups can be very distressing. […] Hiccups that last longer than 48 hours isn’t uncommon for people with advanced cancer and can be very upsetting. […] Common causes of hiccups for people living with a life-limiting illness include gut problems, such as stomach distension or gastroparesis. […] If you have a medical condition, or any obvious cause for your hiccups, treatment will focus on the condition or cause. […] Your healthcare provider can talk to you about medicines that may help by relaxing your muscles, reducing stomach bloating, or controlling the hiccup reflex. […] Sometimes, hiccups can be difficult to manage despite having treatment.

• #135 Management of hiccups in palliative care patients | BMJ Supportive & Palliative Care

  https://spcare.bmj.com/content/8/1/1

  Persistent hiccups are a frustrating experience for palliative care patients, and can have a profound impact on their quality of life. […] The management of persistent hiccups still presents an ongoing clinical challenge however, requiring further research on pathophysiology and treatment strategies. […] This literature review aims to provide guidelines for the treatment of persistent or intractable hiccups in the palliative care setting. […] The treatment of hiccups should generally be guided by the nature of the underlying cause. […] If non-pharmacological manoeuvres and pharmacological interventions are not successful, procedural or surgical interventions should be considered to control intractable hiccups. […] Persistent or intractable hiccups remain a diagnostic and therapeutic challenge, and can affect a significant minority of palliative care patients.

• #136 Palliative care – hiccups | Healthify

  https://healthify.nz/health-a-z/p/palliative-care-hiccups

  Hiccups can be very distressing. […] Having hiccups that last longer than 48 hours isn’t uncommon for people with advanced cancer and can be very upsetting. […] Common causes of hiccups for people living with a life-limiting illness include gut problems, such as stomach distension or gastroparesis. […] If you have a medical condition, or any obvious cause for your hiccups, treatment will focus on the condition or cause. […] Your healthcare provider can talk to you about medicines that may help by relaxing your muscles, reducing stomach bloating, or controlling the hiccup reflex. […] Sometimes, hiccups can be difficult to manage despite having treatment.

• #137 Palliative care – hiccups | Healthify

  https://healthify.nz/health-a-z/p/palliative-care-hiccups

  Hiccups can be very distressing. […] Having hiccups that last longer than 48 hours isn’t uncommon for people with advanced cancer and can be very upsetting. […] Common causes of hiccups for people living with a life-limiting illness include gut problems, such as stomach distension or gastroparesis. […] If you have a medical condition, or any obvious cause for your hiccups, treatment will focus on the condition or cause. […] Your healthcare provider can talk to you about medicines that may help by relaxing your muscles, reducing stomach bloating, or controlling the hiccup reflex. […] Sometimes, hiccups can be difficult to manage despite having treatment.

• #138 Prone to hiccups? Here’s what you need to know | UCLA Health

  https://www.uclahealth.org/news/article/prone-hiccups-heres-what-you-need-know

  Hiccups can be more than just an annoyance. When they happen often or dont go away quickly, they can affect important parts of your life, such as sleeping, eating and socializing. In some cases, hiccups can be a sign of a more serious condition. […] Treatment for hiccups depends on the type of hiccups youre experiencing: […] Having hiccups around the clock for multiple days, weeks or months may cause issues with: Eating, Drinking, Sleeping, Socializing, Working. […] If your hiccups last longer than two days or interrupt your ability to sleep or eat, contact your primary care physician (PCP). […] Chronic hiccups can be a side effect of some medications. They can also occur after surgery or an endoscopic procedure. […] In rare cases, persistent or intractable hiccups can indicate an underlying condition. If they do, youll typically have other symptoms of that condition, too. Hiccups may be a sign of: Cardiovascular disorders, such as aortic aneurism or pericarditis, Central nervous system conditions, with 20% of people with Parkinsons disease reporting recurrent hiccups, Ear, nose and throat disorders, including laryngitis and neoplasms (abnormal tissue growth), Esophageal tumors, which involve persistent hiccups in 25% of cases, Gastrointestinal disorders, including GERD and pancreatitis. […] Your PCP should always be your first call if you have concerns. They can evaluate your hiccups and general health to get you the care you need.

• #139 Hiccups and Heartburn | Cancer-related Side Effects | American Cancer Society

  https://www.cancer.org/cancer/managing-cancer/side-effects/eating-problems/hiccups-and-heartburn.html

  Hiccups (or hiccoughs) are spasms that affect a muscle between your lungs and stomach that is used when you breathe, called the diaphragm. […] Hiccups can be caused by irritation of the phrenic nerve that controls the diaphragm. Several things can irritate this nerve such as: Some cancer medicines, such as certain chemotherapy and targeted drug therapies […] Hiccups are more common in people with advanced cancer. […] Hiccups usually stop on their own in minutes to hours. But hiccups that continue can cause other problems. They can make it hard for people to eat, drink, sleep, and talk to other people. This can lead to being tired, depressed, and having other mood changes. […] If someone has persistent or intractable hiccups, they may need medical treatment. […] Your doctor or cancer care team might prescribe some different medicines for you to help control your hiccups. Each works in a different way so you may need to try more than one before your symptoms are relieved.

• #140 Palliative care – hiccups | Healthify

  https://healthify.nz/health-a-z/p/palliative-care-hiccups

  Hiccups can be very distressing. […] Having hiccups that last longer than 48 hours isn’t uncommon for people with advanced cancer and can be very upsetting. […] Common causes of hiccups for people living with a life-limiting illness include gut problems, such as stomach distension or gastroparesis. […] If you have a medical condition, or any obvious cause for your hiccups, treatment will focus on the condition or cause. […] Your healthcare provider can talk to you about medicines that may help by relaxing your muscles, reducing stomach bloating, or controlling the hiccup reflex. […] Sometimes, hiccups can be difficult to manage despite having treatment.

• #141 Evaluation of gabapentin efficacy in palliative care persistent hiccups management: case series – MedCrave online

  https://medcraveonline.com/JCPCR/evaluation-of-gabapentin-efficacy-in-palliative-care-persistent-hiccups-management-case-series.html

  We have noticed its common to see hiccups in the palliative patients and in most cases need pharmacological intervention. […] In our cases the gabapentin appears to be effective for treating persistent hiccups. […] Gabapentin may have valuable role in managing hiccups in palliative setting.79 Here, we report a promising role of the use of gabapentin for the management of persistent hiccups in a palliative patients. […] Gabapentin, an anti-epileptic drug has many uses in palliative setting, one of them is to treat hiccups through increasing endogenous GABA-mediated inhibition of inspiratory muscle action,1315 reducing calcium influx or both of these mechanisms. […] In palliative care, especially when central causes are suspected, gabapentin is very effective for treating hiccups. […] These cases illustrated the efficacy of gabapentin for the treatment of diagnosed hiccups that does not respond to other drugs. […] Persistent hiccups treatment still is a good area for studies and warrants an extra work.

• #142

  https://journals.lww.com/clinicalneuropharm/fulltext/2010/07000/gabapentin_in_the_treatment_of_hiccups_in_patients.3.aspx

  To evaluate safety and efficacy of gabapentin in the treatment of severe chronic hiccups in patients with advanced cancer. […] The results of the study allow suggesting gabapentin at least as a promising drug in the treatment of severe chronic hiccups in advanced cancer patients.

• #143 Hiccups, indigestion and reflux | Marie Curie

  https://www.mariecurie.org.uk/information/symptoms/hiccups-dyspepsia-and-reflux

  Speak to your GP or another member of your healthcare team if: the hiccups last for more than 48 hours or youre concerned about whats causing them or you’re worried about the effects that theyre having. […] If someone is in their last few days or hours of life, a sedative may help to ease hiccups and make them feel more comfortable.

• #144 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  We encourage clinical trials in this area of critical care medicine and should also encourage more studies to analyse the effectiveness of non-pharmacological methods. […] The neurogenic type occurs because of the involvement of the medulla oblongata and they might lead to respiratory irregularities resulting in a fatal respiratory arrest. […] During the stay in the ICU, the patient had persistent hiccups responding to SOS Metachlorpromide 10mg Intravenously. […] All the steps were undertaken to stop any involuntary spasms of the diaphragm to alleviate the persistent hiccups. […] Appropriate ventilator settings should be strongly promoted in the treatment of hiccups in patients who are mechanically ventilated. […] We encourage clinical trials in this area of critical care medicine. Also, non pharmacological treatment methods such as acupuncture, respiratory monitoring, chest physiotherapy and use of non sedative drugs should be studied and considered to manage patients with persistent hiccups in the ICU.

• #145 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  We encourage clinical trials in this area of critical care medicine and should also encourage more studies to analyse the effectiveness of non-pharmacological methods. […] The neurogenic type occurs because of the involvement of the medulla oblongata and they might lead to respiratory irregularities resulting in a fatal respiratory arrest. […] During the stay in the ICU, the patient had persistent hiccups responding to SOS Metachlorpromide 10mg Intravenously. […] All the steps were undertaken to stop any involuntary spasms of the diaphragm to alleviate the persistent hiccups. […] Appropriate ventilator settings should be strongly promoted in the treatment of hiccups in patients who are mechanically ventilated. […] We encourage clinical trials in this area of critical care medicine. Also, non pharmacological treatment methods such as acupuncture, respiratory monitoring, chest physiotherapy and use of non sedative drugs should be studied and considered to manage patients with persistent hiccups in the ICU.

• #146 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  Hiccups are usually self-limiting and benign but can be distressing when they become persistent or intractable and produce significant morbidity. […] In the intubated patients in neurocritical care, persistent hiccups may cause respiratory alkalosis and are also associated with an increased incidence of ventilator-associated pneumonia. […] Several pharmacological and nonpharmacological strategies have been devised for the treatment of persistent and intractable hiccups. […] An accurate estimate of the burden of hiccups in the neuro-intensive care unit (ICU) leading to unfavorable outcomes and morbidity is unknown. […] Though persistent hiccups which are intractable and of neurogenic origin can result in hyperventilation and respiratory alkalosis, and are a risk factor for ventilator associated pneumonia in intubated and mechanically ventilated patients.

• #147 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  Hiccups (also referred to as “hiccoughs”) are usually a transient condition that affects almost everyone in their lifetime. However, persistent and intractable hiccups are the types which are often linked with unfavorable outcomes and can also result in respiratory alkalosis in the intubated patients. […] The most commonly witnessed hiccups in the neuro-ICU are intractable and neurogenic in nature. […] In this communication, we discuss the strategy of respiratory care and pharmacological management of hiccups in an adult male post decompressive craniotomy in view of unilateral basal ganglion bleed. […] It seems that persistent and intractable hiccups as a risk factor for ventilator-associated pneumonia in patients who are intubated and mechanically ventilated should be given due attention.

• #148 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  Hence, meticulous evaluation and treatment of persistent or intractable hiccups (IH) in neuro-ICU patients is important, in a stepwise and protocolized manner which comprise of physical maneuvers first followed by pharmacological measures in failed or resistant cases. […] Recently U.S. Food and Drug Administration (FDA) revoked the approval of chlorpromazine, citing its serious side effects in treating hiccups. […] A thorough and detailed history is warranted focusing on trigger factors for chronic hiccups along with frequency, duration, progression, and aggravating and relieving factors. […] The treatment approach of persistent hiccups is mostly based on observational reports and case series, and clear-cut guidelines are lacking. […] The treatment is mainly directed at treating the underlying cause when the illness causing hiccups has been identified.

• #149 Hiccups – UF Health

  https://ufhealth.org/conditions-and-treatments/hiccups

  Hiccups are common and normal in newborns and infants. […] Contact your health care provider if hiccups go on for more than a few days. […] To treat hiccups that do not go away, the provider may perform gastric lavage or massage of the carotid sinus in the neck. DO NOT try carotid massage by yourself. This must be done by a provider. […] If hiccups continue, medicines may help. Tube insertion into the stomach (nasogastric intubation) may also help. […] In very rare cases, if medicines or other methods do not work, treatment such as phrenic nerve block may be tried. The phrenic nerve controls the diaphragm.

• #150 Hiccups Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/symptoms/hiccups

  Hiccups are common and normal in newborns and infants. […] Contact your health care provider if hiccups go on for more than a few days. […] If you need to see your provider for hiccups, you will have a physical exam and be asked questions about the problem. […] To treat hiccups that do not go away, the provider may perform gastric lavage or massage of the carotid sinus in the neck. […] If hiccups continue, medicines may help. […] In very rare cases, if medicines or other methods do not work, treatment such as phrenic nerve block may be tried.

• #151 Your Baby Has Hiccups: What Should You Do?

  https://www.webmd.com/baby/what-to-do-if-your-baby-has-hiccups

  You might notice that your baby hiccups a lot they might have even hiccuped when they were still in the womb. This is entirely normal and is usually no reason to worry. […] Hiccups are common in babies. Most newborns hiccup quite often, which can be a sign that your baby is healthy and developing well. […] Babies are not usually bothered by their hiccups and can even eat and sleep when they have them. Usually, a bout of hiccups will go away on its own within 510 minutes, making treatment unnecessary. […] If you’re concerned about your baby’s hiccups, there are some strategies that might help them stop sooner or prevent them altogether: […] Hiccups are normal and usually don’t hurt your baby. In younger babies, hiccups are usually a sign that they need to be seated upright during or after feeding, that feeding needs to be slower for them, or that they need more time before or after feeding to relax. If your baby has a long hiccuping bout, this is no cause for alarm. Seek medical help if your baby looks like they’re in pain or if they haven’t stopped hiccuping for many hours.

• #152 How to Get Rid of Newborn Baby Hiccups – Baptist Health

  https://www.baptisthealth.com/blog/mother-and-baby-care/how-to-get-rid-of-newborn-baby-hiccups-5-tips

  When a newborn hiccups after nursing, it may seem cute at first and leave you wondering, Why do newborns get hiccups? But if your baby has hiccups for an extended period, you may be concerned that its causing them discomfort. […] Fortunately, babies dont seem to be bothered by them. In fact, many can sleep right through a case of hiccups. However, if you decide to take action when your newborn has hiccups after breastfeeding or to prevent hiccups in the first place, there are things you can do. […] But doctors arent sure what causes newborn hiccups after nursing or anytime, for that matter. […] So, while we dont know precisely what causes hiccups in newborns, it generally isnt a medical issue or cause for concern. Still, its understandable to want to provide hiccup relief for your baby.

• #153 How to Get Rid of Newborn Baby Hiccups – Baptist Health

  https://www.baptisthealth.com/blog/mother-and-baby-care/how-to-get-rid-of-newborn-baby-hiccups-5-tips

  If you feel hiccups are a distraction to your baby when you are trying to nurse or that theyre causing your baby distress, newborn hiccups cures include: […] Burping your baby can relieve pressure thats causing the stomach to irritate the diaphragm. […] Sucking on a pacifier can help relax their diaphragm and stop a bout of hiccups. […] If your baby isnt bothered by the hiccups, you can simply let them run their course. Typically, theyll resolve without any intervention. […] Gripe water is a liquid given to address issues like fussiness, gas and hiccups after feeding a newborn. […] It’s crucial to know that gripe water is classified as a dietary supplement. […] While there are steps you can take regarding a newborn and hiccups to reduce the occurrence, it’s crucial to avoid certain traditional remedies that are not only ineffective but can also be harmful or distressing for your baby.

• #154 How to Get Rid of Newborn Baby Hiccups – Baptist Health

  https://www.baptisthealth.com/blog/mother-and-baby-care/how-to-get-rid-of-newborn-baby-hiccups-5-tips

  If you feel hiccups are a distraction to your baby when you are trying to nurse or that theyre causing your baby distress, newborn hiccups cures include: […] Burping your baby can relieve pressure thats causing the stomach to irritate the diaphragm. […] Sucking on a pacifier can help relax their diaphragm and stop a bout of hiccups. […] If your baby isnt bothered by the hiccups, you can simply let them run their course. Typically, theyll resolve without any intervention. […] Gripe water is a liquid given to address issues like fussiness, gas and hiccups after feeding a newborn. […] It’s crucial to know that gripe water is classified as a dietary supplement. […] While there are steps you can take regarding a newborn and hiccups to reduce the occurrence, it’s crucial to avoid certain traditional remedies that are not only ineffective but can also be harmful or distressing for your baby.

• #155 Ways to Get Rid of Baby Hiccups – Brevard Health Alliance

  https://www.brevardhealth.org/blog/how-to-get-rid-of-baby-hiccups/

  Gently pat or rub your babys back to help release trapped air. This can be done during a feeding break and when feeding is over to minimize the likelihood of hiccups. […] Regular burping releases trapped air to prevent hiccups. Remember to burp your baby midway through each feeding and after they finish eating. […] If hiccups occur more often than you would like, discuss the problem with your childs pediatrician. This medical professional can provide guidance on how to manage hiccups and rule out any underlying health issues.

• #156 How to Get Rid of Newborn Baby Hiccups – Baptist Health

  https://www.baptisthealth.com/blog/mother-and-baby-care/how-to-get-rid-of-newborn-baby-hiccups-5-tips

  If you feel hiccups are a distraction to your baby when you are trying to nurse or that theyre causing your baby distress, newborn hiccups cures include: […] Burping your baby can relieve pressure thats causing the stomach to irritate the diaphragm. […] Sucking on a pacifier can help relax their diaphragm and stop a bout of hiccups. […] If your baby isnt bothered by the hiccups, you can simply let them run their course. Typically, theyll resolve without any intervention. […] Gripe water is a liquid given to address issues like fussiness, gas and hiccups after feeding a newborn. […] It’s crucial to know that gripe water is classified as a dietary supplement. […] While there are steps you can take regarding a newborn and hiccups to reduce the occurrence, it’s crucial to avoid certain traditional remedies that are not only ineffective but can also be harmful or distressing for your baby.

• #157 Baby Hiccups – Need To Know | The Breastfeeding Shop

  https://thebreastfeedingshop.com/baby-hiccups-what-you-need-to-know/?srsltid=AfmBOorhxLMN5c6pBoVJ6G7BBePpa1MEvg0nLMfXQ-z78AIetGJn-Y-w

  Burping your baby more frequently will also assist with preventing hiccups. […] When too much milk and air get in the mix, it causes the stomach to expand into the diaphragms area and create hiccups. […] Keep your baby upright for about 10-15 minutes after the feeding session. This will help release any pressure from the diaphragm, allowing air to rise up to the top of the stomach. This can make for better burping. […] If you think your baby might have a more serious underlying issue, please get in contact with your physician. When persistent hiccups are combined with regurgitation and/or signs of baby stomach pain, it may mean reflux. Youll want to consult your pediatrician.

• #158 Ways to Get Rid of Baby Hiccups – Brevard Health Alliance

  https://www.brevardhealth.org/blog/how-to-get-rid-of-baby-hiccups/

  Gently pat or rub your babys back to help release trapped air. This can be done during a feeding break and when feeding is over to minimize the likelihood of hiccups. […] Regular burping releases trapped air to prevent hiccups. Remember to burp your baby midway through each feeding and after they finish eating. […] If hiccups occur more often than you would like, discuss the problem with your childs pediatrician. This medical professional can provide guidance on how to manage hiccups and rule out any underlying health issues.

• #159 Baby Hiccups – Need To Know | The Breastfeeding Shop

  https://thebreastfeedingshop.com/baby-hiccups-what-you-need-to-know/?srsltid=AfmBOorhxLMN5c6pBoVJ6G7BBePpa1MEvg0nLMfXQ-z78AIetGJn-Y-w

  Burping your baby more frequently will also assist with preventing hiccups. […] When too much milk and air get in the mix, it causes the stomach to expand into the diaphragms area and create hiccups. […] Keep your baby upright for about 10-15 minutes after the feeding session. This will help release any pressure from the diaphragm, allowing air to rise up to the top of the stomach. This can make for better burping. […] If you think your baby might have a more serious underlying issue, please get in contact with your physician. When persistent hiccups are combined with regurgitation and/or signs of baby stomach pain, it may mean reflux. Youll want to consult your pediatrician.

• #160 How to Get Rid of Newborn Baby Hiccups – Baptist Health

  https://www.baptisthealth.com/blog/mother-and-baby-care/how-to-get-rid-of-newborn-baby-hiccups-5-tips

  If newborn hiccups are an issue for your baby, its ideal to prevent them in the first place if possible. […] Here are reasons to contact your pediatrician regarding frequent hiccups: […] If your baby isnt having trouble breathing or demonstrating any signs of distress, you can lay them down with hiccups. […] If the steps above dont have much effect and youre still wondering, How can I get rid of newborn baby hiccups? reach out to the Mother Baby Care specialists at Baptist Health. […] Hiccups dont necessarily mean a baby is full. Several issues can cause them, including rapid feeding. […] Yes, you can generally feed a newborn when they have hiccups. If the hiccups seem to be upsetting them or are making it hard for them to latch and suck, you might consider waiting briefly and trying to soothe them before continuing with the feeding. […] Newborn hiccups typically only last a few minutes. Its a good idea to talk with your healthcare provider if your baby often has hiccups that last longer than 10 minutes.

• #161 Hiccups in Children: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hiccups-in-children-care-instructions.abk7510

  Hiccups occur when a spasm contracts the diaphragm. This is a large sheet of muscle that separates the chest cavity from the abdominal cavity. The spasm causes an intake of breath that is suddenly stopped by the closing of the vocal cords. This closure causes the „hiccup” sound. […] Most hiccups go away on their own within a few minutes to a few hours and don’t require any treatment. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It’s also a good idea to know your child’s test results and keep a list of the medicines your child takes. […] Try these safe and easy home remedies if hiccups are making your child uncomfortable. Have your child: Hold their breath and count slowly to 10. Quickly drink a glass of cold water. Eat a teaspoon of sugar. […] Watch closely for changes in your child’s health, and be sure to contact your doctor if: Your child has hiccups for more than 2 days. Your child does not get better as expected.

• #162 Hiccups – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/symptoms-causes/syc-20352613

  Spasms of your diaphragm that you can’t control cause hiccups. The diaphragm is the muscle that separates your chest from your stomach area and plays an important role in breathing. This spasm causes your vocal cords to close briefly, producing a „hic” sound. […] Hiccups are repeated spasms or sudden movements of the diaphragm that you can’t control. […] Eating a large meal, drinking alcoholic or carbonated beverages, or getting excited suddenly may cause hiccups. In some cases, hiccups may be a sign of an underlying medical issue. For most people, hiccups usually last only a few minutes. Rarely, hiccups may continue for months. When they last that long, they can result in weight loss and extreme tiredness. […] Make an appointment to see your health care provider if your hiccups last more than 48 hours or if they’re so severe that they cause issues with eating, sleeping or breathing.

• #163 Hiccups: Causes, Serious Signs, Treatment, Home Remedies and More

  https://www.medicinenet.com/hiccups/article.htm

  Hiccups can be prevented by avoiding overeating, eating too quickly, or drinking too much. […] Most cases of hiccups resolve themselves in a short time and rarely are a medical emergency. See your doctor if hiccups last more than 3 hours, or if they disturb your eating or sleeping habits. […] Hiccups generally go away on their own and do not require medical treatment, however, if hiccups last more than three hours or disturb eating or sleeping, you may see your primary care provider (PCP) such as a family practitioner, internist, or a child’s pediatrician. […] Most hiccups will stop on their own. Home remedies are generally sufficient to resolve hiccups. […] There are numerous home cures for hiccups. You can try these methods at home to get rid of hiccups. […] If hiccups occur during feeding, stop feeding until the hiccups go away. Usually, the hiccups will „go away” in an infant or baby.

• #164 Hiccups, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/17672-hiccups

  Some medications can also cause persistent hiccups. […] Persistent hiccups may also happen after certain surgeries or procedures, including those that require general anesthesia. […] Hiccups that last longer than two days are more than just a nuisance. They can interfere with your quality of life and lead to trouble with basic needs like eating or sleeping. […] Possible medications a healthcare provider may prescribe for you include: Chlorpromazine; Proton pump inhibitor (medicines that reduce stomach acid); Metoclopramide; Baclofen; Gabapentin. […] If another medication you’re taking is causing your hiccups, your provider may tell you to stop taking it and take another instead. […] Call your healthcare provider if your hiccups last longer than two days. […] Persistent hiccups can greatly affect your quality of life. If this happens to you, don’t hesitate to talk to your healthcare provider. They’ll find the cause and recommend treatment so you can start feeling better.

• #165 Hiccups – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/symptoms-causes/syc-20352613

  Spasms of your diaphragm that you can’t control cause hiccups. The diaphragm is the muscle that separates your chest from your stomach area and plays an important role in breathing. This spasm causes your vocal cords to close briefly, producing a „hic” sound. […] Hiccups are repeated spasms or sudden movements of the diaphragm that you can’t control. […] Eating a large meal, drinking alcoholic or carbonated beverages, or getting excited suddenly may cause hiccups. In some cases, hiccups may be a sign of an underlying medical issue. For most people, hiccups usually last only a few minutes. Rarely, hiccups may continue for months. When they last that long, they can result in weight loss and extreme tiredness. […] Make an appointment to see your health care provider if your hiccups last more than 48 hours or if they’re so severe that they cause issues with eating, sleeping or breathing.

• #166 Hiccups

  https://www2.hse.ie/conditions/hiccups/

  Most people get hiccups sometimes. Hiccups usually only last a few minutes and go away without treatment. […] Hiccups usually go away on their own. But there are things you can try to stop or prevent hiccups. These things may not work for everyone. […] Hiccups that last longer than 2 days can be caused by a: health condition, certain medicines. […] Your GP can check if a health condition or medicine causes your hiccups. […] If they find a cause, they may recommend: treatment for the condition, changing your medicine. […] Your GP may prescribe a medicine called chlorpromazine if: your hiccups last longer than 2 days, there is no obvious cause.

• #167 Hiccups – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiccups/symptoms-causes/syc-20352613

  Spasms of your diaphragm that you can’t control cause hiccups. The diaphragm is the muscle that separates your chest from your stomach area and plays an important role in breathing. This spasm causes your vocal cords to close briefly, producing a „hic” sound. […] Hiccups are repeated spasms or sudden movements of the diaphragm that you can’t control. […] Eating a large meal, drinking alcoholic or carbonated beverages, or getting excited suddenly may cause hiccups. In some cases, hiccups may be a sign of an underlying medical issue. For most people, hiccups usually last only a few minutes. Rarely, hiccups may continue for months. When they last that long, they can result in weight loss and extreme tiredness. […] Make an appointment to see your health care provider if your hiccups last more than 48 hours or if they’re so severe that they cause issues with eating, sleeping or breathing.

• #168 Prone to hiccups? Here’s what you need to know | UCLA Health

  https://www.uclahealth.org/news/article/prone-hiccups-heres-what-you-need-know

  Hiccups can be more than just an annoyance. When they happen often or dont go away quickly, they can affect important parts of your life, such as sleeping, eating and socializing. In some cases, hiccups can be a sign of a more serious condition. […] Treatment for hiccups depends on the type of hiccups youre experiencing: […] Having hiccups around the clock for multiple days, weeks or months may cause issues with: Eating, Drinking, Sleeping, Socializing, Working. […] If your hiccups last longer than two days or interrupt your ability to sleep or eat, contact your primary care physician (PCP). […] Chronic hiccups can be a side effect of some medications. They can also occur after surgery or an endoscopic procedure. […] In rare cases, persistent or intractable hiccups can indicate an underlying condition. If they do, youll typically have other symptoms of that condition, too. Hiccups may be a sign of: Cardiovascular disorders, such as aortic aneurism or pericarditis, Central nervous system conditions, with 20% of people with Parkinsons disease reporting recurrent hiccups, Ear, nose and throat disorders, including laryngitis and neoplasms (abnormal tissue growth), Esophageal tumors, which involve persistent hiccups in 25% of cases, Gastrointestinal disorders, including GERD and pancreatitis. […] Your PCP should always be your first call if you have concerns. They can evaluate your hiccups and general health to get you the care you need.

• #169 Stopping and preventing hiccups | OSF HealthCare

  https://www.osfhealthcare.org/blog/stopping-and-preventing-hiccups/

  See your primary care provider. […] Hiccups are an involuntary retraction of the diaphragm, which helps control your breathing. […] Lots of things can trigger a contraction of your diaphragm: carbonated beverages, alcohol, emotional stress, swallowing air. […] If you do have hiccups consistently, for more than a few days at a time, that can be a sign of something more sinister. […] If your hiccups persist more than two weeks, it could be an early warning sign of something you don’t want to miss. See a primary care provider.

• #170 How to Get Rid of Hiccups: Home Remedies, Causes & Symptoms

  https://www.emedicinehealth.com/hiccups/article_em.htm

  A person should see a doctor if the hiccups become chronic and persistent (if they last more than 3 hours), or if they affect sleeping patterns, interfere with eating, or cause reflux of food or vomiting. […] Diagnosis is based on physical evaluation. Laboratory testing is rarely necessary unless the hiccups are suspected to be a symptom of an associated medical condition. […] There are a variety of home remedies to resolve hiccups, which include holding your breath to drinking a glass of water quickly. […] Medical care is rarely needed to cure hiccups. If a person has hiccups for more than two days, they should seek medical care. […] Treatment for getting rid of the hiccups depends on how severe the hiccups are. […] For more severe, persistent hiccups (usually lasting over to 2 days), the doctor may try medications to manage the patient’s hiccups. Chlorpromazine (Thorazine) is usually the first prescription medication tried for hiccups, although drugs such as baclofen (Lioresal) and medications for convulsions such as phenytoin (Dilantin) have also been successful. […] Anesthesia to block the phrenic nerve and surgical implantation of an electronic stimulator to the vagus nerve has been effective. Surgery to disable the phrenic nerve (the nerve that controls the diaphragm) is often the treatment of last resort.

• #171  When are hiccups serious? | Ohio State Health & Discovery

  https://health.osu.edu/health/general-health/when-are-hiccups-serious

  More important than the duration, though, is the onset of additional symptoms with the hiccups. You may need to seek emergency care if your hiccups are accompanied by symptoms such as the sudden onset of numbness or coordination issues. These could indicate a stroke, which is serious and needs immediate treatment. Other symptoms of stroke include the sudden onset of difficulty speaking or swallowing, facial droop, speech change, vision changes (losing part of your vision) or weakness on one side of your body. […] Pay attention to your body. If the onset of hiccups includes any heart-related symptoms, go to an emergency department and get evaluated right away.

• #172  When are hiccups serious? | Ohio State Health & Discovery

  https://health.osu.edu/health/general-health/when-are-hiccups-serious

  More important than the duration, though, is the onset of additional symptoms with the hiccups. You may need to seek emergency care if your hiccups are accompanied by symptoms such as the sudden onset of numbness or coordination issues. These could indicate a stroke, which is serious and needs immediate treatment. Other symptoms of stroke include the sudden onset of difficulty speaking or swallowing, facial droop, speech change, vision changes (losing part of your vision) or weakness on one side of your body. […] Pay attention to your body. If the onset of hiccups includes any heart-related symptoms, go to an emergency department and get evaluated right away.

• #173  When are hiccups serious? | Ohio State Health & Discovery

  https://health.osu.edu/health/general-health/when-are-hiccups-serious

  More important than the duration, though, is the onset of additional symptoms with the hiccups. You may need to seek emergency care if your hiccups are accompanied by symptoms such as the sudden onset of numbness or coordination issues. These could indicate a stroke, which is serious and needs immediate treatment. Other symptoms of stroke include the sudden onset of difficulty speaking or swallowing, facial droop, speech change, vision changes (losing part of your vision) or weakness on one side of your body. […] Pay attention to your body. If the onset of hiccups includes any heart-related symptoms, go to an emergency department and get evaluated right away.

• #174  When are hiccups serious? | Ohio State Health & Discovery

  https://health.osu.edu/health/general-health/when-are-hiccups-serious

  More important than the duration, though, is the onset of additional symptoms with the hiccups. You may need to seek emergency care if your hiccups are accompanied by symptoms such as the sudden onset of numbness or coordination issues. These could indicate a stroke, which is serious and needs immediate treatment. Other symptoms of stroke include the sudden onset of difficulty speaking or swallowing, facial droop, speech change, vision changes (losing part of your vision) or weakness on one side of your body. […] Pay attention to your body. If the onset of hiccups includes any heart-related symptoms, go to an emergency department and get evaluated right away.

• #175  When are hiccups serious? | Ohio State Health & Discovery

  https://health.osu.edu/health/general-health/when-are-hiccups-serious

  More important than the duration, though, is the onset of additional symptoms with the hiccups. You may need to seek emergency care if your hiccups are accompanied by symptoms such as the sudden onset of numbness or coordination issues. These could indicate a stroke, which is serious and needs immediate treatment. Other symptoms of stroke include the sudden onset of difficulty speaking or swallowing, facial droop, speech change, vision changes (losing part of your vision) or weakness on one side of your body. […] Pay attention to your body. If the onset of hiccups includes any heart-related symptoms, go to an emergency department and get evaluated right away.

• #176  When are hiccups serious? | Ohio State Health & Discovery

  https://health.osu.edu/health/general-health/when-are-hiccups-serious

  More important than the duration, though, is the onset of additional symptoms with the hiccups. You may need to seek emergency care if your hiccups are accompanied by symptoms such as the sudden onset of numbness or coordination issues. These could indicate a stroke, which is serious and needs immediate treatment. Other symptoms of stroke include the sudden onset of difficulty speaking or swallowing, facial droop, speech change, vision changes (losing part of your vision) or weakness on one side of your body. […] Pay attention to your body. If the onset of hiccups includes any heart-related symptoms, go to an emergency department and get evaluated right away.

• #177  When are hiccups serious? | Ohio State Health & Discovery

  https://health.osu.edu/health/general-health/when-are-hiccups-serious

  More important than the duration, though, is the onset of additional symptoms with the hiccups. You may need to seek emergency care if your hiccups are accompanied by symptoms such as the sudden onset of numbness or coordination issues. These could indicate a stroke, which is serious and needs immediate treatment. Other symptoms of stroke include the sudden onset of difficulty speaking or swallowing, facial droop, speech change, vision changes (losing part of your vision) or weakness on one side of your body. […] Pay attention to your body. If the onset of hiccups includes any heart-related symptoms, go to an emergency department and get evaluated right away.

• #178 Singultus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538225/

  Hiccups can be acute, lasting less than 48 hours, persistent, lasting over 2 days, or intractable, lasting more than one month. […] This activity stresses the role of the interprofessional team in the care of affected patients. […] Explain a well-coordinated interprofessional team approach to provide effective care to patients affected by persistent or intractable hiccups. […] Hiccups are often caused by gastrointestinal disorders such as gastroesophageal reflux. […] Acute hiccups can be uncomfortable, and a brief annoyance, however persistent and intractable hiccups have a significant impact on quality of life by interfering with eating, sleeping, speaking, and social activities, and can be a harbinger of serious medical pathology. […] Important steps in the treatment of persistent and intractable hiccups are, first, to assess whether the patient is using a medication known to induce hiccups, and second, to determine whether hiccups are associated with GERD.

• #179 Managing Hiccups at End of Life – Enclara Pharmacia

  https://enclarapharmacia.com/palliative-pearls/managing-hiccups-at-end-of-life

  The successful management of intractable hiccups in hospice care can significantly enhance the quality of life for patients facing terminal illnesses. Interdisciplinary collaboration and individualized care plans are critical in addressing challenging symptoms such as persistent hiccups in this vulnerable population.

• #180 Loyola Neurologists Find Intractable Hiccups May Be More Common Than We Think | News | Loyola Medicine

  https://www.loyolamedicine.org/newsroom/press-releases/intractable-hiccups-may-be-more-common-we-think

  Hiccup treatments cross multiple disciplines, including neurology, gastroenterology, pulmonology and primary care, Drs. Rouse and Wodziak wrote. There are no formal guidelines for treating intractable hiccups. Many treatments are founded merely on a physician’s own experience or anecdotal evidence. […] „There is a lack of good quality evidence to recommend specific treatment for hiccups,” Drs. Rouse and Wodziak wrote.

• #181 Loyola Neurologists Find Intractable Hiccups May Be More Common Than We Think | News | Loyola Medicine

  https://www.loyolamedicine.org/newsroom/press-releases/intractable-hiccups-may-be-more-common-we-think

  Hiccup treatments cross multiple disciplines, including neurology, gastroenterology, pulmonology and primary care, Drs. Rouse and Wodziak wrote. There are no formal guidelines for treating intractable hiccups. Many treatments are founded merely on a physician’s own experience or anecdotal evidence. […] „There is a lack of good quality evidence to recommend specific treatment for hiccups,” Drs. Rouse and Wodziak wrote.

• #182 Loyola Neurologists Find Intractable Hiccups May Be More Common Than We Think | News | Loyola Medicine

  https://www.loyolamedicine.org/newsroom/press-releases/intractable-hiccups-may-be-more-common-we-think

  Hiccup treatments cross multiple disciplines, including neurology, gastroenterology, pulmonology and primary care, Drs. Rouse and Wodziak wrote. There are no formal guidelines for treating intractable hiccups. Many treatments are founded merely on a physician’s own experience or anecdotal evidence. […] „There is a lack of good quality evidence to recommend specific treatment for hiccups,” Drs. Rouse and Wodziak wrote.

• #183 Loyola Neurologists Find Intractable Hiccups May Be More Common Than We Think | News | Loyola Medicine

  https://www.loyolamedicine.org/newsroom/press-releases/intractable-hiccups-may-be-more-common-we-think

  Hiccup treatments cross multiple disciplines, including neurology, gastroenterology, pulmonology and primary care, Drs. Rouse and Wodziak wrote. There are no formal guidelines for treating intractable hiccups. Many treatments are founded merely on a physician’s own experience or anecdotal evidence. […] „There is a lack of good quality evidence to recommend specific treatment for hiccups,” Drs. Rouse and Wodziak wrote.

• #184 Loyola Neurologists Find Intractable Hiccups May Be More Common Than We Think | News | Loyola Medicine

  https://www.loyolamedicine.org/newsroom/press-releases/intractable-hiccups-may-be-more-common-we-think

  Hiccup treatments cross multiple disciplines, including neurology, gastroenterology, pulmonology and primary care, Drs. Rouse and Wodziak wrote. There are no formal guidelines for treating intractable hiccups. Many treatments are founded merely on a physician’s own experience or anecdotal evidence. […] „There is a lack of good quality evidence to recommend specific treatment for hiccups,” Drs. Rouse and Wodziak wrote.

• #185 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  The effective management of symptoms (hiccups being an example) is dependent not only on a number of clinical approaches but also on the support offered by the multidisciplinary team. Listening to the patients feelings and fears may help them to put the symptom into context and help them to view their quality of life with new hope and meaning.

• #186

  https://jhoponline.com/issue-archive/2014-issues/december-vol-4-no-4/16296-hiccups

  Patients with persistent or intractable hiccups often require pharmacologic intervention to alleviate the condition or complications. The only US Food and Drug Administrationapproved hiccup remedy is chlorpromazine, which may not be useful in many patients because of its associated side effects. […] Currently, there is little guidance on which agent should be used initially for hiccups of different etiologies. Because of the larger body of literature, most practitioners use chlorpromazine, metoclopramide, or baclofen as the initial treatment modality; a trial of multiple single agents or combinations of agents is also common. […] In conclusion, although there are many reports of agents that help with the management of intractable hiccups, little current evidence exists regarding which agent, at what dose, and for which etiology should be used initially in patients. Agent and dose selection should be based on individual patient risks and comorbidities to achieve the best effect with minimal adverse consequences.

• #187 Management of hiccups in palliative care patients | BMJ Supportive & Palliative Care

  https://spcare.bmj.com/content/8/1/1

  Persistent hiccups are a frustrating experience for palliative care patients, and can have a profound impact on their quality of life. […] The management of persistent hiccups still presents an ongoing clinical challenge however, requiring further research on pathophysiology and treatment strategies. […] This literature review aims to provide guidelines for the treatment of persistent or intractable hiccups in the palliative care setting. […] The treatment of hiccups should generally be guided by the nature of the underlying cause. […] If non-pharmacological manoeuvres and pharmacological interventions are not successful, procedural or surgical interventions should be considered to control intractable hiccups. […] Persistent or intractable hiccups remain a diagnostic and therapeutic challenge, and can affect a significant minority of palliative care patients.

• #188 FF #81 Management of Hiccups | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/management-of-hiccups/

  Hiccups (singultus) are an involuntary reflex involving the respiratory muscles of the chest and diaphragm, mediated by the phrenic and vagus nerves and a central (brainstem) reflex center. A single episode can last for a few seconds to as long as several days. When they last longer than 48 hours, hiccups are termed persistent; longer than one month, intractable. Persistent and intractable hiccups can be very distressing to patients and families and diminish quality of life. Etiologies range in seriousness from stress/excitement, gastric or esophageal distention, corticosteroids, idiopathic, post-surgical, chemotherapy, cancer, myocardial infarction, liver disease, uremia, and CNS lesions. Irritation of the vagus nerve or diaphragm is a common pathophysiologic mechanism. […] Once hiccups have lasted beyond a time-limited annoyance, deciding on therapeutic intervention should be based on a thorough clinical assessment and, if possible, treatment directed at the underlying cause. A thorough history, review of medications, focused review of systems, and physical exam may help guide initial choice of treatment. Many drug and non-drug treatments have been used, but there is little evidence of any one superior approach to management. The patient’s prognosis, current level of function, and potential adverse effects from any proposed treatment should be considered.

• #189 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  Hence, meticulous evaluation and treatment of persistent or intractable hiccups (IH) in neuro-ICU patients is important, in a stepwise and protocolized manner which comprise of physical maneuvers first followed by pharmacological measures in failed or resistant cases. […] Recently U.S. Food and Drug Administration (FDA) revoked the approval of chlorpromazine, citing its serious side effects in treating hiccups. […] A thorough and detailed history is warranted focusing on trigger factors for chronic hiccups along with frequency, duration, progression, and aggravating and relieving factors. […] The treatment approach of persistent hiccups is mostly based on observational reports and case series, and clear-cut guidelines are lacking. […] The treatment is mainly directed at treating the underlying cause when the illness causing hiccups has been identified.

• #190 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  In majority of the cases, no cause is found and the treatment is mainly empirical to ameliorate the symptoms. […] Physical maneuvers such as interrupting normal respiratory function (e.g., breath holding, Valsalva maneuver), stimulating nasopharynx or uvula (e.g., sipping cold water, gargling with water, swallowing a teaspoon of dry sugar), increasing vagal stimulation (e.g., pressing on the eyeballs), and countering irritation of the diaphragm (e.g., pulling knees to chest, leaning forward to compress the chest) are first-line treatments for hiccups. […] Drug therapy should be reserved for treatment of hiccups when physical maneuvers have failed. […] The pharmacological treatment is summarized in Table 3.

• #191 :: Journal of Neurocritical Care

  https://www.e-jnc.org/m/journal/view.php?doi=10.18700/jnc.200018

  In majority of the cases, no cause is found and the treatment is mainly empirical to ameliorate the symptoms. […] Physical maneuvers such as interrupting normal respiratory function (e.g., breath holding, Valsalva maneuver), stimulating nasopharynx or uvula (e.g., sipping cold water, gargling with water, swallowing a teaspoon of dry sugar), increasing vagal stimulation (e.g., pressing on the eyeballs), and countering irritation of the diaphragm (e.g., pulling knees to chest, leaning forward to compress the chest) are first-line treatments for hiccups. […] Drug therapy should be reserved for treatment of hiccups when physical maneuvers have failed. […] The pharmacological treatment is summarized in Table 3.

• #192

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk7514

  Hiccups occur when a spasm contracts the diaphragm. This is a large sheet of muscle that separates the chest cavity from the abdominal cavity. The spasm causes an intake of breath that is suddenly stopped by the closing of the vocal cords. This closure causes the „hiccup” sound. […] Most hiccups go away on their own within a few minutes to a few hours and don’t require any treatment. […] Hiccups that last longer than 48 hours are called persistent hiccups. Hiccups that last longer than a month are called intractable hiccups. Both kinds of hiccups may be a sign of a more serious health problem. Tests may be needed to help find the cause. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems.

• #193 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  The effective management of symptoms (hiccups being an example) is dependent not only on a number of clinical approaches but also on the support offered by the multidisciplinary team. Listening to the patients feelings and fears may help them to put the symptom into context and help them to view their quality of life with new hope and meaning.

• #194 Managing Hiccups at End of Life – Enclara Pharmacia

  https://enclarapharmacia.com/palliative-pearls/managing-hiccups-at-end-of-life

  The successful management of intractable hiccups in hospice care can significantly enhance the quality of life for patients facing terminal illnesses. Interdisciplinary collaboration and individualized care plans are critical in addressing challenging symptoms such as persistent hiccups in this vulnerable population.

• #195 Management of hiccups in palliative care patients | BMJ Supportive & Palliative Care

  https://spcare.bmj.com/content/8/1/1

  Persistent hiccups are a frustrating experience for palliative care patients, and can have a profound impact on their quality of life. […] The management of persistent hiccups still presents an ongoing clinical challenge however, requiring further research on pathophysiology and treatment strategies. […] This literature review aims to provide guidelines for the treatment of persistent or intractable hiccups in the palliative care setting. […] The treatment of hiccups should generally be guided by the nature of the underlying cause. […] If non-pharmacological manoeuvres and pharmacological interventions are not successful, procedural or surgical interventions should be considered to control intractable hiccups. […] Persistent or intractable hiccups remain a diagnostic and therapeutic challenge, and can affect a significant minority of palliative care patients.

• #196 Interventions for treating persistent and intractable hiccups in adults

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6452787/

  Persistent and intractable hiccups (typically defined as lasting for more than 48 hours and one month respectively) can be of serious detriment to a patient’s quality of life, although they are relatively uncommon. […] A wide range of pharmacological and nonpharmacological interventions have been used for the treatment of persistent and intractable hiccups. However, there is little evidence as to which interventions are effective or harmful. […] The objective of this review was to evaluate the effectiveness of pharmacological and nonpharmacological interventions used in the treatment of persistent and intractable hiccups of any aetiology in adults. […] There is insufficient evidence to guide the treatment of persistent or intractable hiccups with either pharmacological or nonpharmacological interventions.

• #197 Interventions for treating persistent and intractable hiccups in adults

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6452787/

  The paucity of high quality studies indicate a need for randomised placebo-controlled trials of both pharmacological and nonpharmacological treatments. […] Although relatively uncommon, persistent and intractable hiccups can be of serious detriment to a patient’s quality of life. […] Many different drugs and nondrug measures have been suggested to stop long-lasting hiccups. […] Our conclusion is that there is insufficient evidence to recommend a particular treatment for hiccups. […] A wide range of pharmacological and nonpharmacological interventions have been used for the treatment of persistent and intractable hiccups. However, there is little evidence as to which interventions are effective or harmful. […] There is a paucity of high quality studies examining the effectiveness of pharmacological or nonpharmacological interventions for persistent and intractable hiccups. […] In conclusion there is very little evidence to guide the treatment of persistent or intractable hiccups either pharmacologically or nonpharmacologically.

• #198 Interventions for treating persistent and intractable hiccups in adults

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6452787/

  The paucity of high quality studies indicate a need for randomised placebo-controlled trials of both pharmacological and nonpharmacological treatments. […] Although relatively uncommon, persistent and intractable hiccups can be of serious detriment to a patient’s quality of life. […] Many different drugs and nondrug measures have been suggested to stop long-lasting hiccups. […] Our conclusion is that there is insufficient evidence to recommend a particular treatment for hiccups. […] A wide range of pharmacological and nonpharmacological interventions have been used for the treatment of persistent and intractable hiccups. However, there is little evidence as to which interventions are effective or harmful. […] There is a paucity of high quality studies examining the effectiveness of pharmacological or nonpharmacological interventions for persistent and intractable hiccups. […] In conclusion there is very little evidence to guide the treatment of persistent or intractable hiccups either pharmacologically or nonpharmacologically.

• #199 Loyola Neurologists Find Intractable Hiccups May Be More Common Than We Think | News | Loyola Medicine

  https://www.loyolamedicine.org/newsroom/press-releases/intractable-hiccups-may-be-more-common-we-think

  Hiccup treatments cross multiple disciplines, including neurology, gastroenterology, pulmonology and primary care, Drs. Rouse and Wodziak wrote. There are no formal guidelines for treating intractable hiccups. Many treatments are founded merely on a physician’s own experience or anecdotal evidence. […] „There is a lack of good quality evidence to recommend specific treatment for hiccups,” Drs. Rouse and Wodziak wrote.

• #200 Loyola Neurologists Find Intractable Hiccups May Be More Common Than We Think | News | Loyola Medicine

  https://www.loyolamedicine.org/newsroom/press-releases/intractable-hiccups-may-be-more-common-we-think

  Hiccup treatments cross multiple disciplines, including neurology, gastroenterology, pulmonology and primary care, Drs. Rouse and Wodziak wrote. There are no formal guidelines for treating intractable hiccups. Many treatments are founded merely on a physician’s own experience or anecdotal evidence. […] „There is a lack of good quality evidence to recommend specific treatment for hiccups,” Drs. Rouse and Wodziak wrote.

• #201 Loyola Neurologists Find Intractable Hiccups May Be More Common Than We Think | News | Loyola Medicine

  https://www.loyolamedicine.org/newsroom/press-releases/intractable-hiccups-may-be-more-common-we-think

  Hiccup treatments cross multiple disciplines, including neurology, gastroenterology, pulmonology and primary care, Drs. Rouse and Wodziak wrote. There are no formal guidelines for treating intractable hiccups. Many treatments are founded merely on a physician’s own experience or anecdotal evidence. […] „There is a lack of good quality evidence to recommend specific treatment for hiccups,” Drs. Rouse and Wodziak wrote.

• #202 Management of hiccups in palliative care patients | BMJ Supportive & Palliative Care

  https://spcare.bmj.com/content/8/1/1

  Persistent hiccups are a frustrating experience for palliative care patients, and can have a profound impact on their quality of life. […] The management of persistent hiccups still presents an ongoing clinical challenge however, requiring further research on pathophysiology and treatment strategies. […] This literature review aims to provide guidelines for the treatment of persistent or intractable hiccups in the palliative care setting. […] The treatment of hiccups should generally be guided by the nature of the underlying cause. […] If non-pharmacological manoeuvres and pharmacological interventions are not successful, procedural or surgical interventions should be considered to control intractable hiccups. […] Persistent or intractable hiccups remain a diagnostic and therapeutic challenge, and can affect a significant minority of palliative care patients.

• #203 Interventions for treating persistent and intractable hiccups in adults

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6452787/

  The paucity of high quality studies indicate a need for randomised placebo-controlled trials of both pharmacological and nonpharmacological treatments. […] Although relatively uncommon, persistent and intractable hiccups can be of serious detriment to a patient’s quality of life. […] Many different drugs and nondrug measures have been suggested to stop long-lasting hiccups. […] Our conclusion is that there is insufficient evidence to recommend a particular treatment for hiccups. […] A wide range of pharmacological and nonpharmacological interventions have been used for the treatment of persistent and intractable hiccups. However, there is little evidence as to which interventions are effective or harmful. […] There is a paucity of high quality studies examining the effectiveness of pharmacological or nonpharmacological interventions for persistent and intractable hiccups. […] In conclusion there is very little evidence to guide the treatment of persistent or intractable hiccups either pharmacologically or nonpharmacologically.

• #204 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  We encourage clinical trials in this area of critical care medicine and should also encourage more studies to analyse the effectiveness of non-pharmacological methods. […] The neurogenic type occurs because of the involvement of the medulla oblongata and they might lead to respiratory irregularities resulting in a fatal respiratory arrest. […] During the stay in the ICU, the patient had persistent hiccups responding to SOS Metachlorpromide 10mg Intravenously. […] All the steps were undertaken to stop any involuntary spasms of the diaphragm to alleviate the persistent hiccups. […] Appropriate ventilator settings should be strongly promoted in the treatment of hiccups in patients who are mechanically ventilated. […] We encourage clinical trials in this area of critical care medicine. Also, non pharmacological treatment methods such as acupuncture, respiratory monitoring, chest physiotherapy and use of non sedative drugs should be studied and considered to manage patients with persistent hiccups in the ICU.

• #205 Interventions for treating persistent and intractable hiccups in adults

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6452787/

  The paucity of high quality studies indicate a need for randomised placebo-controlled trials of both pharmacological and nonpharmacological treatments. […] Although relatively uncommon, persistent and intractable hiccups can be of serious detriment to a patient’s quality of life. […] Many different drugs and nondrug measures have been suggested to stop long-lasting hiccups. […] Our conclusion is that there is insufficient evidence to recommend a particular treatment for hiccups. […] A wide range of pharmacological and nonpharmacological interventions have been used for the treatment of persistent and intractable hiccups. However, there is little evidence as to which interventions are effective or harmful. […] There is a paucity of high quality studies examining the effectiveness of pharmacological or nonpharmacological interventions for persistent and intractable hiccups. […] In conclusion there is very little evidence to guide the treatment of persistent or intractable hiccups either pharmacologically or nonpharmacologically.

• #206

  https://jhoponline.com/issue-archive/2014-issues/december-vol-4-no-4/16296-hiccups

  Patients with persistent or intractable hiccups often require pharmacologic intervention to alleviate the condition or complications. The only US Food and Drug Administrationapproved hiccup remedy is chlorpromazine, which may not be useful in many patients because of its associated side effects. […] Currently, there is little guidance on which agent should be used initially for hiccups of different etiologies. Because of the larger body of literature, most practitioners use chlorpromazine, metoclopramide, or baclofen as the initial treatment modality; a trial of multiple single agents or combinations of agents is also common. […] In conclusion, although there are many reports of agents that help with the management of intractable hiccups, little current evidence exists regarding which agent, at what dose, and for which etiology should be used initially in patients. Agent and dose selection should be based on individual patient risks and comorbidities to achieve the best effect with minimal adverse consequences.

• #207 HiccAway! UT Health San Antonio physician develops device to relieve hiccups – UT Health San Antonio

  https://news.uthscsa.edu/hiccaway-ut-health-san-antonio-physician-develops-device-to-relieve-hiccups/

  A neuro-intensive care physician at UT Health San Antonio has invented a science-based way to stop hiccups. […] Although hiccups usually are temporary, some cases may last for hours or days and could signal a medical problem. […] Dr. Seifi set out to invent a treatment. […] The device is called HiccAway, a name conceived by medical students and residents attending rounds with Dr. Seifi. […] HiccAway does that, he said. By forceful suction, the diaphragm and phrenic nerve are activated, and at the same time, the water comes into the mouth and swallowing occurs. The vagus nerve is triggered and the hiccup goes away. […] We have tested it on a 1-year-old child. It worked, Dr. Seifi said. […] Honestly I am proud that this is a scientific device, because other ‘cures’ for hiccups are like voodoo things, but this is purely science, Dr. Seifi said.

• #208

  https://www.nursingcenter.com/journalarticle?Article_ID=2580469&Journal_ID=260877&Issue_ID=2580420

  There is insufficient evidence to guide the treatment of persistent or intractable hiccups; to date, no studies have involved advanced neuro-oncological patients who have experienced persistent hiccups with the aim of understanding their experience, gaining insights, and contributing to knowledge in the field. […] Persistent hiccups have a negative impact on patients’ and families’ quality of life, leading to extreme anguish and to a feeling of powerlessness when it becomes clear that there is no useful pharmacological therapy.

• #209 Hiccups in the Neuro-Critical Care Unit: A Symptom Less Studied? | Journal of Medical Research and Innovation W3.CSS

  https://jmrionline.com/jmri/article/view/37

  We encourage clinical trials in this area of critical care medicine and should also encourage more studies to analyse the effectiveness of non-pharmacological methods. […] The neurogenic type occurs because of the involvement of the medulla oblongata and they might lead to respiratory irregularities resulting in a fatal respiratory arrest. […] During the stay in the ICU, the patient had persistent hiccups responding to SOS Metachlorpromide 10mg Intravenously. […] All the steps were undertaken to stop any involuntary spasms of the diaphragm to alleviate the persistent hiccups. […] Appropriate ventilator settings should be strongly promoted in the treatment of hiccups in patients who are mechanically ventilated. […] We encourage clinical trials in this area of critical care medicine. Also, non pharmacological treatment methods such as acupuncture, respiratory monitoring, chest physiotherapy and use of non sedative drugs should be studied and considered to manage patients with persistent hiccups in the ICU.

• #210 HiccAway! UT Health San Antonio physician develops device to relieve hiccups – UT Health San Antonio

  https://news.uthscsa.edu/hiccaway-ut-health-san-antonio-physician-develops-device-to-relieve-hiccups/

  A neuro-intensive care physician at UT Health San Antonio has invented a science-based way to stop hiccups. […] Although hiccups usually are temporary, some cases may last for hours or days and could signal a medical problem. […] Dr. Seifi set out to invent a treatment. […] The device is called HiccAway, a name conceived by medical students and residents attending rounds with Dr. Seifi. […] HiccAway does that, he said. By forceful suction, the diaphragm and phrenic nerve are activated, and at the same time, the water comes into the mouth and swallowing occurs. The vagus nerve is triggered and the hiccup goes away. […] We have tested it on a 1-year-old child. It worked, Dr. Seifi said. […] Honestly I am proud that this is a scientific device, because other ‘cures’ for hiccups are like voodoo things, but this is purely science, Dr. Seifi said.

• #211 Remedies for Prolonged Hiccups | AAFP

  https://www.aafp.org/pubs/afp/issues/2001/0501/p1684.html

  Hiccups are an annoyance to nearly everyone at one time or another. Fortunately, they are also usually self-limited and benign. It is unusual for persons to seek care for hiccups unless the episode is particularly prolonged. Prolonged hiccups, however, can be debilitating and may be a sign of serious underlying disease. Thus, when patients do present with hiccups for medical attention, it is important to evaluate for potentially serious underlying causes. […] Hiccups lasting longer than two days are termed persistent and those lasting longer than one month are considered intractable. Intractable hiccups will frequently be a sign of underlying organic disease; therefore, obtaining a thorough history and performing a physical examination is important to evaluate for potentially serious causes.

• #212 FF #81 Management of Hiccups | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/management-of-hiccups/

  Hiccups (singultus) are an involuntary reflex involving the respiratory muscles of the chest and diaphragm, mediated by the phrenic and vagus nerves and a central (brainstem) reflex center. A single episode can last for a few seconds to as long as several days. When they last longer than 48 hours, hiccups are termed persistent; longer than one month, intractable. Persistent and intractable hiccups can be very distressing to patients and families and diminish quality of life. Etiologies range in seriousness from stress/excitement, gastric or esophageal distention, corticosteroids, idiopathic, post-surgical, chemotherapy, cancer, myocardial infarction, liver disease, uremia, and CNS lesions. Irritation of the vagus nerve or diaphragm is a common pathophysiologic mechanism. […] Once hiccups have lasted beyond a time-limited annoyance, deciding on therapeutic intervention should be based on a thorough clinical assessment and, if possible, treatment directed at the underlying cause. A thorough history, review of medications, focused review of systems, and physical exam may help guide initial choice of treatment. Many drug and non-drug treatments have been used, but there is little evidence of any one superior approach to management. The patient’s prognosis, current level of function, and potential adverse effects from any proposed treatment should be considered.

• #213 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  Metoclopramide and baclofen aim to relieve gastric distension by improving gastric emptying and relaxing the diaphragm. […] They are also important to assess the patients bowel functioning and to treat constipation, if indicated, as this may be contributing to the gastric distension. […] If the hiccups are not resolved by this, haloperidol and chlorpromazine could be used with the aim of suppressing the hiccup reflex. […] Hiccups can often cause severe distress and they can consequently affect the quality of life for some terminally ill patients. Indeed, persistent hiccups can effect the way patients talk, sleep, eat and drink, and in some can lead to weight loss, exhaustion, anxiety and depression (Wilcock and Twycross, 1996). […] The levels of anxiety and emotional distress suffered by a patient may contribute to hiccups. In palliative care, understanding the patients perception of the impact of the symptom on his/her quality of life is essential in order to alleviate distress and promote comfort.

• #214 The management of hiccups in terminally ill patients | Nursing Times

  https://www.nursingtimes.net/end-of-life-and-palliative-care/the-management-of-hiccups-in-terminally-ill-patients-02-08-2005/

  The effective management of symptoms (hiccups being an example) is dependent not only on a number of clinical approaches but also on the support offered by the multidisciplinary team. Listening to the patients feelings and fears may help them to put the symptom into context and help them to view their quality of life with new hope and meaning.

• #215 Singultus – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538225/

  Hiccups can be acute, lasting less than 48 hours, persistent, lasting over 2 days, or intractable, lasting more than one month. […] This activity stresses the role of the interprofessional team in the care of affected patients. […] Explain a well-coordinated interprofessional team approach to provide effective care to patients affected by persistent or intractable hiccups. […] Hiccups are often caused by gastrointestinal disorders such as gastroesophageal reflux. […] Acute hiccups can be uncomfortable, and a brief annoyance, however persistent and intractable hiccups have a significant impact on quality of life by interfering with eating, sleeping, speaking, and social activities, and can be a harbinger of serious medical pathology. […] Important steps in the treatment of persistent and intractable hiccups are, first, to assess whether the patient is using a medication known to induce hiccups, and second, to determine whether hiccups are associated with GERD.

• #216 Managing Hiccups at End of Life – Enclara Pharmacia

  https://enclarapharmacia.com/palliative-pearls/managing-hiccups-at-end-of-life

  The successful management of intractable hiccups in hospice care can significantly enhance the quality of life for patients facing terminal illnesses. Interdisciplinary collaboration and individualized care plans are critical in addressing challenging symptoms such as persistent hiccups in this vulnerable population.

• #217 Management of hiccups in palliative care patients | BMJ Supportive & Palliative Care

  https://spcare.bmj.com/content/8/1/1

  Persistent hiccups are a frustrating experience for palliative care patients, and can have a profound impact on their quality of life. […] The management of persistent hiccups still presents an ongoing clinical challenge however, requiring further research on pathophysiology and treatment strategies. […] This literature review aims to provide guidelines for the treatment of persistent or intractable hiccups in the palliative care setting. […] The treatment of hiccups should generally be guided by the nature of the underlying cause. […] If non-pharmacological manoeuvres and pharmacological interventions are not successful, procedural or surgical interventions should be considered to control intractable hiccups. […] Persistent or intractable hiccups remain a diagnostic and therapeutic challenge, and can affect a significant minority of palliative care patients.

• #218 Palliative care – hiccups | Healthify

  https://healthify.nz/health-a-z/p/palliative-care-hiccups

  Hiccups can be very distressing. […] Having hiccups that last longer than 48 hours isn’t uncommon for people with advanced cancer and can be very upsetting. […] Common causes of hiccups for people living with a life-limiting illness include gut problems, such as stomach distension or gastroparesis. […] If you have a medical condition, or any obvious cause for your hiccups, treatment will focus on the condition or cause. […] Your healthcare provider can talk to you about medicines that may help by relaxing your muscles, reducing stomach bloating, or controlling the hiccup reflex. […] Sometimes, hiccups can be difficult to manage despite having treatment.

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