Materiały źródłowe

• #1 Hiccups: Practice Essentials, Background, Pathophysiology

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

  Hiccups can occur at any age. They may even be observed in utero; preterm infants spend up to 2.5% of their time hiccupping. […] Although hiccups occur less frequently with advancing age, intractable hiccups are more common in adult life. Females develop hiccups more frequently during early adulthood than males of the same age do. […] The overall incidence of hiccups appears to be the same in males as it is in females; however, protracted and intractable hiccups occur more frequently in men (82% of cases). […] A review of the literature (1990-2013) comprising 318 studies found a male predominance in hiccup patients, particularly when the causes were not related to the central nervous system or were unknown.

• #2 Hiccups – UpToDate

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

  Hiccups are a common and usually transient condition affecting almost everyone during their lifetime. […] 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. […] Studies show a greater prevalence of hiccups in men and in people who are taller. In one study, the greater prevalence among males (odds ratio [OR] 2.42, 95% CI 1.40-4.17) was particularly notable in the subset of patients who did not have a central nervous system cause for their hiccups (OR 11.72, 95% CI 3.16-43.50). In a case series of 220 patients with intractable hiccups, approximately 80 percent of patients were older men. No racial, geographic, or socioeconomic variation in hiccups has been documented.

• #3 Hiccups: a common problem with some unusual causes and cures

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5072913/

  Most hiccup episodes are self-limiting and disappear after a few minutes. Despite being very frequent, they do not have any clinical repercussions, and medical care is not usually requested. […] In the present case, the CXR guided us to the diagnosis and CT was needed to confirm the cause of persistent hiccups: an acute aortic syndrome that caused thoracic aortic enlargement due to an intramural aortic haematoma. This haematoma extended to partially occupy the aortopulmonary window and presumably caused compression of the phrenic nerve that stimulates the diaphragm, which was an initial symptom of the patient with hiccups. […] Complications from hiccups are rare but they can occur and include discomfort, difficulty in feeding, gastro-oesophageal reflux, respiratory alkalosis (in tracheostomised patients), wound dehiscence, sleep deprivation, and psychiatric disorders.

• #4 Singultus – StatPearls – NCBI Bookshelf

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

  Hiccups occur in all ages, from in utero to the elderly. The incidence and prevalence of hiccups in the community are unknown, and there does not appear to be differences based on racial or geographic variation. Reports suggest there are as many as 4,000 admissions yearly in the U.S. for hiccups. Intractable hiccups have a predominance for older males, with an odds ratio of 2.4, and those with greater height and weight. The incidence of persistent hiccups is higher in patients with certain disorders, especially those with central nervous system disorders such as Parkinsons Disease, advanced cancer where the incidence may be as high as 4-9%, and 8-10% in those with gastroesophageal reflux disease (GERD).

• #5 Hiccups – UpToDate

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

  Hiccups are a common and usually transient condition affecting almost everyone during their lifetime. […] 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. […] Studies show a greater prevalence of hiccups in men and in people who are taller. In one study, the greater prevalence among males (odds ratio [OR] 2.42, 95% CI 1.40-4.17) was particularly notable in the subset of patients who did not have a central nervous system cause for their hiccups (OR 11.72, 95% CI 3.16-43.50). In a case series of 220 patients with intractable hiccups, approximately 80 percent of patients were older men. No racial, geographic, or socioeconomic variation in hiccups has been documented.

• #6 Hiccups (Singultus) | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617164/all/Hiccups__Singultus_

  Fetal hiccups are common in pregnancy, and are frequently felt in the third trimester. […] Hiccups are a physiologic movement in newborns, who may spend as much as 2.5% of their time hiccupping, which decreases in infancy. […] There is no seasonal, geographic, racial, or socioeconomic predilection. […] Persistent (48 hours) and intractable (1 month) hiccups more commonly occur in men and adults.

• #7 Singultus – StatPearls – NCBI Bookshelf

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

  Hiccups occur in all ages, from in utero to the elderly. The incidence and prevalence of hiccups in the community are unknown, and there does not appear to be differences based on racial or geographic variation. Reports suggest there are as many as 4,000 admissions yearly in the U.S. for hiccups. Intractable hiccups have a predominance for older males, with an odds ratio of 2.4, and those with greater height and weight. The incidence of persistent hiccups is higher in patients with certain disorders, especially those with central nervous system disorders such as Parkinsons Disease, advanced cancer where the incidence may be as high as 4-9%, and 8-10% in those with gastroesophageal reflux disease (GERD).

• #8 Neurotransmitters in hiccups | SpringerPlus | Full Text

  https://springerplus.springeropen.com/articles/10.1186/s40064-016-3034-3

  Hiccups are the sudden involuntary contractions of the diaphragm and intercostal muscles. There are approximately 4000 admissions for hiccups each year in the United States. […] According to a report by William H. Dobelle, approximately 4000 hospital admissions due to hiccups are reported each year in the United States (Dobelle 1999). The intractable hiccups are more common in men (82 %) than in women. Most of the men suffering from hiccups are 50 years of age or older (Cymet 2002). […] The incidence and prevalence of persistent and intractable hiccups in the community has not been studied.

• #9 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 happen to anyone at any time. […] 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. […] As many as 4,000 people in the United States are hospitalized yearly for hiccups. […] If your hiccups last longer than two days or interrupt your ability to sleep or eat, contact your primary care physician (PCP). […] In rare cases, persistent or intractable hiccups can indicate an underlying condition.

• #10 Hiccups – UpToDate

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

  Hiccups are a common and usually transient condition affecting almost everyone during their lifetime. […] 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. […] Studies show a greater prevalence of hiccups in men and in people who are taller. In one study, the greater prevalence among males (odds ratio [OR] 2.42, 95% CI 1.40-4.17) was particularly notable in the subset of patients who did not have a central nervous system cause for their hiccups (OR 11.72, 95% CI 3.16-43.50). In a case series of 220 patients with intractable hiccups, approximately 80 percent of patients were older men. No racial, geographic, or socioeconomic variation in hiccups has been documented.

• #11 Hiccups – UpToDate

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

  Hiccups are a common and usually transient condition affecting almost everyone during their lifetime. […] 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. […] Studies show a greater prevalence of hiccups in men and in people who are taller. In one study, the greater prevalence among males (odds ratio [OR] 2.42, 95% CI 1.40-4.17) was particularly notable in the subset of patients who did not have a central nervous system cause for their hiccups (OR 11.72, 95% CI 3.16-43.50). In a case series of 220 patients with intractable hiccups, approximately 80 percent of patients were older men. No racial, geographic, or socioeconomic variation in hiccups has been documented.

• #12 Analysis of Factors Associated with Hiccups Using the FAERS Database

  https://www.mdpi.com/1424-8247/15/1/27

  From the results of this study, approximately 74% of the reports of hiccups involved men. […] The results of the multivariate analysis showed that, as in previous reports, male gender was extracted as an independent risk factor for hiccups. […] This study revealed that hiccups as a side effect are more likely to occur in males, and it is suspected that the effects of the drugs differ by gender. […] In this study, we found no association between hiccups and body weight, which is among the physical information included in FAERS. […] We performed an exhaustive univariate analysis of the association between hiccups and drugs using FAERS. […] This is the first report to examine the suspected drugs and patient’s information by gender. […] We believe that further molecular–chemical investigations of the suspect drugs will lead to the elucidation of the mechanism responsible for drug-induced hiccups.

• #13 Hiccups – UpToDate

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

  Hiccups are a common and usually transient condition affecting almost everyone during their lifetime. […] 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. […] Studies show a greater prevalence of hiccups in men and in people who are taller. In one study, the greater prevalence among males (odds ratio [OR] 2.42, 95% CI 1.40-4.17) was particularly notable in the subset of patients who did not have a central nervous system cause for their hiccups (OR 11.72, 95% CI 3.16-43.50). In a case series of 220 patients with intractable hiccups, approximately 80 percent of patients were older men. No racial, geographic, or socioeconomic variation in hiccups has been documented.

• #14 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! […] Upwards of 4,000 admissions per year for evaluation/management of hiccups […] Intractable hiccups are more common in men […] Non-CNS mediated hiccups have a strong male predominance with odds ratio of 11.72 […] CNS mediated hiccups do not exhibit gender predominance […] Prevalence of recurrent hiccups in advanced cancer patients is around 5% […] 20% of Parkinsons patients reported frequent hiccups […] Recurrent hiccups are present in 10% of those with GERD.

• #15 Hiccups – UpToDate

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

  Hiccups are a common and usually transient condition affecting almost everyone during their lifetime. […] 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. […] Studies show a greater prevalence of hiccups in men and in people who are taller. In one study, the greater prevalence among males (odds ratio [OR] 2.42, 95% CI 1.40-4.17) was particularly notable in the subset of patients who did not have a central nervous system cause for their hiccups (OR 11.72, 95% CI 3.16-43.50). In a case series of 220 patients with intractable hiccups, approximately 80 percent of patients were older men. No racial, geographic, or socioeconomic variation in hiccups has been documented.

• #16 Neurotransmitters in hiccups | SpringerPlus | Full Text

  https://springerplus.springeropen.com/articles/10.1186/s40064-016-3034-3

  Hiccups are the sudden involuntary contractions of the diaphragm and intercostal muscles. There are approximately 4000 admissions for hiccups each year in the United States. […] According to a report by William H. Dobelle, approximately 4000 hospital admissions due to hiccups are reported each year in the United States (Dobelle 1999). The intractable hiccups are more common in men (82 %) than in women. Most of the men suffering from hiccups are 50 years of age or older (Cymet 2002). […] The incidence and prevalence of persistent and intractable hiccups in the community has not been studied.

• #17 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

  MAYWOOD, IL Everyone gets hiccups, but some people suffer intractable hiccups that last longer than a month, according to two Loyola Medicine neurologists. […] „Intractable hiccups can occur more often than we realize and present to multiple medical disciplines,” Stasia Rouse, MD, and Matthew Wodziak, MD, wrote in the journal Current Neurology and Neuroscience Reports. […] About 4,000 people in the United States are hospitalized each year for hiccups. […] Ninety-one percent of people who suffer intractable hiccups are men, most of whom are over age 50. […] 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.

• #18 Hiccups: Practice Essentials, Background, Pathophysiology

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

  Hiccups can occur at any age. They may even be observed in utero; preterm infants spend up to 2.5% of their time hiccupping. […] Although hiccups occur less frequently with advancing age, intractable hiccups are more common in adult life. Females develop hiccups more frequently during early adulthood than males of the same age do. […] The overall incidence of hiccups appears to be the same in males as it is in females; however, protracted and intractable hiccups occur more frequently in men (82% of cases). […] A review of the literature (1990-2013) comprising 318 studies found a male predominance in hiccup patients, particularly when the causes were not related to the central nervous system or were unknown.

• #19 The Dangers of Hiccups!!

  https://sinaiem.org/foam/the-dangers-of-hiccups/

  Often benign and self-limiting, but if persistent may be due to a medication, GERD, stroke, ACS or cancer/chemo. Common in pediatrics and more likely to be benign. In adults has a male predominance. […] Intractable hiccups have a male predominance in non-CNS causes with odds ratio of 2.42. Younger ages, affects females more often. Less likely organic causes in children and full-term infants. […] Clinical Presentation/History: Normally self-resolving by 48 hours and intractable if greater than 1 month.

• #20 Singultus – StatPearls – NCBI Bookshelf

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

  Hiccups occur in all ages, from in utero to the elderly. The incidence and prevalence of hiccups in the community are unknown, and there does not appear to be differences based on racial or geographic variation. Reports suggest there are as many as 4,000 admissions yearly in the U.S. for hiccups. Intractable hiccups have a predominance for older males, with an odds ratio of 2.4, and those with greater height and weight. The incidence of persistent hiccups is higher in patients with certain disorders, especially those with central nervous system disorders such as Parkinsons Disease, advanced cancer where the incidence may be as high as 4-9%, and 8-10% in those with gastroesophageal reflux disease (GERD).

• #21 Hiccups – UpToDate

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

  Hiccups are a common and usually transient condition affecting almost everyone during their lifetime. […] 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. […] Studies show a greater prevalence of hiccups in men and in people who are taller. In one study, the greater prevalence among males (odds ratio [OR] 2.42, 95% CI 1.40-4.17) was particularly notable in the subset of patients who did not have a central nervous system cause for their hiccups (OR 11.72, 95% CI 3.16-43.50). In a case series of 220 patients with intractable hiccups, approximately 80 percent of patients were older men. No racial, geographic, or socioeconomic variation in hiccups has been documented.

• #22 Demographic and Clinical Risk Factors of Hiccups

  https://www.gavinpublishers.com/article/view/demographic-and-clinical-risk-factors-of-hiccups

  The hiccup is a common somatic side effect of medication. […] Our previous analysis of the Japanese Adverse Drug Event Report Database identified male sex and height as factors related to hiccup risk. […] While the clinical features and pathogenesis of hiccups have been partially elucidated, there has been no analysis of the relation between hiccups and clinical variables, and to this end, we examined the relation among hiccups, patients demographics and clinical risk factors. […] We suggest that low BMI is a reliable physical index related to hiccup risk, while chemotherapy and certain malignant tumors are clinical risk factors. […] These results may assist in elucidating the underlying mechanisms and guiding therapy to reduce hiccup risk. […] Although the study was performed in the single institution, many cases were accumulated as in multi-center studies.

• #23 Demographic and Clinical Risk Factors of Hiccups

  https://www.gavinpublishers.com/article/view/demographic-and-clinical-risk-factors-of-hiccups

  The hiccup is a common somatic side effect of medication. […] Our previous analysis of the Japanese Adverse Drug Event Report Database identified male sex and height as factors related to hiccup risk. […] While the clinical features and pathogenesis of hiccups have been partially elucidated, there has been no analysis of the relation between hiccups and clinical variables, and to this end, we examined the relation among hiccups, patients demographics and clinical risk factors. […] We suggest that low BMI is a reliable physical index related to hiccup risk, while chemotherapy and certain malignant tumors are clinical risk factors. […] These results may assist in elucidating the underlying mechanisms and guiding therapy to reduce hiccup risk. […] Although the study was performed in the single institution, many cases were accumulated as in multi-center studies.

• #24 Analysis of Factors Associated with Hiccups Using the FAERS Database

  https://www.mdpi.com/1424-8247/15/1/27

  From the results of this study, approximately 74% of the reports of hiccups involved men. […] The results of the multivariate analysis showed that, as in previous reports, male gender was extracted as an independent risk factor for hiccups. […] This study revealed that hiccups as a side effect are more likely to occur in males, and it is suspected that the effects of the drugs differ by gender. […] In this study, we found no association between hiccups and body weight, which is among the physical information included in FAERS. […] We performed an exhaustive univariate analysis of the association between hiccups and drugs using FAERS. […] This is the first report to examine the suspected drugs and patient’s information by gender. […] We believe that further molecular–chemical investigations of the suspect drugs will lead to the elucidation of the mechanism responsible for drug-induced hiccups.

• #25 Hiccups (Singultus) | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617164/all/Hiccups__Singultus_

  Fetal hiccups are common in pregnancy, and are frequently felt in the third trimester. […] Hiccups are a physiologic movement in newborns, who may spend as much as 2.5% of their time hiccupping, which decreases in infancy. […] There is no seasonal, geographic, racial, or socioeconomic predilection. […] Persistent (48 hours) and intractable (1 month) hiccups more commonly occur in men and adults.

• #26 Hiccups (Singultus) | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617164/all/Hiccups__Singultus_

  Fetal hiccups are common in pregnancy, and are frequently felt in the third trimester. […] Hiccups are a physiologic movement in newborns, who may spend as much as 2.5% of their time hiccupping, which decreases in infancy. […] There is no seasonal, geographic, racial, or socioeconomic predilection. […] Persistent (48 hours) and intractable (1 month) hiccups more commonly occur in men and adults.

• #27 Hiccups: Practice Essentials, Background, Pathophysiology

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

  Hiccups can occur at any age. They may even be observed in utero; preterm infants spend up to 2.5% of their time hiccupping. […] Although hiccups occur less frequently with advancing age, intractable hiccups are more common in adult life. Females develop hiccups more frequently during early adulthood than males of the same age do. […] The overall incidence of hiccups appears to be the same in males as it is in females; however, protracted and intractable hiccups occur more frequently in men (82% of cases). […] A review of the literature (1990-2013) comprising 318 studies found a male predominance in hiccup patients, particularly when the causes were not related to the central nervous system or were unknown.

• #28 The Dangers of Hiccups!!

  https://sinaiem.org/foam/the-dangers-of-hiccups/

  Often benign and self-limiting, but if persistent may be due to a medication, GERD, stroke, ACS or cancer/chemo. Common in pediatrics and more likely to be benign. In adults has a male predominance. […] Intractable hiccups have a male predominance in non-CNS causes with odds ratio of 2.42. Younger ages, affects females more often. Less likely organic causes in children and full-term infants. […] Clinical Presentation/History: Normally self-resolving by 48 hours and intractable if greater than 1 month.

• #29 Hiccups – UpToDate

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

  Hiccups are a common and usually transient condition affecting almost everyone during their lifetime. […] 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. […] Studies show a greater prevalence of hiccups in men and in people who are taller. In one study, the greater prevalence among males (odds ratio [OR] 2.42, 95% CI 1.40-4.17) was particularly notable in the subset of patients who did not have a central nervous system cause for their hiccups (OR 11.72, 95% CI 3.16-43.50). In a case series of 220 patients with intractable hiccups, approximately 80 percent of patients were older men. No racial, geographic, or socioeconomic variation in hiccups has been documented.

• #30 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1154709

  Hiccups are more common in diseases affecting the gastrointestinal or central nervous system (CNS). […] 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. […] Recurrent hiccups occur in about 3% of the healthy population, compared to approximately 20% with Parkinson disease and 10% of patients with gastroesophageal reflux disease (GERD). […] Overall, the prevalence of hiccups in advanced cancer has been reported to be 3.9%4.8%. […] A variety of CNS pathologies cause IH.

• #31 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 are more common in people with advanced cancer. […] Hiccups that last more than 2 days can be considered persistent. […] 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. […] Hiccups that last a long time can be a sign of a serious problem.

• #32 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1154709

  Hiccups are more common in diseases affecting the gastrointestinal or central nervous system (CNS). […] 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. […] Recurrent hiccups occur in about 3% of the healthy population, compared to approximately 20% with Parkinson disease and 10% of patients with gastroesophageal reflux disease (GERD). […] Overall, the prevalence of hiccups in advanced cancer has been reported to be 3.9%4.8%. […] A variety of CNS pathologies cause IH.

• #33 Hiccup: Mystery, Nature and Treatment

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

  There is no doubt that any space occupying lesion in the brain has the chance to elicit hiccup. […] A patient with mediastinal lymph node sarcoidosis, which was likely the lesion invading the hiccup reflex arc, had persistent hiccup that did not respond to steroid therapy. […] It is well known that GERD is commonly associated with belching. […] Post-operative hiccups were reported in subjects receiving various surgeries, for example, Whipple operation and colectomy. […] Serious hiccup is not unusual among the cancer patients. […] Twenty percent of parkinsonism (PD) patients had frequent hiccups compared to 3% of the controls. […] Interestingly, many measures on human body have been known to elicit serious hiccups. […] Basically, transient hiccups are self-limited, and neither etiological evaluation nor immediate treatment is needed for these subjects unless their hiccup recurs.

• #34 Singultus – StatPearls – NCBI Bookshelf

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

  Hiccups occur in all ages, from in utero to the elderly. The incidence and prevalence of hiccups in the community are unknown, and there does not appear to be differences based on racial or geographic variation. Reports suggest there are as many as 4,000 admissions yearly in the U.S. for hiccups. Intractable hiccups have a predominance for older males, with an odds ratio of 2.4, and those with greater height and weight. The incidence of persistent hiccups is higher in patients with certain disorders, especially those with central nervous system disorders such as Parkinsons Disease, advanced cancer where the incidence may be as high as 4-9%, and 8-10% in those with gastroesophageal reflux disease (GERD).

• #35 Singultus – StatPearls – NCBI Bookshelf

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

  Hiccups occur in all ages, from in utero to the elderly. The incidence and prevalence of hiccups in the community are unknown, and there does not appear to be differences based on racial or geographic variation. Reports suggest there are as many as 4,000 admissions yearly in the U.S. for hiccups. Intractable hiccups have a predominance for older males, with an odds ratio of 2.4, and those with greater height and weight. The incidence of persistent hiccups is higher in patients with certain disorders, especially those with central nervous system disorders such as Parkinsons Disease, advanced cancer where the incidence may be as high as 4-9%, and 8-10% in those with gastroesophageal reflux disease (GERD).

• #36 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1154709

  Hiccups are more common in diseases affecting the gastrointestinal or central nervous system (CNS). […] 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. […] Recurrent hiccups occur in about 3% of the healthy population, compared to approximately 20% with Parkinson disease and 10% of patients with gastroesophageal reflux disease (GERD). […] Overall, the prevalence of hiccups in advanced cancer has been reported to be 3.9%4.8%. […] A variety of CNS pathologies cause IH.

• #37 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! […] Upwards of 4,000 admissions per year for evaluation/management of hiccups […] Intractable hiccups are more common in men […] Non-CNS mediated hiccups have a strong male predominance with odds ratio of 11.72 […] CNS mediated hiccups do not exhibit gender predominance […] Prevalence of recurrent hiccups in advanced cancer patients is around 5% […] 20% of Parkinsons patients reported frequent hiccups […] Recurrent hiccups are present in 10% of those with GERD.

• #38 Demographic and Clinical Risk Factors of Hiccups

  https://www.gavinpublishers.com/article/view/demographic-and-clinical-risk-factors-of-hiccups

  The hiccup is a common somatic side effect of medication. […] Our previous analysis of the Japanese Adverse Drug Event Report Database identified male sex and height as factors related to hiccup risk. […] While the clinical features and pathogenesis of hiccups have been partially elucidated, there has been no analysis of the relation between hiccups and clinical variables, and to this end, we examined the relation among hiccups, patients demographics and clinical risk factors. […] We suggest that low BMI is a reliable physical index related to hiccup risk, while chemotherapy and certain malignant tumors are clinical risk factors. […] These results may assist in elucidating the underlying mechanisms and guiding therapy to reduce hiccup risk. […] Although the study was performed in the single institution, many cases were accumulated as in multi-center studies.

• #39 Demographic and Clinical Risk Factors of Hiccups

  https://www.gavinpublishers.com/article/view/demographic-and-clinical-risk-factors-of-hiccups

  We collected 256 cases of hiccups, surpassing the case-number of our previous study with the Japanese Adverse Drug Event Report Database including 160 cases of hiccups. […] Among hospital events, chemotherapy, and death within 24 hours after hospitalization were identified as independent risk factors for hiccups in the patients above 40 years old using multivariable analysis. […] We also analyzed associations between hiccup incidence and specific ICD-10 and Japanese MDC categories. […] We identified nine disease categories associated with hiccups, with several strongly associated categories according to volcano plot analysis. […] Multivariable analysis identified subarachnoid hemorrhage, intracerebral hemorrhage in hemisphere, and tumor of brain as strong independent risk factors among patients with CNS diseases. […] It is possible that these lesions damage nerves of the hiccup reflex arc. […] Further study of the associations between cancer type, chemotherapy regime, and hiccup risk is clearly warranted as hiccups can reduce treatment tolerance and quality of life.

• #40 Demographic and Clinical Risk Factors of Hiccups

  https://www.gavinpublishers.com/article/view/demographic-and-clinical-risk-factors-of-hiccups

  We collected 256 cases of hiccups, surpassing the case-number of our previous study with the Japanese Adverse Drug Event Report Database including 160 cases of hiccups. […] Among hospital events, chemotherapy, and death within 24 hours after hospitalization were identified as independent risk factors for hiccups in the patients above 40 years old using multivariable analysis. […] We also analyzed associations between hiccup incidence and specific ICD-10 and Japanese MDC categories. […] We identified nine disease categories associated with hiccups, with several strongly associated categories according to volcano plot analysis. […] Multivariable analysis identified subarachnoid hemorrhage, intracerebral hemorrhage in hemisphere, and tumor of brain as strong independent risk factors among patients with CNS diseases. […] It is possible that these lesions damage nerves of the hiccup reflex arc. […] Further study of the associations between cancer type, chemotherapy regime, and hiccup risk is clearly warranted as hiccups can reduce treatment tolerance and quality of life.

• #41 Demographic and Clinical Risk Factors of Hiccups

  https://www.gavinpublishers.com/article/view/demographic-and-clinical-risk-factors-of-hiccups

  We collected 256 cases of hiccups, surpassing the case-number of our previous study with the Japanese Adverse Drug Event Report Database including 160 cases of hiccups. […] Among hospital events, chemotherapy, and death within 24 hours after hospitalization were identified as independent risk factors for hiccups in the patients above 40 years old using multivariable analysis. […] We also analyzed associations between hiccup incidence and specific ICD-10 and Japanese MDC categories. […] We identified nine disease categories associated with hiccups, with several strongly associated categories according to volcano plot analysis. […] Multivariable analysis identified subarachnoid hemorrhage, intracerebral hemorrhage in hemisphere, and tumor of brain as strong independent risk factors among patients with CNS diseases. […] It is possible that these lesions damage nerves of the hiccup reflex arc. […] Further study of the associations between cancer type, chemotherapy regime, and hiccup risk is clearly warranted as hiccups can reduce treatment tolerance and quality of life.

• #42 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1154709

  There is high preponderance of developing IH following an ischemic insult to the brainstem including pons or involvement of posterior inferior cerebellar artery. […] Vascular lesions of CNS are the most common cause of IH followed by infective (meningitis, encephalitis), structural lesions, such as a multitude of space occupying lesions like cavernous angiomas or tuberculomas, and inflammatory and demyelinating conditions such as multiple sclerosis and neuromyelitis optica.

• #43 Analysis of factors associated with hiccups based on the Japanese Adverse Drug Event Report database | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172057

  Hiccups are occasionally experienced by most individuals. […] Previous studies showed that hiccups may occur as an adverse effect of certain medicines during chemotherapy. […] The present study aimed to investigate the influence of medicines and patient characteristics on hiccups using a large-sized adverse drug event report database and, specifically, the Japanese Adverse Drug Event Report (JADER) database. […] Medicines associated with hiccups included dexamethasone, levofolinate, fluorouracil, oxaliplatin, carboplatin, and irinotecan. […] The results of the present study suggest that it is possible to predict a high risk of hiccups using patient characteristics. […] We confirmed that dexamethasone was the drug that has the strongest influence on the induction of hiccups. […] However, the influence of anti-cancer agents on the induction of hiccups cannot be denied.

• #44 Analysis of factors associated with hiccups based on the Japanese Adverse Drug Event Report database | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172057

  Hiccups are occasionally experienced by most individuals. […] Previous studies showed that hiccups may occur as an adverse effect of certain medicines during chemotherapy. […] The present study aimed to investigate the influence of medicines and patient characteristics on hiccups using a large-sized adverse drug event report database and, specifically, the Japanese Adverse Drug Event Report (JADER) database. […] Medicines associated with hiccups included dexamethasone, levofolinate, fluorouracil, oxaliplatin, carboplatin, and irinotecan. […] The results of the present study suggest that it is possible to predict a high risk of hiccups using patient characteristics. […] We confirmed that dexamethasone was the drug that has the strongest influence on the induction of hiccups. […] However, the influence of anti-cancer agents on the induction of hiccups cannot be denied.

• #45 Analysis of factors associated with hiccups based on the Japanese Adverse Drug Event Report database | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172057

  The incidence of persistent or intractable hiccups is significantly higher in men. […] Our results supported these findings (OR: 32.6, 95% CI: 6.8585.1). […] The multivariable analysis indicated that anti-cancer drugs and dexamethasone are independent risk factors for hiccups. […] In our examination, there were 66 cases of hiccups in patients who did not use dexamethasone. […] This supports the results of the multivariable analysis showing that the use of anti-cancer drugs is one of the independent risk factors influencing the onset of hiccups.

• #46 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.

• #47 Hiccups | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hiccups-1?embed_domain=hackmd.io%2525252f%25252540yipuafecsl2jsu8smr5njq%2525252fbnjhjgjghjghjgh&lang=us

  Hiccups are a symptom that has probably been experienced by everyone at some point in their lives. Chronic intractable hiccups are rare. […] Chronic, persistent hiccups refers to any episode with a duration greater than 48 hours. Intractable hiccups, sometimes defined as those lasting more than two months, can be very disabling, causing inability to sleep, depression, and chronic exhaustion, with secondary deleterious effects on an individual’s health.

• #48 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.

• #49 Hiccup: Mystery, Nature and Treatment

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

  Hiccup occurrence is not only confined to the adults but also observed among the infants and children. […] Persistent hiccup means episode lasting for 48 hours or more, whereas those longer than 2 months are considered intractable. […] Unfortunately, there is no guideline available to direct treating this serious disorders effectively. […] The pathophysiological mechanism of hiccup is related to lesions in its reflex arc shown in Figure. […] In the review of recent literature, too many causes of hiccups have been reported. […] Briefly, Table 1 summarizes the reported etiology of persistent and intractable hiccups. […] Brain ischemia or stroke is not rare among the individuals with intractable hiccup and in some patients cerebrovascular cause was correctly diagnosed months later.

• #50 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.

• #51 Hiccups | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hiccups-1?embed_domain=hackmd.io%2525252f%25252540yipuafecsl2jsu8smr5njq%2525252fbnjhjgjghjghjgh&lang=us

  Hiccups are a symptom that has probably been experienced by everyone at some point in their lives. Chronic intractable hiccups are rare. […] Chronic, persistent hiccups refers to any episode with a duration greater than 48 hours. Intractable hiccups, sometimes defined as those lasting more than two months, can be very disabling, causing inability to sleep, depression, and chronic exhaustion, with secondary deleterious effects on an individual’s health.

• #52 The chronic hiccup chronicles | Drug Discovery News

  https://www.drugdiscoverynews.com/the-chronic-hiccup-chronicles-15840

  Researchers and patients developed unexpected and innovative solutions to a mysterious disease that appears as little more than a hiccup. […] Doctors classified Allards painful diaphragmatic spasms as hiccups, and they lasted uncontrolled for fifteen years. For Allard and about one in a 100,000 people, hiccups are a chronic condition without a known cause or a reliable therapeutic option, leaving many to take matters into their own hands. […] Every year, an average of 4,723 people in the United States are admitted to the hospital due to hiccups. […] If hiccups last longer, then they enter the class of persistent or chronic hiccups. If hiccups last for years, then they are labeled intractable hiccups. Of patients admitted to the hospital for hiccups, 44.1 percent have temporary hiccups, 36.9 percent have persistent hiccups, and 19 percent have intractable hiccups.

• #53 Orphanet: Chronic hiccup

  https://www.orpha.net/en/disease/detail/396

  Chronic hiccup is a rare movement disorder characterized by involuntary spasmodic contractions of the inspiratory muscles synchronized with larynx closure lasting for more than 48 hours. […] The disorder is thought to affect approximately 1/100,000 individuals. Chronic hiccup affect males more often than females. […] Persistent hiccups can reduce quality of life. Very long intractable disease may be debilitating.

• #54 The chronic hiccup chronicles | Drug Discovery News

  https://www.drugdiscoverynews.com/the-chronic-hiccup-chronicles-15840

  Researchers and patients developed unexpected and innovative solutions to a mysterious disease that appears as little more than a hiccup. […] Doctors classified Allards painful diaphragmatic spasms as hiccups, and they lasted uncontrolled for fifteen years. For Allard and about one in a 100,000 people, hiccups are a chronic condition without a known cause or a reliable therapeutic option, leaving many to take matters into their own hands. […] Every year, an average of 4,723 people in the United States are admitted to the hospital due to hiccups. […] If hiccups last longer, then they enter the class of persistent or chronic hiccups. If hiccups last for years, then they are labeled intractable hiccups. Of patients admitted to the hospital for hiccups, 44.1 percent have temporary hiccups, 36.9 percent have persistent hiccups, and 19 percent have intractable hiccups.

• #55 Hiccups: a common problem with some unusual causes and cures

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5072913/

  Most hiccup episodes are self-limiting and disappear after a few minutes. Despite being very frequent, they do not have any clinical repercussions, and medical care is not usually requested. […] In the present case, the CXR guided us to the diagnosis and CT was needed to confirm the cause of persistent hiccups: an acute aortic syndrome that caused thoracic aortic enlargement due to an intramural aortic haematoma. This haematoma extended to partially occupy the aortopulmonary window and presumably caused compression of the phrenic nerve that stimulates the diaphragm, which was an initial symptom of the patient with hiccups. […] Complications from hiccups are rare but they can occur and include discomfort, difficulty in feeding, gastro-oesophageal reflux, respiratory alkalosis (in tracheostomised patients), wound dehiscence, sleep deprivation, and psychiatric disorders.

• #56 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. […] There is no accurate estimate of the prevalance of hiccups in the patients admitted in the neuro-ICU. […] The most commonly witnessed hiccups in the neuro-ICU are intractable and neurogenic in nature. […] We would like to inform that it seems 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. We encourage clinical trials in this area of critical care medicine.

• #57 Hiccups: a common problem with some unusual causes and cures

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5072913/

  Most hiccup episodes are self-limiting and disappear after a few minutes. Despite being very frequent, they do not have any clinical repercussions, and medical care is not usually requested. […] In the present case, the CXR guided us to the diagnosis and CT was needed to confirm the cause of persistent hiccups: an acute aortic syndrome that caused thoracic aortic enlargement due to an intramural aortic haematoma. This haematoma extended to partially occupy the aortopulmonary window and presumably caused compression of the phrenic nerve that stimulates the diaphragm, which was an initial symptom of the patient with hiccups. […] Complications from hiccups are rare but they can occur and include discomfort, difficulty in feeding, gastro-oesophageal reflux, respiratory alkalosis (in tracheostomised patients), wound dehiscence, sleep deprivation, and psychiatric disorders.

• #58 Hiccups: a common problem with some unusual causes and cures

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5072913/

  Most hiccup episodes are self-limiting and disappear after a few minutes. Despite being very frequent, they do not have any clinical repercussions, and medical care is not usually requested. […] In the present case, the CXR guided us to the diagnosis and CT was needed to confirm the cause of persistent hiccups: an acute aortic syndrome that caused thoracic aortic enlargement due to an intramural aortic haematoma. This haematoma extended to partially occupy the aortopulmonary window and presumably caused compression of the phrenic nerve that stimulates the diaphragm, which was an initial symptom of the patient with hiccups. […] Complications from hiccups are rare but they can occur and include discomfort, difficulty in feeding, gastro-oesophageal reflux, respiratory alkalosis (in tracheostomised patients), wound dehiscence, sleep deprivation, and psychiatric disorders.

• #59 Hiccups: a common problem with some unusual causes and cures

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5072913/

  Most hiccup episodes are self-limiting and disappear after a few minutes. Despite being very frequent, they do not have any clinical repercussions, and medical care is not usually requested. […] In the present case, the CXR guided us to the diagnosis and CT was needed to confirm the cause of persistent hiccups: an acute aortic syndrome that caused thoracic aortic enlargement due to an intramural aortic haematoma. This haematoma extended to partially occupy the aortopulmonary window and presumably caused compression of the phrenic nerve that stimulates the diaphragm, which was an initial symptom of the patient with hiccups. […] Complications from hiccups are rare but they can occur and include discomfort, difficulty in feeding, gastro-oesophageal reflux, respiratory alkalosis (in tracheostomised patients), wound dehiscence, sleep deprivation, and psychiatric disorders.

• #60 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. […] There is no accurate estimate of the prevalance of hiccups in the patients admitted in the neuro-ICU. […] The most commonly witnessed hiccups in the neuro-ICU are intractable and neurogenic in nature. […] We would like to inform that it seems 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. We encourage clinical trials in this area of critical care medicine.

• #61 Hiccups: a common problem with some unusual causes and cures

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5072913/

  Most hiccup episodes are self-limiting and disappear after a few minutes. Despite being very frequent, they do not have any clinical repercussions, and medical care is not usually requested. […] In the present case, the CXR guided us to the diagnosis and CT was needed to confirm the cause of persistent hiccups: an acute aortic syndrome that caused thoracic aortic enlargement due to an intramural aortic haematoma. This haematoma extended to partially occupy the aortopulmonary window and presumably caused compression of the phrenic nerve that stimulates the diaphragm, which was an initial symptom of the patient with hiccups. […] Complications from hiccups are rare but they can occur and include discomfort, difficulty in feeding, gastro-oesophageal reflux, respiratory alkalosis (in tracheostomised patients), wound dehiscence, sleep deprivation, and psychiatric disorders.

• #62 Hiccups: a common problem with some unusual causes and cures

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5072913/

  Most hiccup episodes are self-limiting and disappear after a few minutes. Despite being very frequent, they do not have any clinical repercussions, and medical care is not usually requested. […] In the present case, the CXR guided us to the diagnosis and CT was needed to confirm the cause of persistent hiccups: an acute aortic syndrome that caused thoracic aortic enlargement due to an intramural aortic haematoma. This haematoma extended to partially occupy the aortopulmonary window and presumably caused compression of the phrenic nerve that stimulates the diaphragm, which was an initial symptom of the patient with hiccups. […] Complications from hiccups are rare but they can occur and include discomfort, difficulty in feeding, gastro-oesophageal reflux, respiratory alkalosis (in tracheostomised patients), wound dehiscence, sleep deprivation, and psychiatric disorders.

• #63 Hiccups | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hiccups-1?embed_domain=hackmd.io%2525252f%25252540yipuafecsl2jsu8smr5njq%2525252fbnjhjgjghjghjgh&lang=us

  Hiccups are a symptom that has probably been experienced by everyone at some point in their lives. Chronic intractable hiccups are rare. […] Chronic, persistent hiccups refers to any episode with a duration greater than 48 hours. Intractable hiccups, sometimes defined as those lasting more than two months, can be very disabling, causing inability to sleep, depression, and chronic exhaustion, with secondary deleterious effects on an individual’s health.

• #64 Hiccups: a common problem with some unusual causes and cures

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5072913/

  Most hiccup episodes are self-limiting and disappear after a few minutes. Despite being very frequent, they do not have any clinical repercussions, and medical care is not usually requested. […] In the present case, the CXR guided us to the diagnosis and CT was needed to confirm the cause of persistent hiccups: an acute aortic syndrome that caused thoracic aortic enlargement due to an intramural aortic haematoma. This haematoma extended to partially occupy the aortopulmonary window and presumably caused compression of the phrenic nerve that stimulates the diaphragm, which was an initial symptom of the patient with hiccups. […] Complications from hiccups are rare but they can occur and include discomfort, difficulty in feeding, gastro-oesophageal reflux, respiratory alkalosis (in tracheostomised patients), wound dehiscence, sleep deprivation, and psychiatric disorders.

• #65 Hiccups | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hiccups-1?embed_domain=hackmd.io%2525252f%25252540yipuafecsl2jsu8smr5njq%2525252fbnjhjgjghjghjgh&lang=us

  Hiccups are a symptom that has probably been experienced by everyone at some point in their lives. Chronic intractable hiccups are rare. […] Chronic, persistent hiccups refers to any episode with a duration greater than 48 hours. Intractable hiccups, sometimes defined as those lasting more than two months, can be very disabling, causing inability to sleep, depression, and chronic exhaustion, with secondary deleterious effects on an individual’s health.

• #66 Hiccups: Casual Annoyance or Medical Concern?

  https://www.pharmacytimes.com/view/hiccups-casual-annoyance-or-medical-concern

  In some cases, however, severe intractable hiccups may lead to malnutrition, fatigue, dehydration, weight loss, and decreased quality of life. In this case, immediate medical treatment should be sought to identify the etiology and commence treatment. […] Persistent hiccups in one teenage woman were reported to cause swallowing dysfunction, which ultimately resulted in acute respiratory failure. […] Additionally, a case report described persistent hiccups leading to nausea, syncope, and eventually cardiorespiratory failure in an elderly man. […] Unfortunately, no data suggests any specific markers that can be measured to predict whether or not hiccups can have serious consequences.

• #67 Hiccups | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/hiccups-1?embed_domain=hackmd.io%2525252f%25252540yipuafecsl2jsu8smr5njq%2525252fbnjhjgjghjghjgh&lang=us

  Hiccups are a symptom that has probably been experienced by everyone at some point in their lives. Chronic intractable hiccups are rare. […] Chronic, persistent hiccups refers to any episode with a duration greater than 48 hours. Intractable hiccups, sometimes defined as those lasting more than two months, can be very disabling, causing inability to sleep, depression, and chronic exhaustion, with secondary deleterious effects on an individual’s health.

• #68 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1154709

  Hiccups are more common in diseases affecting the gastrointestinal or central nervous system (CNS). […] 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. […] Recurrent hiccups occur in about 3% of the healthy population, compared to approximately 20% with Parkinson disease and 10% of patients with gastroesophageal reflux disease (GERD). […] Overall, the prevalence of hiccups in advanced cancer has been reported to be 3.9%4.8%. […] A variety of CNS pathologies cause IH.

• #69 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. […] There is no accurate estimate of the prevalance of hiccups in the patients admitted in the neuro-ICU. […] The most commonly witnessed hiccups in the neuro-ICU are intractable and neurogenic in nature. […] We would like to inform that it seems 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. We encourage clinical trials in this area of critical care medicine.

• #70 Hiccups: Casual Annoyance or Medical Concern?

  https://www.pharmacytimes.com/view/hiccups-casual-annoyance-or-medical-concern

  In some cases, however, severe intractable hiccups may lead to malnutrition, fatigue, dehydration, weight loss, and decreased quality of life. In this case, immediate medical treatment should be sought to identify the etiology and commence treatment. […] Persistent hiccups in one teenage woman were reported to cause swallowing dysfunction, which ultimately resulted in acute respiratory failure. […] Additionally, a case report described persistent hiccups leading to nausea, syncope, and eventually cardiorespiratory failure in an elderly man. […] Unfortunately, no data suggests any specific markers that can be measured to predict whether or not hiccups can have serious consequences.

• #71 Hiccups: Casual Annoyance or Medical Concern?

  https://www.pharmacytimes.com/view/hiccups-casual-annoyance-or-medical-concern

  In some cases, however, severe intractable hiccups may lead to malnutrition, fatigue, dehydration, weight loss, and decreased quality of life. In this case, immediate medical treatment should be sought to identify the etiology and commence treatment. […] Persistent hiccups in one teenage woman were reported to cause swallowing dysfunction, which ultimately resulted in acute respiratory failure. […] Additionally, a case report described persistent hiccups leading to nausea, syncope, and eventually cardiorespiratory failure in an elderly man. […] Unfortunately, no data suggests any specific markers that can be measured to predict whether or not hiccups can have serious consequences.

• #72 Hiccups | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hiccups

  Hiccups may be symptomatic of disease. […] Hiccups that last for days, weeks or even years may be symptomatic of underlying disease. […] Certain lung or brain disorders can sometimes interfere with the functioning of the diaphragm and make the person prone to hiccups. […] Prolonged hiccups should be medically investigated.

• #73 KoreaMed Synapse

  https://synapse.koreamed.org/articles/1154709

  There is high preponderance of developing IH following an ischemic insult to the brainstem including pons or involvement of posterior inferior cerebellar artery. […] Vascular lesions of CNS are the most common cause of IH followed by infective (meningitis, encephalitis), structural lesions, such as a multitude of space occupying lesions like cavernous angiomas or tuberculomas, and inflammatory and demyelinating conditions such as multiple sclerosis and neuromyelitis optica.

• #74 Hiccup: Mystery, Nature and Treatment

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

  There is no doubt that any space occupying lesion in the brain has the chance to elicit hiccup. […] A patient with mediastinal lymph node sarcoidosis, which was likely the lesion invading the hiccup reflex arc, had persistent hiccup that did not respond to steroid therapy. […] It is well known that GERD is commonly associated with belching. […] Post-operative hiccups were reported in subjects receiving various surgeries, for example, Whipple operation and colectomy. […] Serious hiccup is not unusual among the cancer patients. […] Twenty percent of parkinsonism (PD) patients had frequent hiccups compared to 3% of the controls. […] Interestingly, many measures on human body have been known to elicit serious hiccups. […] Basically, transient hiccups are self-limited, and neither etiological evaluation nor immediate treatment is needed for these subjects unless their hiccup recurs.

• #75 The chronic hiccup chronicles | Drug Discovery News

  https://www.drugdiscoverynews.com/the-chronic-hiccup-chronicles-15840

  Chronic and intractable hiccups affect all areas of life eating, drinking, sleeping which is a big problem. […] While hiccups can arise from benign gastrointestinal problems, they may also indicate more pervasive conditions that are difficult to identify. Chronic or intractable hiccups may be caused by cancers in the brain, pancreas, stomach, gastrointestinal tract, or esophagus. […] There are more than 100 possible causes of hiccups. […] To get a better understanding of the many different causes of hiccups, Busch and her team are working on a local patient registry called the Heidelberg Register of Singultus Disease, where patients can complete a questionnaire about their symptoms. […] The gold standard is to find the underlying cause [of hiccups] and to somehow treat it, said Fox.

• #76 Diagnosis: A Serious Case of Hiccups – The New York Times

  https://www.nytimes.com/2011/09/25/magazine/diagnosis-a-serious-case-of-hiccups.html

  THE PHYSIOLOGY OF HICCUPS Hiccups, more officially referred to as singultus (from the Latin, to catch your breath while sobbing), are repeated, spasmodic contractions of the diaphragm causing a quick inhalation that is then cut short by an involuntary closing of the glottis. Mostly these episodes are transient and benign. Hiccups lasting more than 48 hours are considered persistent. If they last longer than a month, they are termed intractable. The longest recorded bout of hiccups lasted 68 years. […] Hiccups have many causes. Anything that can irritate the phrenic nerve, which controls the diaphragm, can cause the little spasms. It can be something as common as eating too much to an abscess or a tumor on any of the structures near the nerve that runs from the brain to the diaphragm and beyond. Hiccups following surgery are thought to come from a mild injury to this nerve caused by the tube used to help the patient breathe during the operation. Damage to certain parts of the brain — because of trauma or disease — can also cause hiccups. Toxins, most commonly alcohol, can do it. So can stress.

• #77 Hiccups: Casual Annoyance or Medical Concern?

  https://www.pharmacytimes.com/view/hiccups-casual-annoyance-or-medical-concern

  Hiccups are typically intermittent, with episodes usually lasting fewer than 24 hours. However, they can be persistent, lasting up to a month, or intractable, lasting longer than a month. […] Persistent and intractable hiccups, on the other hand, are usually a result of a chronic pathophysiologic disorder, rather than an acute event. These etiologies are categorized by whether they originate in the central nervous system (CNS) or the peripheral nervous system (PNS). […] CNS causes of hiccups include structural processes, most commonly neoplasms, multiple sclerosis, or head trauma. Infectious processes of the CNS include encephalitis and meningitis. Finally, CNS vascular processes including stroke and arteritis can also cause hiccups. […] Hiccups have also been implicated as a symptom of myocardial infarction.

• #78 Diagnosis: A Serious Case of Hiccups – The New York Times

  https://www.nytimes.com/2011/09/25/magazine/diagnosis-a-serious-case-of-hiccups.html

  Ferrante remembered hearing about two other patients in Metropolitan’s emergency room with persistent hiccups and who were found to have a life-threatening condition: a blood clot in the lungs, also known as a pulmonary embolus. This occurs when a clot that formed somewhere in the body breaks free and travels in the bloodstream and lodges in a lung. Pulmonary embolism can be a serious problem. Each year there are as many as 300,000 cases in the United States. It’s also a diagnosis that is frequently missed. In one study of 67 cases of fatal pulmonary emboli, the diagnosis was not even considered in more than half of the cases. […] The difficulty in diagnosing pulmonary embolism is that the symptoms are variable and common. Most patients — but not all — feel short of breath. Chest pain is common. A racing heart is another clue. But these symptoms can also be seen in a patient having a heart attack or in one sick with pneumonia or bronchitis or in a patient who has a fractured rib. Although testing for pulmonary embolus has become easier with the development of a CT scanner, it remains one of the most commonly missed diagnoses.

• #79 Diagnosis: A Serious Case of Hiccups – The New York Times

  https://www.nytimes.com/2011/09/25/magazine/diagnosis-a-serious-case-of-hiccups.html

  Hassen has been fascinated by patients who present with hiccups and are given a diagnosis of a pulmonary embolism ever since he admitted the first case nearly two years ago. A thorough review of the medical literature turned up only a single previous case, and yet in Hassen’s hospital there have been three such cases in just two years. Was this a fluke? Or was it that these cases are actually more common than previously known — that hiccups can be indicative of a pulmonary embolus?

• #80 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.

• #81 Hiccups and psychosis: two atypical presentations of COVID-19 | International Journal of Emergency Medicine | Full Text

  https://intjem.biomedcentral.com/articles/10.1186/s12245-021-00333-0

  The first referred a 3-day history of hiccups that had not resolved with metoclopramide. […] Although hiccups lasting 48h are rare, the workup should try to identify organic pathology. […] Similar to the case previously reported by Prince et al., where a 62-year-old woman presented with a 4-day history of hiccups, our patient had a chest X-ray and a CT scan showing ground-glass and consolidative pulmonary opacities compatible with SARS-CoV-2 pneumonia. […] We present two atypical cases of COVID-19. While most atypical manifestations have been described among children, older adults, and patients with multiple comorbidities, these cases include two young previously healthy men. To our knowledge, this is the second case of hiccups and COVID-19 reported in the literature.

• #82 Persistent hiccups after acute COVID-19 successfully treated with chlorpromazine: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-024-04500-8

  Hiccups are among the rare complications of COVID-19 infections. […] However, there are very few published reports of persistent hiccups occurring in the post-acute COVID-19 period. […] Most of the published cases report hiccups occurring in the acute COVID-19 period. […] Consequently, hiccups occurring in the post-acute COVID-19 period may not be attributable to COVID-19. […] This case has highlighted the need to consider post-acute COVID-19 in the differential diagnosis of persistent hiccup. […] There are very few documented reports of persistent hiccups occurring in the post-acute COVID period. […] This is one of the few case reports of persistent hiccups in the post-acute COVID-19 period. […] Persistent hiccups can occur in the post-acute COVID-19 period. Clinicians need to be aware of this atypical presentation, so that they can manage patients appropriately.

• #83 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

  MAYWOOD, IL Everyone gets hiccups, but some people suffer intractable hiccups that last longer than a month, according to two Loyola Medicine neurologists. […] „Intractable hiccups can occur more often than we realize and present to multiple medical disciplines,” Stasia Rouse, MD, and Matthew Wodziak, MD, wrote in the journal Current Neurology and Neuroscience Reports. […] About 4,000 people in the United States are hospitalized each year for hiccups. […] Ninety-one percent of people who suffer intractable hiccups are men, most of whom are over age 50. […] 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.

• #84 Hiccup: Mystery, Nature and Treatment

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

  Hiccup occurrence is not only confined to the adults but also observed among the infants and children. […] Persistent hiccup means episode lasting for 48 hours or more, whereas those longer than 2 months are considered intractable. […] Unfortunately, there is no guideline available to direct treating this serious disorders effectively. […] The pathophysiological mechanism of hiccup is related to lesions in its reflex arc shown in Figure. […] In the review of recent literature, too many causes of hiccups have been reported. […] Briefly, Table 1 summarizes the reported etiology of persistent and intractable hiccups. […] Brain ischemia or stroke is not rare among the individuals with intractable hiccup and in some patients cerebrovascular cause was correctly diagnosed months later.

• #85 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

  MAYWOOD, IL Everyone gets hiccups, but some people suffer intractable hiccups that last longer than a month, according to two Loyola Medicine neurologists. […] „Intractable hiccups can occur more often than we realize and present to multiple medical disciplines,” Stasia Rouse, MD, and Matthew Wodziak, MD, wrote in the journal Current Neurology and Neuroscience Reports. […] About 4,000 people in the United States are hospitalized each year for hiccups. […] Ninety-one percent of people who suffer intractable hiccups are men, most of whom are over age 50. […] 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.

• #86 The chronic hiccup chronicles | Drug Discovery News

  https://www.drugdiscoverynews.com/the-chronic-hiccup-chronicles-15840

  Chronic and intractable hiccups affect all areas of life eating, drinking, sleeping which is a big problem. […] While hiccups can arise from benign gastrointestinal problems, they may also indicate more pervasive conditions that are difficult to identify. Chronic or intractable hiccups may be caused by cancers in the brain, pancreas, stomach, gastrointestinal tract, or esophagus. […] There are more than 100 possible causes of hiccups. […] To get a better understanding of the many different causes of hiccups, Busch and her team are working on a local patient registry called the Heidelberg Register of Singultus Disease, where patients can complete a questionnaire about their symptoms. […] The gold standard is to find the underlying cause [of hiccups] and to somehow treat it, said Fox.

• #87 The chronic hiccup chronicles | Drug Discovery News

  https://www.drugdiscoverynews.com/the-chronic-hiccup-chronicles-15840

  Chronic and intractable hiccups affect all areas of life eating, drinking, sleeping which is a big problem. […] While hiccups can arise from benign gastrointestinal problems, they may also indicate more pervasive conditions that are difficult to identify. Chronic or intractable hiccups may be caused by cancers in the brain, pancreas, stomach, gastrointestinal tract, or esophagus. […] There are more than 100 possible causes of hiccups. […] To get a better understanding of the many different causes of hiccups, Busch and her team are working on a local patient registry called the Heidelberg Register of Singultus Disease, where patients can complete a questionnaire about their symptoms. […] The gold standard is to find the underlying cause [of hiccups] and to somehow treat it, said Fox.

• #88 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 happen to anyone at any time. […] 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. […] As many as 4,000 people in the United States are hospitalized yearly for hiccups. […] If your hiccups last longer than two days or interrupt your ability to sleep or eat, contact your primary care physician (PCP). […] In rare cases, persistent or intractable hiccups can indicate an underlying condition.

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