Chlorpromazine thorazine is usually the firstline medication prescribed for hiccups. Intractable hiccup poses a management chal lenge to clinicians. Treatment of 341 patients with persistent or intractable hiccups was reported in 15 published studies. Management of hiccups in palliative care patients bmj. Having been a resident of iran for 36 years and acquired knowledge of persian, i became the owner of one volume, entitled the therapeutics of joseph. We describe the successful treatment of idiopathic intractable hiccup with cisatracurium under intravenous iv general anesthesia. Appropriate ventilator settings should be strongly promoted in the treatment of hiccups in patients who are mechanically ventilated. Home remedies or ways to get rid of hiccups include. A hiccup bout is an episode of hiccups that lasts up to 48 hours persistent hiccups continue more than 48 hours, up to one month. Baclofen, a treatment for chronic hiccup journal of pain. Successful treatment of idiopathic intractable hiccup with baclofen and supportive treatment. See your doctor if hiccups last more than three hours, or if they disturb your eating or sleeping habits. This involuntary contraction causes your vocal cords to close very briefly, which produces the characteristic sound of a hiccup. Hiccups are a common experience, and warrant treatment only when they.
Chlorpromazine and haloperidol are medicines which can relax the diaphragm muscle or its nerve supply and may stop persistent hiccups. There are many popular remedies that are said to stop a short bout of hiccups but they are based on peoples individual experiences. Therapy whenever possible, the treatment of hiccups should be directed at the underlying cause of the condition. Hiccups pharmacologic treatment if possible, direct at specific cause baclofen only drug studied in double blind randomized placebo controlled study chlorpromazine only fda approved drug for hiccups other anti. Most cases need no treatment, as a bout of hiccups usually soon goes. Interestingly, some of the same medications used to treat hiccups have also.
This may mea n a dose increase or a change of medication. Complete cessation within a given period post treatment of hiccups, changes in frequency or intensity of hiccups, concomitant symptom score, and adverse events will be. Replacement therapy with dopamine agonists in pd patients is considered to induce certain episodes of hiccup. In situations where no readily reversible cause is. Direct treatment toward the specific illness causing the hiccups, if this is identified. Pdf hiccup is the sudden onset of erratic diaphragmatic and intercostal. Intractable hiccups are very uncommon happening in about 1 in 100,000 people.
Selfcare at home numerous home remedies for hiccups exist. This might be caused by eating too much or too quickly, having a bloated stomach, drinking alcohol or carbonated beverages, or experiencing a stressful situation. Managing hiccups the college of family physicians of canada. If hiccups are difficult to control, advice will be sought from specialist palliative care colleagues. The pharmacological treatment of hiccups the pharmacological management of hiccups is based on case studies and clinical.
Medication is usually effective in treating chronic hiccups, but further investigation into the underlying cause is necessary to determine how to prevent the hiccups from returning. Hiccups are usually harmless and resolve by themselves after a few minutes. For stomach problems such as acid reflux or a stretched distended stomach. Finally, alternative medicines and remedies are convenient to treat hiccups with uncertain effect. Hiccups are caused by involuntary contractions of your diaphragm the muscle that separates your chest from your abdomen and plays an important role in breathing. These cases highlight the present state of knowledge related to hiccup. If no specific pathology has been identified, or no definitive treatment is possible, then a wide range of physical table 2 and pharmacological treatments have been described for the treatment of hiccups. This discussion focuses on the definition and classification of hiccup, etiologies, postulated theories to explain its function, the few studies performed to date, and nonpharmacologic and pharmacologic treatment. Ketamine for the treatment of hiccups during and following. For persistent hiccups lasting more than three hours treatment varies, and you may need to contact your doctor.
The associated risks of invasive treatment should be weighed against the foreseen benefits, to avoid a generally benign condition resulting in serious, treatment. Etlological treatment is not always available and chronic hiccup treat ment has c. What are the treatment options for hiccups in palliative care patients. Youll also learn when hiccups might be a sign of another condition. Persistent hiccups are a frustrating experience for palliative care patients, and can have a profound impact on their quality of life. 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.
If hiccups persist after using simple measures, try chlorpromazine thorazine, 25 to 50 mg po tid or qid. Drugs that may be used to treat longterm hiccups include. The efficacy of baclofen in the treatment of chronic hiccup is demonstrated in two cases. The term hiccup derives from the sound of the event. The american cancer society medical and editorial content team.
Intractable hiccups also referred to as hiccoughs in the literature can be especially problematic when treating patients with advanced cancer or in the palliative care setting. When they last for 2 months, they are called intractable hiccups. Hiccups may be a minor symptom of transient duration or may progress to exhaust the patients strength and produce marked depression or even death. Home remedies are generally sufficient to resolve hiccupping. Successful treatment of idiopathic intractable hiccup with. Learn more about the causes, treatments, and risk factors. Always discuss all treatment options with your doctor before making a decision, including whether to start or discontinue any treatment plan. Hiccups are managed easily with home remedies and avoiding predisposing factors, but occasionally may need pharmacological or other types of management. The treatment for hiccup bouts tends to focus on home remedies as there are a number of different methods that have shown success when stopping the occurrence of hiccups.
You should see your doctor if you have hiccups that go on for longer than 48 hours. Klaus hergt, md, recorded an effective relief of hiccups by vomiting 195. It is not clear how effective they are, as they have not been tested by research trials. This further strengthens my theory that abolishing the venousarterial co2 gradient is a definitive treatment for hiccups. A left phrenic nerve crush was eventually successful.
Management of hiccups palliative care network of wisconsin. In contrast, persistent and intractable hiccups that. This topic will discuss the pathophysiology, etiology, evaluation, and treatment of hiccups. Hiccups happen when you have repeated involuntary spasms of the diaphragm.
Some drugs that are used to treat hiccups can also induce hiccups. In some cases, prolonged hiccups that last for days or weeks may be symptomatic of underlying disorders. If the vagus nerve that runs from the brain to the stomach is stimulated, hiccups can also be alleviated. Gabapentin, an alpha2delta ligand with structural similarity to gaba and the ability to block voltageoperated calcium channels to reduce release of several neurotransmitters including glutamate and substance p.
Causes and treatment of persistent hiccups hiccups consist ofinvoluntary brief bursts ofintense, coordinated inspiratory activity involving thediaphragm and inspiratory intercostal muscles with reciprocal inhibition oftheexpiratory intercostals. For example, anticonvulsants in various preparations are indicated to treat intractable hiccups. In conclusions, hiccup is likely to result from lesions involving the. Whenever possible, the treatment of hiccups should be directed at the underlying cause of the condition. Management once hiccups have lasted beyond a timelimited annoyance, deciding on therapeutic intervention should be based on a thorough clinical assessment and, if possible, treatment directed at the underlying cause. Well cover 26 of the most popular and effective remedies for hiccups, including a few youve probably never heard of. Finally, alternative medicines and remedies are convenient to treat hiccups with. However, the treatment of chronic hiccups is slightly more complicated as the majority of the approaches to treating chronic hiccups are based more on observational studies. Many widely divergent causes for hiccups are known, such as diaphragmatic irritation in pleurisy, subphrenic abscess, or retention of toxic products in. This article provides an evidencebased approach overview of the causes and treatment of this not infrequently debilitating condition for such patients, with a management algorithm. Most cases of hiccups can be cured or resolve in a short time, and rarely are a medical emergency.
If medicine is given for hiccups, watch for dizziness. This was written in herat in the year 917 ah, corresponding to 1511 ad. Whatever the reason, most people want to know how to get rid of hiccups quickly before they become a nuisance. The reason that these remedies are thought to work is that carbon dioxide buildup in the blood will stop hiccups. If less invasive treatments arent effective, your doctor may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups. Treatment should be guided by the duration and intensity of the hiccups and initiated by a specialist physician. Brief episodes of hiccups, which often induce annoyance in patients and merriment in observers, are a common part of life. And if you test one of those old wives tales about stopping hiccups say, getting someone to scare you. Chronic hiccups are more serious than standard hiccups and usually require a doctors attention. A patient who developed hiccups after laparotomy was treated with numerous drugs with limited success. Hiccups, or hiccoughs, are involuntary sounds made by spasms of the diaphragm. Hiccups may be present during all stages of sleep and the amplitude and frequency of sleep hiccup have stagedependent characteristics. Other medications used to treat hiccups include haloperidol haldol and metoclopramide reglan.796 144 1270 1258 1641 1261 535 196 217 1196 821 1577 269 705 1411 1419 98 579 940 240 538 422 736 1060 1405 1113 1470 324 138 23 32 501 1184 1319