Hiccups

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What is it about ?

Hiccups are caused by the sudden contraction of the diaphragm and the muscles between the ribs, followed by the closing of the glottis. Hiccups can occur frequently. In the event of hiccups, the number of contractions can vary from 4 to 60 times per minute.

Hiccups are generally a trivial and transient phenomenon with no apparent cause. It is not known what exactly causes the hiccups.

The possible causes of long-lasting hiccups are as follows:

  • Brainstem involvement (stroke, brain tumor, multiple sclerosis, etc),
  • Affection in the rib cage (for example heart attack (infarction)),
  • Affection in the upper abdomen (for example diaphragmatic hernia),
  • Accumulation of toxic substances (for example alcohol poisoning, taking certain drugs),
  • Accumulation of wastes due to poor kidney function.
  • Certain psychiatric disorders),
  • Terminal cancer.

What is its frequency?

Everyone has hiccups at one time. It becomes less common as we get older, but seizures can be longer. Persistent, stubborn hiccups affect men more often than women. The doctor sees about 7 new cases of hiccups per 10,000 contacts per year, mostly in people aged 45 to 64.

How to recognize it?

An acute attack of hiccups lasts a maximum of 48 hours and usually passes spontaneously. Usually, the hiccups appear because of the dilation of the stomach. This can happen after a heavy meal, temperature changes in food or drink, after drinking carbonated drinks and / or too much alcohol. Since there is no disease at the root of the problem, in these cases hiccups are said to be physiological.

If the hiccup lasts longer than 48 hours, it is called persistent hiccups. If the episode lasts more than 2 months, we speak of refractory hiccups.

What can you do ?

Usually the hiccups go away on their own. There are solutions, but there is no evidence that they are all equally effective: hold your breath or breathe in a paper bag, eat a spoon of fine, dry sugar, scare the person, gargle with ice water or drink water from the opposite side of the glass, etc.

To prevent your stomach from expanding too suddenly, take the time to eat and drink, and chew your food well. Avoid consuming carbonated drinks.

Since alcohol consumption increases the risk of hiccups, moderate your consumption.

What can your doctor do?

The doctor will ask you questions about the possible causes of the hiccups. Depending on what you tell him and your complaints, he may suggest additional tests, for example a blood test or a chest x-ray. He will refer you to an otolaryngologist (ENT) or internist if you suffer from frequent and prolonged episodes of hiccups (more than 24 hours) and persistent or tenacious hiccups. But often, there is no physical cause for the problem.

If non-drug solutions are not sufficient, medication may be considered. The doctor will prescribe drugs that act on gastric emptying or on the nervous system. Of course, it will always be necessary to treat a disease that causes the hiccups.

Source

Foreign clinical practice guide ‘Hiccups’ (2010), updated on 08.16.2016 and adapted to the Belgian context on 03.09.2016 – ebpracticenet

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