Hiccup

From Wikipedia, the free encyclopedia

Name of Symptom/Sign:
**Hiccup**
*Classifications and external resources*
ICD-10	R06.6
ICD-9	786.8

A hiccup or hiccough (generally pronounced "HICK-cup" (IPA: [ˈhɪ.kəp]) independent of the spelling) is an involuntary spasm of the diaphragm; typically this repeats several times a minute. The sudden rush of air into the lungs causes the glottis to close, creating the "hic" listen (help·info) noise. A bout of hiccups generally resolves by itself, although many home remedies are in circulation to shorten the duration, and medication is occasionally necessary. By extension, the term "hiccup" is also used to describe a small and unrepeated aberration in an otherwise consistent pattern. The medical term is singultus.

While many cases develop spontaneously, hiccups are known to develop often in specific situations, such as eating too quickly, taking a cold drink while eating a hot meal, eating very hot or spicy food, laughing vigorously or coughing, drinking an excess of an alcoholic beverage, or electrolyte imbalance. Hiccups may be caused by pressure to the phrenic nerve by other anatomical structures, or rarely by tumors and certain kidney disease. It is reported that 30% of chemotherapy patients suffer singultus as a side effect to treatment. (American Cancer Society)

It is still unclear to scientists exactly why hiccups occur, particularly because it doesn't seem to give us any specific benefit. Some speculation exists that hiccups are a remnant of a bodily function that has been phased out by evolution, such as the move from aquatic gilled creatures to land animals. Ultrasounds have also shown that unborn fetuses experience hiccups. Some suggested hypotheses include hiccups as a possible muscle exercise for the child's respiratory system prior to birth or as a preventive measure to keep amniotic fluid from entering the lungs[1]. More research is required to ascertain their true nature, origins, and purpose, if any.

1 Medical treatment
2 World record
3 Footnotes
4 References
5 External links

[edit] Medical treatment

Referred to as singultus, hiccups are treated medically only in severe and persistent (termed "intractable") cases. Haloperidol (Haldol, an anti-psychotic and sedative), metoclopramide (Reglan, a gastrointestinal stimulant), and chlorpromazine (Thorazine, an anti-psychotic with strong sedative effects) are used in cases of intractable hiccups. In severe or resistant cases, baclofen (an anti-spasmodic) is sometimes required to suppress hiccups. Effective treatment with sedatives often requires a dose that either renders the person unconscious or highly lethargic. Hence, medicating singultus is done short-term and is not a situation where the affected individual could continue with normal life activities while taking the medication.

Persistent and intractable hiccups due to electrolyte imbalance (hypokalemia, hyponatremia) may benefit from drinking a carbonated beverage containing salt to balance out the potassium-sodium levels in the nervous system. The carbonation promotes quicker absorption.

The New York Times reports that Dr. Bryan R. Payne, a neurosurgeon at the Louisiana State University Health Sciences Center in New Orleans, has had some success with an experimental new procedure in which a vagus nerve stimulator is implanted in the upper chest of patients with an intractable case of hiccups. "It sends rhythmic bursts of electricity to the brain by way of the vagus nerve, which passes through the neck. The Food and Drug Administration approved the vagus nerve stimulator in 1997 as a way to control seizures in some patients with epilepsy. In 2005, the agency endorsed the use of the stimulator as a treatment of last resort for people with severe depression" [2].

In 2006, Francis Fesmire of the University of Tennessee College of Medicine received an Ig Nobel prize for medicine when he published "Termination of intractable hiccups with digital rectal massage" in 1988.<ref>Fesmire F. (1988). "Termination of intractable hiccups by digital rectal massage". Ann Emerg Med 17: 872.</ref> In an attempt to block the runaway messages on the vagus nerve, Fesmire found that the stimulation of the vagus nerve by digital rectal massage worked, stopping the patients bout of hiccupping. Fesmire also commented "An orgasm results in incredible stimulation of the vagus nerve. From now on, I will be recommending sex – culminating with orgasm – as the cure-all for intractable hiccups.", so perhaps this is a more efficient and desirable cure for intractable hiccups.[3]

One home remedy to interrupt the pattern of vagus nerve stimulation is to swallow a spoonful of peanut butter. Some people also have success consuming very sweet or tart substances.[4]. Another home remedy involves holding one's breath while taking seven swallows of water.

Ordinary hiccups can be cured easily with no medical practices needed; in most cases they can be stopped simply by sitting down and concentrating on breathing patterns (deep breaths) for 1-2 minutes.

[edit] World record

The Guinness World Record for the longest continuous bout of hiccups (1922–1990) goes to Charles Osborne (1894–1991) from Anthon, Iowa. The hiccups started in 1922 at a rate of 40 times per minute, slowing to 20 and eventually stopping in February 1990 – a total of 68 years.[5]

[edit] Footnotes

[edit] References

C. Straus, K. Vasilakos, RJA Wilson, et al., A phylogenetic hypothesis for the origin of hiccoughs, In: Bioessays, Vol.25, 2003, S.182-188, Abstract
Launois et al., Hiccup in adults:an overview, In: European Respiratory Journal, 1993, S.563-575, Abstract
Davis J. Newsom, An experimental study of hiccup, In: Brain, 1970, Vol.93, S.851-72
J.S. Jones, T. Lloyd, L. Cannon, Persistent hiccups as an unusual manifestation of hyponatremia, In J. Emerg Med, 1987; 5:283-287
H.J. Kaufman, Hiccups: causes, mechanisms, and treatment, In: Pract. Gastroenterology, 1985; 9:12-20
J.H. Lewis, Hiccups: causes and cures, In: J. Clin. Gastroenterology, 1985; 7:539-552
M.S. Lipsky, Chronic hiccups, In: Am. Fam. Physician, 1986; 34:173-177
M.D. Nathan, R.T. Leshner, A.P. Keller, Intractable hiccups (singultus), In: Laryngoscope, 1980; 90:1612-1618
J.V. Souadjian, J.C. Cain, Intractable hiccups: etiologic factors in 220 cases, In: Postgrad Med., 1968; 43:72-77
M.S. Wagner, J.S. Stapczynski, Persistent hiccups, In: Ann. Emerg. Med., 1982; 11:24-26