Intractable hiccups associated with medical conditions

Hiccups typically occur between four to sixty times in a minute. Acute hiccups are common which start without any specific reason and go away in a few minutes. They often can be stopped by holding the breath or breathing into a paper bag.

Everyone gets hiccups, but some people suffer intractable hiccups that last longer than a month, according to two Loyola Medicine neurologists.

Chief neurology resident, Stasia Rouse and Assistant professor Matthew Wodziak said, "Intractable hiccups can occur more often than we realize and present to multiple medical disciplines."

Persistent hiccups (lasting longer than two days) and intractable hiccups (lasting longer than a month) generally are associated with underlying medical conditions.

They interfere with eating, socializing and sleeping and can significantly impair a patient's quality of life.

The researchers described a hiccup as an involuntary, spasmodic contraction of the diaphragm and sometimes the intercostal muscles (tiny muscles between the ribs).

Common hiccup triggers are drinking carbonated drinks or eating a large meal. Anxiety or stress also can trigger hiccups, along with alcohol, spices, smoking or other irritants to the gastrointestinal or respiratory tracts.

Intractable hiccups usually have underlying causes. In one patient, for example, hiccups were traced to arthritis in the sternoclavicular joint (the joint connecting the collarbone to the breastbone). In another patient, hiccups were linked to pulmonary embolisms (blood clots in the lungs). Certain drugs also can trigger hiccups.

In addition to treating the underlying cause, if known, physicians can treat hiccups with various medications, including baclofen, gabapentin, metoclopramide, chlorpromazine and haloperidol, Drs. Rouse and Wodziak wrote.

Rouse and Wodziak said, "There are no formal guidelines for treating intractable hiccups. Many treatments are founded merely on a physician's own experience or anecdotal evidence."

The full findings are present in the journal- Current Neurology and Neuroscience Reports.