Hiccups

Abstract

Hiccup is a repeated involuntary spasm of the diaphragm followed by sudden rush of air into the lungs causing closure of the glottis which chokes the inflow of further air and produces a characteristic sound. This condition is common and transient and rarely intractable. Hiccup is said to be the result of irritation of afferent and/or efferent diaphragmatic nerves or medullary centre that controls the respiratory muscles–particularly the diaphragm. The exact aetiology is not known, but is supposed to be often caused by gastric distension, alcohol consumption, or swallowing of hot or irritating substances. Various other causes include metabolic, posterior cranial fossa tumours, and psychological disorders, etc. The exact mechanism is not known though various mechanisms have been described. Hiccup is usually benign, transient, and self limiting, with a duration of less than one hour without any complication. Hiccup will need only routine history, physical examination, and routine investigations, rarely requiring specific specialised investigations. Hiccups are managed easily with home remedies and avoiding predisposing factors, but occasionally may need pharmacological or other types of management. Pranayama and yogic exercises are useful in their management. Drugs often used in prolonged cases are baclofen, lidocaine, GI motilator drugs, antacids, antidepressants, etc. Complications are rare except for causing social embarrassment, distress, insomnia, etc.