Hiccups: Difference between revisions

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===Definitions===
===Definitions===
*Hiccup bout: >48 hours
*Hiccup bout: <48 hours
*Persistent hiccups: 48 hours to 1 month
*Persistent hiccups: 48 hours to 1 month
*Intractable hiccups: >1 month
*Intractable hiccups: >1 month
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***[[Meningitis]]
***[[Meningitis]]
***[[Brain abscess]]
***[[Brain abscess]]
***[[Neurosyphillis]]
***[[Neurosyphilis]]
***Subphrenic abscess
***Subphrenic abscess
**Structural
**Structural
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***Brainstem neoplasms
***Brainstem neoplasms
***[[Multiple sclerosis]]
***[[Multiple sclerosis]]
***Syringomyelia
***[[Syringomyelia]]
***Hydrocephalus
***[[Hydrocephalus]]
**Vagus and phrenic nerve irritation
**Vagus and phrenic nerve irritation
***Goiter
***[[thyroid disease|Goiter]]
***[[Pharyngitis]]
***[[Pharyngitis]]
***[[Laryngitis]]
***[[Laryngitis]]
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**[[Hepatitis]]
**[[Hepatitis]]
**Aerophagia
**Aerophagia
**Esophagael distention
**Esophageal distention
**[[Esophagitis]]
**[[Esophagitis]]
**[[Bowel obstruction]]
**[[Bowel obstruction]]
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*Drugs
*Drugs
**Alpha methyldopa
**Alpha methyldopa
**Short-acting [[barbituates]]
**Short-acting [[barbiturates]]
**Chemotherapeutic agents (eg, carboplatin)
**Chemotherapeutic agents (eg, carboplatin)
**[[Dexamethasone]]
**[[Dexamethasone]]
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**[[Conversion reaction]]
**[[Conversion reaction]]
**Excitement
**Excitement
**[[Malingering]]
**Malingering
**[[Schizophrenia]]
**[[Schizophrenia]]
**Stress
**Stress
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*Consider auditory canal exam (foreign body against TM can trigger hiccups)
*Consider auditory canal exam (foreign body against TM can trigger hiccups)
*Consider [[Hyponatremia]] and [[Hypocalcemia]]
*Consider [[Hyponatremia]] and [[Hypocalcemia]]
*Consider CXR
*Consider [[CXR]]


==Management==
==Management==
*Physical Maneuvers (stimulating pharynx blocks the vagal portion of the reflex arc)
*Physical Maneuvers (stimulating pharynx blocks the vagal portion of the reflex arc)
**Remove foreign body from ear
**Remove [[ear foreign body|foreign body]] from ear
**Swallow teaspoon of sugar
**Swallow teaspoon of sugar
**Sip ice water
**Sip ice water
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[[Category:GI]]
[[Category:GI]]
[[category:Symptoms]]

Revision as of 18:00, 23 January 2020

Background

  • Usually initiated by gastric distention from food, carbonated beverage, or air
  • Also known as Singultus

Definitions

  • Hiccup bout: <48 hours
  • Persistent hiccups: 48 hours to 1 month
  • Intractable hiccups: >1 month

Clinical Features

  • Hiccups

Differential Diagnosis

Hiccups

Evaluation

  • Clinical diagnosis
  • Consider auditory canal exam (foreign body against TM can trigger hiccups)
  • Consider Hyponatremia and Hypocalcemia
  • Consider CXR

Management

  • Physical Maneuvers (stimulating pharynx blocks the vagal portion of the reflex arc)
    • Remove foreign body from ear
    • Swallow teaspoon of sugar
    • Sip ice water
    • Drink water quickly
  • Meds

Disposition

  • Discharge for uncomplicated hiccups

See Also

References