Difference between revisions of "Hiccups"

(Text replacement - "==Diagnosis==" to "==Evaluation==")
(Definitions)
 
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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
 
***[[Head trauma]]
 
***[[Head trauma]]
***Intracranial neoplasms
+
***[[Intracranial neoplasm]]
 
***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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**[[Asthma]]
 
**[[Asthma]]
 
**[[Pleuritis]]
 
**[[Pleuritis]]
**[[Aortic aneurysm]]
+
**[[Nontraumatic thoracic aortic dissection|Aortic dissection]]
 
**[[Mediastinitis]]
 
**[[Mediastinitis]]
 
**Mediastinal tumors
 
**Mediastinal tumors
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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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*Clinical diagnosis
 
*Clinical diagnosis
 
*Consider auditory canal exam (foreign body against TM can trigger hiccups)
 
*Consider auditory canal exam (foreign body against TM can trigger hiccups)
*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]]

Latest 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