Definition

Involve an involuntary (reflex) diaphragmatic contraction, causing sudden inspiration. The incoming air is stopped by closure of the glottis which produces a characteristic sound. Hiccups do not appear to perform any useful or protective function.

• • Transient hiccups (usual): <48 hours.

  • Persistent or protracted hiccups (rare): >48 hours.

Causes

GI, stress, structural pathology

Diagnosis

Physical examination, bloods, CXR, ECG, CT

Management

• Self-help, valsalva etc.

• Chlorpromazine (7-10 days)

• Metoclopramide for max 5 days

• Others: quinidine sulphate, phenytoin, valproic acid, baclofen, haloperidol, nifedipine, amitriptyline, gabapentin, sertraline, carbon dioxide (sometimes utilized).

Resources

https://cks.nice.org.uk/topics/hiccups/