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Hiccups

Maria Montanez Villacampa, MD, Renee F. del Carmen, MD and Nida Hussain, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Hiccups are caused by a repetitive sudden involuntary contraction of the inspiratory muscles (predominantly the diaphragm) and terminated by the abrupt closure of the glottis, which ...

DIAGNOSIS

  • Hiccup attacks usually occur at brief intervals and last seconds or minutes. Persistent bouts lasting >48 hours often imply an underlying physical or metabolic disorder.

  • Intractable hiccup...

TREATMENT

  • Outpatient (usually)

  • Inpatient (if elderly, debilitated, or intractable hiccups)

  • Many hiccup treatments are purely anecdotal.

GENERAL MEASURES

  • Evaluate frequent bouts or persistent hiccups.

  • Treat...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Until hiccups cease 

DIET

Avoid gastric distension from overeating, carbonated beverages, and aerophagia. 

PATIENT EDUCATION

See “General Measures.”...

REFERENCES

1
Witter F, Dipietro J, Costigan K, et al. The relationship between hiccups and heart rate in the fetus. J Matern Fetal Neonatal Med.  2007;20(4):289–292. [View Abstract on OvidMedline]
...

ADDITIONAL READING

  • Berger TJ. A rash case of hiccups. J Emerg Med.  2013;44(1):e107–e108. [View Abstract on OvidMedline]

  • Chang FY, Lu CL. Hiccup: mystery, nature and treatment. J Neurogastroentero...

CODES

ICD10

  • R06.6 Hiccough

  • F45.8 Other somatoform disorders

ICD9

  • 786.8 Hiccough

  • 306.1 Respiratory malfunction arising from mental factors

SNOMED

  • 65958008 Hiccoughs (finding)

  • 191955009 Psychogenic hiccough

CLINICAL PEARLS

  • Most hiccups resolve spontaneously.

  • An organic cause is more likely in men and individuals with intractable hiccups.

  • Rule out foreign body in the ear canal as a trigger.

  • Baclofen and gaba...

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