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$Unique_ID{BRK03821}
$Pretitle{}
$Title{Hiccups, Chronic}
$Subject{Hiccups Chronic Hiccups Hiccough Singultus Intractable Hiccups
Hiccups Persistent }
$Volume{}
$Log{}
Copyright (C) 1989 National Organization for Rare Disorders, Inc.
708:
Hiccups, Chronic
** IMPORTANT **
It is possible that the main title of the article (Chronic Hiccups) is
not the name you expected. Please check the SYNONYM listing to find the
alternate names and disorder subdivisions covered by this article.
Synonyms
Hiccups
Hiccough
Singultus
Intractable Hiccups
Hiccups, Persistent
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Hiccups are sudden, involuntary, repeated spasms of the diaphragm,
followed by an intake of air into the larynx which causes the characteristic
"hic" sound. They may occur a few times within a minute or several times a
second. Normally, Hiccups last for only a few minutes. However, when they
persist for days or weeks they can be very serious.
Symptoms
Chronic Hiccups last for hours or days, or they recur very often with only a
few hours relief between spasms. The persistence of hiccups may indicate a
serious illness. Some of the illnesses that include persistent hiccups as a
symptom are: pleurisy of the diaphragm, pneumonia, uremia, alcoholism,
disorders of the stomach or esophagus, and bowel diseases. Hiccups may also
be associated with pancreatitis, pregnancy, bladder irritation, liver cancer
or hepatitis. Surgery, tumors, and lesions may also cause persistent
hiccups.
Causes
Hiccups are caused by irritation of nerves or the brain medullary centers
that control the muscles used in breathing, especially in the diaphragm.
When Persistent Hiccups occur they may be the result of a brain lesion,
tumors, intestinal diseases, liver or kidney disorders or uremic poisoning.
They may be caused by surgery or the drugs used during surgery. Chronic
Hiccups also occur for unknown reasons. Persistent Hiccups that go unchecked
can cause exhaustion, lack of sleep and weight loss.
Affected Population
Hiccups affect males more often than females. Hiccups occur in practically
every human being, but Chronic Hiccups are very rare.
Related Disorders
There are many disorders involving the Autonomic Nervous System which
controls unconscious activities of the body such as breathing, sweating,
heartbeat, hiccups, coughing, etc.
Therapies: Standard
Treatment of ordinary hiccups is not necessary since they stop with no
treatment within a few minutes.
Treatment of Chronic Hiccups includes drug therapy with intramuscular
haloperidol, chlorpromazine, metoclopramide, anticonvulsants, quinidine or
carbamazepine. If the hiccups occur during anaesthesia or surgery the
treatment is usually Ephedrine or Ketamine. Hypnosis has been used in some
patients, as well as acupuncture. Injections into the phrenic nerve, which
controls the movement of the diaphragm, and surgery to sever the phrenic
nerve in the neck, has been used in cases where all other therapies have
failed.
Therapies: Investigational
Researchers at Walter Reed Army Hospital have been studying the drug
nifedipine (Adalat or Procardia) as a treatment for Chronic Hiccups. This
drug, which is a calcium channel blocker most commonly prescribed to control
high blood pressure, stopped Chronic Hiccuping in 5 out of 7 patients
treated. More research is needed to determine whether nifedipine will be
effective in the long-term treatment of patients with Chronic Hiccups.
In a report of a study in England, it was noted that the drug Baclofen
was effective in stopping the chronic hiccups of a single patient. The
patient's close relations also had attack of Chronic Hiccups suggesting a
genetic cause.
This disease entry is based upon medical information available through
September 1989. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information about this disorder.
Resources
For more information on Chronic Hiccups, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
NIH/National Heart, Blood and Lung Institute
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-4236
References
TREATMENT OF INTRACTABLE HICCUPS WITH INTRAMUSCULAR HALOPERIDOL. T.J. Ives,
et al.; Am J Psychiatry, (November, 1985, issue 142 (11)). Pp. 1368-1369.
CHRONIC HICCUPS. M.S. Lipsky, Am Fam Physician (November, 1986, issue 34
(5)). Pp. 173-177.
HICCUPS: CAUSES AND CURES. J.H. Lewis, J Clin Gastroenterol, (December,
1985, issue 7 (6)). Pp. 539-552.
HICCUPS AND ESOPHAGEAL DYSFUNCTION. G. Triadafilopoulos, Am J
Gastroenterol, Am J Gastroenterol (February, 1989, issue 84 (2)). Pp. 164-
149.
SLEEP HICCUP. J.J. Askenasy, Sleep, (April, 1988, issue 11 (2)). Pp.
187-194.