Brief episodes of hiccups are a common part of life. Prolonged attacks are a more serious phenomenon and often pose a diagnostic dilemma. These attacks have been associated with significant morbidity and even death. Metabolic causes of hiccups include:
Hyponatremia
Hypokalemia
Hypocalcemia
Hyperglycemia
Uremia
Hypocarbia
Hiccups lasting longer than 48 hours are considered persistent or protracted. Hiccups lasting longer than 1 month are termed intractable. Hiccups that occur during sleep are rare and are probably due to an underlying condition; hiccups during sleep rule out a psychogenic cause.
Many nonpharmacologic remedies are used in the emergency department. Examples include:
Stimulation of the nasopharynx by applying forcible traction to the tongue, swallowing granulated sugar, gargling with water, sipping ice water, drinking from the far side of a glass, biting on a lemon, or inhaling noxious agents (eg, ammonia)
C3-5 dermatome stimulation by tapping or rubbing the back of the neck, coolant sprays, or acupuncture
Direct pharyngeal stimulation by a nasal or oral catheter (as much as 90% effective)
Direct uvular stimulation by a spoon or cotton-tip applicator
Removal of gastric contents by means of emetics or a nasogastric tube
Learn more about hiccups.
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Cite this: Richard H. Sinert. Fast Five Quiz: Annoying Medical Conditions - Medscape - Apr 25, 2022.
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