HICCUP
The sudden involuntary contraction of a powerful muscle called the
diaphragm causes the vocal cords to shut producing the characteristic `hic’
sound of the hiccup. The diaphragm is a muscle separating the chest from the
abdomen and it helps in breathing.
Causes of hiccups
1.
Most often, no cause can
be determined for a hiccup. It stops as suddenly as it starts producing
temporary discomfort.
2.
Drugs like diazepam,
lorazepam , drugs used to treat acidity , ondansetron used to control vomiting and others may
cause hiccups as a side-effect.
3.
Hiccups commonly occur
as a result of eating too fast, consuming fatty or spicy foods or swallowing a
lot of air while eating. They may also occur due to having carbonated drinks or
alcohol during the meal. The gas in the drink makes the stomach expand which
irritates the phrenic nerve leading to hiccups.
4.
In some chronic
conditions like kidney failure, diabetes,
alcoholism, brain tumours involving the brainstem, liver disease, pneumonia and
other lung problems, hiccups are reported.
5.
Breathing in poisonous
fumes can also result in hiccups.
6.
Abdominal surgery may
irritate the phrenic nerve resulting in hiccups.
Symptoms
and signs of hiccups
The most obvious sign is the `hic’ sound that is heard when the
hiccupping starts.
The hiccup generally subsides on its own after a few minutes but
if it continues it can prevent a person from carrying out his daily activities
and may cause embarrassment which can lead him to avoid going out in public and
becoming an introvert.
If hiccups last for more than three hours or prevent you from
getting a good night’s sleep, it is time to bring it to the attention of your
doctor. If hiccups occur along with fever, abdominal pain and difficulty in
breathing, go to a hospital immediately.
Diagnosis of hiccups
Most often, a hiccup is so characteristic that it cannot be
mistaken for anything else. If the patient is not sure whether the sound is a
hiccup, he can be observed by a health worker or doctor to confirm the same. No
investigation can confirm hiccups.
Investigations of hiccups
Routine blood tests are done to check for infection, diabetes and
kidney status.
If the doctor suspects a medical condition which is causing the
hiccups, he may recommend investigations like a CT scan or MRI to determine the
state of the diaphragm and phrenic nerve. A chest X-ray is done routinely to
rule out any chest problems that may be the culprit.
The vocal cords can be visualized by laryngoscopy which is usually
done by an E.N.T surgeon. Alternatively an upper gastro intestinal endoscopy
(OGD scopy) may be done to visualize the food pipe and stomach.
If a problem in the brain is suspected, scans of the brain may be
ordered.
Treatment of hiccups
Both home remedies and medical treatment find a place in the
treatment of hiccups. Most people who get hiccups often swear by home cures
which stop the hiccups completely. The idea behind these maneuvers is to increase
the levels of carbon dioxide in the body and override the nerve signals that
cause hiccups. Here are some mentioned.
1.
Hold your breath for as
long as you can and swallow when you feel the hiccup coming. Repeat this a few
times, take a deep breath and start over till the hiccups subside.
2.
Another popular remedy
is to fill a glass of water, bend forwards and drink the water from the far
side of the glass. Remember to drink quickly.
3.
Get hold of a brown
paper bag and breathe in it. Blow in and out about ten times fast till you find
your face has become red. Hold the bag around your mouth that so that no air
gets in from outside.
4.
Chew crushed ice, gargle
or sip ice water to get rid of hiccups.
Alternative remedies include biofeedback and meditation which will
keep you calm and prevent any nervous outbursts which in turn lead to hiccups.
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