hiccough


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hiccup

 [hik´up]
spasmodic involuntary contraction of the diaphragm that results in uncontrolled breathing in of air; it is accompanied by a peculiar noise produced by a beginning inhalation that is suddenly checked by closure of the glottis. Hiccups have many different possible causes, such as rapid eating, irritation in the digestive or respiratory system, or irritation of the diaphragm muscle itself; they sometimes occur as a complication following some kinds of surgery or in serious diseases such as uremia and epidemic encephalitis; and they may have a purely emotional cause. The condition is serious only when it persists for a long time; hiccups usually stop after a few minutes. Called also hiccough and singultus.

Standard home remedies for hiccups include holding the breath, swallowing sugar or a bread crust, pulling the tongue forward, applications of cold to the back of the neck, simply sipping water slowly, and breathing into a paper bag. The bag has the effect of cutting off normal exchange of air with the surrounding atmosphere. The air in the bag, after a few breaths, will have an increasingly high carbon dioxide content, and so will the air in the lungs, and finally the blood. As a result, the automatic respiratory centers in the brain call for stronger and deeper breathing to get rid of the carbon dioxide. This frequently makes the contractions of the diaphragm more regular and eliminates the hiccups. (Patients should be cautioned not to use this paper bag method for longer than one minute at a time.) In extreme cases of prolonged hiccups, sedatives or antianxiety agents may be necessary.
An abrupt inspiratory muscle contraction, followed within 35 msec by glottic closure; the hiccup center is in the spinal cord between C3 and C5; an afferent impulse is carried by the vagus and phrenic nerves and thoracic sympathetic chain; the efferent impulse is carried by the phrenic nerve with branches to the glottis and accessory respiratory muscles
Aetiology Idiopathic, psychogenic, abdominal disease—gastric distension, gastrointestinal hemorrhage, bowel obstruction—esophagospasm or inflammation including hepatitis, peritonitis, gastritis, enteritis, appendicitis, pancreatitis, abrupt temperature change, alcohol, inferior wall MI, irritation of tympanic membrane, metabolic derangements—azotemia, hyponatraemia, uremia—diaphragmatic irritants, diseases of chest wall, lung, and heart—mediastinitis, tumours, aortic aneurysms, subphrenic abcesses, pericarditis—foreign bodies, excess smoking, excitement or stress, toxins, drugs—general anesthesia, barbiturates, diazepam, alpha-methyldopa—pneumonia, herpes zoster, central and peripheral nervous system disease—encephalitis, tumours, meningitis, brainstem infarcts, phrenic nerve compression, cervical cord lesions; intractable hiccupping may result in inability to eat or sleep, arrhythmias or reflux oesophagitis, or may be compatible with a normal life. The most recalcitrant case of hypersingultation occurred in an American pig farmer, which began in 1922, and continued to 1987
Management No therapy is consistently effective.Chlorpromazine, a dopaminergic blocker, and diphenhydramine may be as effective as—and more dignified than—standing on one’s head and other ‘folk’ maneuvers; other dopaminergic blockers include haloperidol, metoclopramide and apomorphine; rare cases respond to amantidine or amitriptyline, carbamazepine, nifedipine, baclofen, ketamine, phenytoin and lidocaine, with fewer side effects

hic·cup

, hiccough (hik'ŭp)
A diaphragmatic spasm causing a sudden inhalation interrupted by a spasmodic closure of the glottis.

hiccup, hiccough

spasmodic involuntary contraction of the diaphragm that results in uncontrolled breathing in of air; called also singultus. The peculiar noise of hiccups is produced by a beginning inspiration that is suddenly checked by closure of the glottis. Commonly seen in puppies. An unusual occurrence in horses affected by electrolyte imbalances, especially hypocalcemia. The clinical effect is hiccup with each cardiac cycle, often present on only one side of the diaphragm. See also synchronous diaphragmatic flutter.
References in periodicals archive ?
Like a diagnostician, like Janet observing his female hysteric in her four-part attack of hiccoughs and belch, the poet persona focuses on the organs of the hysterical attack and on the structure of the alternations between exhalation and inhalation.
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A little time later, I started to hiccough, and my mother pulled aside the tablecloth.
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