|
|
|
|
Hiccup
|
| |
|
| |
A hiccup or hiccough (normally pronounced "HICK-up"; ), is the spasmodic contraction of the diaphragm that repeats several times per minute. In humans, the abrupt rush of air into the lungs causes the epiglottis to close, creating the "hic" noise. In medicine, it is known as synchronous diaphragmatic flutter (SDF), or singultus.
The term "hiccup" is also used to describe a small and unrepeated aberration in an otherwise consistent pattern.
A bout of hiccups, in general, resolves itself without intervention, although many home remedies claim to shorten the duration, and medical treatment is occasionally necessary.
ups (singultus) can be caused by many central and peripheral nervous system disorders, all from injury or irritation to the phrenic and vagus nerves, as well as toxic or metabolic disorders affecting aforementioned systems. Hiccups often occur after drinking carbonated beverages or alcohol.
Discussion
Ask a question about 'Hiccup' Start a new discussion about 'Hiccup' Answer questions from other users |
Encyclopedia
A hiccup or hiccough (normally pronounced "HICK-up"; ), is the spasmodic contraction of the diaphragm that repeats several times per minute. In humans, the abrupt rush of air into the lungs causes the epiglottis to close, creating the "hic" noise. In medicine, it is known as synchronous diaphragmatic flutter (SDF), or singultus.
The term "hiccup" is also used to describe a small and unrepeated aberration in an otherwise consistent pattern.
A bout of hiccups, in general, resolves itself without intervention, although many home remedies claim to shorten the duration, and medical treatment is occasionally necessary.
Causes
Hiccups (singultus) can be caused by many central and peripheral nervous system disorders, all from injury or irritation to the phrenic and vagus nerves, as well as toxic or metabolic disorders affecting aforementioned systems. Hiccups often occur after drinking carbonated beverages or alcohol. Persistent or intractable hiccups may be caused by any condition which irritates or damages the relevant nerves. Chemotherapy—which includes a huge amount of different drugs—has been implicated in hiccups (some data states 30 percent of treated), whilst other studies have not proven such a relationship. Many times chemotherapy is applied to tumors sitting at places that are by themselves prone to cause hiccups, if irritated.
List of possible causes of hiccup (singultus):
- Carbonated beverages
- Lack of water
- Eating too fast
- Being hungry for a while
- Taking a cold drink while eating a hot meal
- Burping
- Eating very hot or spicy food
- Laughing vigorously
- Coughing
- Drinking alcoholic beverages in excess
- Crying out loud (sobbing causes air to enter the stomach)
- Some smoking situations where abnormal inhalation can occur (in tobacco or other smoke like cannabis, perhaps triggered by precursors to coughing)
- Electrolyte imbalance
- Talking for too long
- Clearing the throat
- Use of some of the stronger opiate/opioid painkillers such as heroin, morphine, methadone and oxycodone
- Lack of vitamins
- Overstretching of the neck
- Laryngitis
- Heartburn (gastroesophageal reflux)
- Sensation that there is food in the esophagus
- Irritation of the eardrum (which is innervated by the vagus nerve)
- Pressure to the phrenic nerve
- Chemotherapy
- General anesthesia
- Surgery
- Bloating
- Tumor
- Infection
- Diabetes
- Standing up too fast
- Vomiting
- Seizure
- Lack of Oxygen
Phylogenetic hypothesis
Christian Straus and co-workers at the Respiratory Research Group, University of Calgary, Canada, propose that the hiccup is an evolutionary remnant of earlier amphibian respiration; amphibians such as frogs gulp air and water via a rather simple motor reflex akin to mammalian hiccuping. In support of this idea, they observe that the motor pathways that enable hiccuping form early during fetal development, before the motor pathways that enable normal lung ventilation to form; thus according to recapitulation theory the hiccup is evolutionarily antecedent to modern lung respiration. Additionally, they point out that hiccups and amphibian gulping are inhibited by elevated CO2 and can be completely stopped by the drug Baclofen (a GABAB receptor agonist), illustrating a shared physiology and evolutionary heritage. These proposals would explain why premature infants spend 2.5% of their time hiccuping, indeed they are gulping just like amphibians, as their lungs are not yet fully formed.
Treatment
Ordinary hiccups are cured easily without medical intervention; in most cases they can be stopped simply by forgetting about them. However, there are a number of anecdotal treatments for casual cases of hiccups. Some of the more common home remedies include giving the afflicted a fright or shock, drinking water (sometimes in an unorthodox manner), and altering one's breathing.
Medical treatment
Hiccups are treated medically only in severe and persistent (termed "intractable") cases, such as in the case of a 15-year-old girl who, in 2007, hiccuped continuously for five weeks. Haloperidol (Haldol, an anti-psychotic and sedative), metoclopramide (Reglan, a gastrointestinal stimulant), and chlorpromazine (Thorazine, an anti-psychotic with strong sedative effects) are used in cases of intractable hiccups. In severe or resistant cases, baclofen, an anti-spasmodic, is sometimes required to suppress hiccups. Effective treatment with sedatives often requires a dose that renders the person either unconscious or highly lethargic. Hence, medicating singultus is done short-term, as the affected individual cannot continue with normal life activities while taking the medication.
Digital rectal massage has been recommended as a remedy that causes immediate cessation of hiccups and which should be tried before resorting to drugs.
Persistent and intractable hiccups due to electrolyte imbalance (hypokalemia, hyponatremia) may benefit from drinking a carbonated beverage containing salt to normalize the potassium-sodium balance in the nervous system. The carbonation promotes quicker absorption. Carbonated beverages have though by themselves a tendency to provoke hiccup in some persons.
The administration of intranasal vinegar is thought to be safe and handy method to stimulate dorsal wall of nasopharynx, where the pharyngeal branch of the glossopharyngeal nerve (afferent of the hiccup reflex arc) is distributed.
Dr. Bryan R. Payne, a neurosurgeon at the Louisiana State University Health Sciences Center in New Orleans, has had some success with an experimental new procedure in which a vagus nerve stimulator is implanted in the upper chest of patients with an intractable case of hiccups. "It sends rhythmic bursts of electricity to the brain by way of the vagus nerve, which passes through the neck. The Food and Drug Administration approved the vagus nerve stimulator in 1997 as a way to control seizures in some patients with epilepsy. In 2005, the agency endorsed the use of the stimulator as a treatment of last resort for people with severe depression."
Home remedies
While numerous home remedies are offered, they mostly fall into three broad categories: purely psychosomatic cures centered around relaxation and distraction, cures involving swallowing and eating (with the general rationale that this would remove irritants or reset mechanisms in the affected region), and cures involving controlled/altered breathing.
Long-term cases
American man Charles Osborne had the hiccups for 68 years, from 1922 to 1990, and was entered in the Guinness World Records as the man with the Longest Attack of Hiccups.
In January 2007, teenager Cheyenne Motland from Washington in the United States set a national record for females by hiccuping since October 29, 1997. To this day, her hiccups continue to plague her. After her hiccups returned, her neurologist suggested that she may actually have Tourette syndrome.
See also
External links
|
| |
|
|
