Hiccup is defined as an involuntary contraction of the muscle that is at the base of the lungs (or diaphragm) accompanied by the sudden closure of the vocal cords. In general, hiccups last for few minutes hours or occasionally a day or two. There are hiccups that continue for an extended period of time known as chronic hiccups. Occasionally hiccups persist for a month and recur frequently over an extended period of time. The longest recorded time span of hiccup lasted for over 60 years.
Hiccups are also associated with pancreatitis, tumors, and lesions , pregnancy, bladder irritation, liver cancer or hepatitis also cause persistent hiccups.
Hiccups often start for no apparent reason and continue on their own for a few minutes. We should be concerned about the period when there are hiccups that process over a period of time, cause exhaustion and weight loss from lack of sleep, and interaction of normal eating patterns.
Although the cause of hiccups is not known, however some of the triggers are thought to cause because of the spicy food, hot liquids, any disease or illness which irritates the nerves which control the diaphragm. The hiccup reflex takes into consideration the synchronized action of the diaphragm, the muscles that open and close the windpipe( trachea), and the nerves which act upon these muscles where the spinal cord and this hiccup center lies which is located somewhere between the cervical vertebrae numbered C3 and C5. From these locations, the nerve fibers from the brain monitors the activity and signal the contraction of the nerve known as the phrenic nerve, which permits exhalation. Medications prescribed by doctors can easily be purchased from an online pharmacy app.
The diaphragm may contract involuntarily( spasm) and the air is drawn into the lungs if any of these nerves in the cycle is irritated for any reason.
The conditions which lead to intractable hiccups are long enough and might require long periods of time in order to isolate and identify these include:- brain lesions, tumors, etc.
Another cause of hiccups in the central nervous system (CNS). The CNS is made up of the brain and spinal cord. If the CNS is damaged, body loses the ability to control hiccups.
CNS damage which leads to persistent hiccups includes:
• meningitis and encephalitis (infections which cause swelling in the brain)
• head trauma or brain injury
• hydrocephalus (a considerable amount of fluid on the brain)
• neurosyphilis and other brain infections
Persistent hiccups can also be caused by:
• overuse of alcohol
• tobacco use
• an anesthesia reaction after surgery
• certain types of drugs, like barbiturates, steroids, and tranquilizers
• an electrolyte imbalance
• kidney failure
• arteriovenous malformation(a condition where arteries and veins are tangled in the brain)
• cancer and chemotherapy treatments
• Parkinson’s disease (a degenerative brain disease)
The procedures used to treat or diagnose other conditions include:
• use of catheters for accessing the heart muscle
• placement of an oesophageal stent to prop open the esophagus
• bronchoscopy ( an instrument which is used to look inside the lungs)
Find the root medical cause of the hiccup and address that issue Treatments in order to stop intractable hiccups involve medications, non-medical therapies, or surgery.
Drinking ice water, holding breath, biting lemon, swallowing sugar, breathing into a paper bag, or pulling your knees to your chest ar tried for self-help methods. However, if no correctable cause can be found you should consult a doctor. Treatment depends on your case and your medical needs.
The following tests are useful in understanding the cause of persistent or intractable hiccups:
• blood tests in order to identify signs of infection, diabetes, kidney disease
• liver function tests taking an image of the diaphragm with a chest X-ray, CT scan, or MRI
• an echocardiogram to assess heart function
• an endoscopy, which uses a thin, lighted tube with a camera on the end to investigate your esophagus, windpipe, stomach, and intestine
• Bronchoscopy, which uses a thin, lighted tube with a camera on the end in order to examine lungs and airways
Medications for treating intractable hiccups include:
• Baclofen (Gablofen) a muscle relaxant
• Chlorpromazine medicine used to treat psychiatric illnesses
• Haloperidol, a kind of tranquilizer
• Metoclopramide (Reglan), to treat problems in the esophagus and GERD
• Anticonvulsant drugs such as phenytoin, valproic acid, gabapentin (Horizant, Neurontin), and carbamazepine (Carbatrol)
• Pain medication
The dose might be slowly reduced until you can stop taking the medicine. Prescription drugs can be uploaded and medicines can be purchased from online chemist’s drugstore.
Consult your doctor if the hiccups return after you stop taking the medication.
In rare cases, medications are ineffective in treating hiccups. Thus other treatment plans must be taken up.
Doctors may suggest surgery if none of the above methods work.
The procedure temporarily or permanently blocks the phrenic nerve in the neck. The phrenic nerve, causes the diaphragm to contract and relax as it runs from the spinal cord to the diaphragm.
Although very rarely hiccups persist for a month and recur frequently over an extended period of time. However, extended hiccups must be checked as it leads to serious complications.