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Chronic Hiccups

Abstract

Purpose of review

Nearly 4000 patients will be admitted to hospital in the US this year for hiccups. Hiccups are controlled by a complex reflex arc between peripheral receptors and the brainstem. Any disruption along this pathway may produce hiccups. Typically, hiccups resolve spontaneously but in certain pathologies symptoms may persist. Persistent hiccups may be considered a sign of underlying pathology. The most common cause involves GERD.

Recent findings

Based on etiologies, studies have shown that first-line therapy should use a proton pump inhibitor (PPI) and involve appropriate gastrointestinal consultation. If symptoms persist, other etiologies such as central causes need to be explored.

Summary

We review the pathophysiology of hiccups including multiple causes and the appropriate work up for each. We review several studies examining new treatments, both pharmacological and interventional, that may help patients. Initial therapy should still involve a PPI but several new therapies may be beneficial.

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Correspondence to Zubair Malik MD.

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Kerstin Austin declares he has no conflict of interest. Sara Bonnes declares she has no conflict of interest. Harrison Daniel declares he has no conflict of interest.

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Reichenbach, Z.W., Piech, G.M. & Malik, Z. Chronic Hiccups. Curr Treat Options Gastro 18, 43–59 (2020). https://doi.org/10.1007/s11938-020-00273-3

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Keywords

  • Hiccups
  • Singultus
  • Hiccough