Hiccups is a topic covered in the 5-Minute Emergency Consult.

To view the entire topic, please or purchase a subscription.

Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:

Emergency Central

-- The first section of this topic is shown below --

Basics

Description

  • Sudden, involuntary contraction of the diaphragm (usually unilateral) and other inspiratory muscles terminated by abrupt closure of the glottis
  • Medical terminology: Singultus
  • Usually occur with a frequency of 4–60/min
  • Occurs as a result of stimulation of the hiccup reflex arc:
    • Irritation of the vagus and phrenic nerves
    • The “hiccup center” is located in the upper spinal cord or brainstem
  • Classification:
    • Hiccup bout: <48 hr
    • Persistent hiccups: 48 hr–1 mo
    • Intractable hiccups: >1 mo
  • Male > female (4:1)

Etiology

  • GI:
    • Gastric distention, overeating, eating too fast
    • Esophageal: Gastroesophageal reflux, achalasia, candida esophagitis, cancer
    • Gastric: Ulcers, cancer
    • Hepatic: Hepatitis, hepatoma
    • Pancreatic: Pancreatitis, pseudocyst, cancer
    • Bowel obstruction
    • Inflammatory bowel disease
    • Cholelithiasis, cholecystitis
    • Appendicitis
    • Abdominal aortic aneurysm
    • Postoperative, abdominal procedure
  • Diaphragmatic irritation:
    • Hiatal hernia
    • Intra-abdominal mass
    • Pericarditis
    • Eventration
    • Splenomegaly, hepatomegaly
    • Peritonitis
  • CNS:
    • Vascular lesions: Ischemic/hemorrhagic stroke, head trauma, arteriovenous malformations
    • Infectious: Encephalitis, meningitis, abscess
    • Structural: Cancer, Parkinson disease, multiple sclerosis, hydrocephalus
    • Ventriculoperitoneal shunt
  • Thoracic:
    • Infectious: Pneumonia, TB
    • Cardiac: MI, pericarditis
    • Aortic aneurysm
    • Cancer
    • Mediastinal lymphadenopathy
  • Head and neck:
    • Otic foreign body irritating the tympanic membrane
    • Pharyngitis
    • Laryngitis
    • Goiter
    • Retropharyngeal/peritonsillar abscess
    • Neck mass
  • Metabolic:
    • Uremia
    • Hyponatremia
    • Hypocalcemia
    • Gout
    • DM
  • Toxic/drug induced:
    • Alcohol
    • Tobacco
    • α-methyldopa
    • Benzodiazepines
    • Steroids
    • Barbiturates
    • Narcotics
    • Chemotherapeutic agents
    • Antibiotics
    • General anesthesia
  • Psychogenic causes:
    • Stress/excitement
    • Grief
    • Malingering
    • Conversion disorder
  • Idiopathic

-- To view the remaining sections of this topic, please or purchase a subscription --

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Hiccups ID - 307376 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307376/all/Hiccups ER -