Summary
Definition
History and exam
Key diagnostic factors
- "hic" sound
Other diagnostic factors
- duration <48 hours (typically benign hiccups)
- duration >48 hours (chronic hiccups)
- persistence during sleep
- associated features of underlying cause
- weight loss and malnutrition
Risk factors
- aerophagia, temperature changes, and emotional states
- diaphragmatic and phrenic nerve irritation
- vagus nerve irritation
- central nervous system disorders
- metabolic/electrolyte abnormalities
- toxins/drugs
- psychogenic disorders
- sedation or anesthesia
Diagnostic tests
1st tests to order
- clinical diagnosis
Tests to consider
- CBC
- serum electrolytes
- BUN
- C-reactive protein and erythrocyte sedimentation rate
- liver function tests
- gamma glutamyl transpeptidase (gamma-GT)
- serum amylase
- toxicology screen
- arterial blood gas
- ECG
- chest x-ray
- pulmonary function tests
- CT abdomen
- endoscopy of the upper gastrointestinal tract
- CT or MRI head
- lumbar puncture
- otoscopy
- pharyngoscopy
Treatment algorithm
benign hiccups
chronic hiccups
Contributors
Authors
Aminah Jatoi, MD
Professor of Oncology
Department of Oncology
Mayo Clinic
Rochester
MN
გაფრთხილება:
AJ has received a grant review for Pfizer (money is paid to her institution) and research funding from AstraZeneca. AJ is on an advisory board for Meter Health and Novartis. AJ is an author of one reference cited in this topic.
მადლიერება
Professor Aminah Jatoi would like to gratefully acknowledge Professor Peter Kranke, Dr Yvonne Jelting, and Dr Thomas M. Metterlein, previous contributors to this topic.
გაფრთხილება:
PK is an author of a reference cited in this topic. YJ and TMM declare that they have no competing interests.
რეცენზენტები
Andy Smith, BM, BS, MRCP, FRCA
Consultant Anaesthetist and Associate Director of Research and Development
Director
Lancaster Patient Safety Research Unit
Royal Lancaster Infirmary
Lancaster
UK
გაფრთხილება:
AS declares that he has no competing interests.
Stefan K. Burgdorf, MD
Registrar
Department of Surgical Gastroenterology
Herlev Hospital
University of Copenhagen
Denmark
გაფრთხილება:
SKB declares that he has no competing interests.
Howard Smith, MD, FACP
Academic Director of Pain Management
Associate Professor of Anesthesiology
Department of Anesthesiology
Albany Medical College
Albany
NY
გაფრთხილება:
HS is an author of a reference cited in this topic.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
წყაროები
ძირითადი სტატიები
Lewis JH. Hiccups: causes and cures. J Clin Gastroenterol. 1985 Dec;7(6):539-52. აბსტრაქტი
Wagner MS, Stapczynski JS. Persistent hiccups. Ann Emerg Med. 1982 Jan;11(1):24-6. აბსტრაქტი
Rousseau P. Hiccups. South Med J. 1995 Feb;88(2):175-81. აბსტრაქტი
Moretto EN, Wee B, Wiffen PJ, et al. Interventions for treating persistent and intractable hiccups in adults. Cochrane Database Syst Rev. 2013 Jan 31;(1):CD008768.სრული ტექსტი აბსტრაქტი
Zhu LL, Wang WX, Guo XG. Acupuncture for hiccups after stroke: a systematic review. Chin J Evid Based Med. 2011;11:325-8.
გამოყენებული სტატიები
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დიფერენციული დიაგნოზები
- Gasping
- Burping
მეტი დიფერენციული დიაგნოზებიგაიდლაინები
- Adverse events associated with EGD and EGD-related techniques
მეტი გაიდლაინები
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