Hiccups. Most everyone has experienced this annoyance at some point. While they are usually considered a benign symptom, intractable hiccups have been shown to lead to depression and physical exhaustion. Hiccups can be caused by disturbance in the reflex arc that includes the brainstem, phrenic nerve, vagus nerve, and sympathetic chain. It can be caused by mechanical irritation, toxic irritation, emotional imbalances or rarely, neurological disease.

This week, we outline some of the treatments of hiccups and also highlight a specific case that is near and dear to Dr. Kalidas.If you have suffered from hiccups, you have probably tried a host of home remedies, including holding your breath, getting someone to scare you, or breathing into a paper bag. While those may work to some extent, intractable hiccups may warrant other therapies.

A few years ago, a close member of the Kalidas family started experiencing hiccups, late one evening. The hiccups were strong and kept him up for the majority of the evening. The next morning, the 86 year old male was walking to greet his son, when he developed acute right sided weakness in both his upper and lower extremity. If his son was not there to catch him, he would have fallen to the ground. It was thought that the hiccups he experienced was due to low oxygen

The patient was experiencing a stroke, and it was only through the marvels of modern medicine that the Neuroradiologist was able to directly lyse the clot. He was also treated because of his prompt presentation to the hospital. If you or your loved one experiences  a stroke, it is imperative to reach the hospital as SOON as possible. Life saving medications can be administered before 4 hours. If you miss this window of time, you may be left with a severe disability, that could have been prevented. Remember, time is brain!

While this patient has been recovering from this episode over the last several years, his hiccups resumed a few weeks ago and have been intractable. With Chlorpromazine making the patient very lethargic, many alternative therapies were tried. After acupuncture , chinese medicines, ginger, peanut butter, and valsalva maneuvers didn’t produce any results, the patient and his family tried pressure points.  The pressure points helped alleviate the hiccups and brought him some relief.

If you or your loved one experiences hiccups, they may be a benign symptom that goes away without notice. However, if the hiccups become intractable, it is important to understand the underlying cause. While traditional therapies may not always be efficacious, there are many alternative options that have been proposed.