Suggest Treatment For Violet Hiccups
Prologed Hiccups Need Management
Detailed Answer:
Thank you for asking!
Brief episodes of hiccups are a common part of life; however, prolonged attacks are a more serious phenomenon and have been associated with significant morbidity and even death.
To know what is causing hiccups following issues need to be addressed as they are the major likely reasons for hiccups.
Surgical history
Comprehensive drug history
Indicators of psychogenic origin
Arrhythmia-induced syncope
Gastroesophageal reflux
Weight loss
Insomnia
Emotional distress
Alcoholism and acute alcohol ingestion
Then comes the role of examination of body parts thoroughly for example
Head – Foreign body or aberrant hair adjacent to tympanic membrane; glaucoma
Mouth - Pharyngitis
Neck – Inflammation; mass lesions; goiter; voice abnormalities; stiffness
Chest – Tumors; pneumonia; asthma
Cardiovascular system – Arrhythmias; myocardial infarction (MI); pericarditis; unequal pulses
Abdomen – Gastric atony; organomegaly; subphrenic abscess; cholecystitis; appendicitis; abdominal aortic aneurysm (AAA); pancreatitis; peritonitis
Rectum – Mass lesions
Nervous system – Focal lesions; disordered higher mental function; indications of multiple sclerosis
Then comes the role of Workup and labs and radiology imaging ot help the cause
Electrolytes - Hyponatremia, hypokalemia, hypocalcemia, and hyperglycemia
Renal function tests - Uremia
Liver function tests - Hepatitis
Amylase and lipase levels - Pancreatitis
White blood cell (WBC) count
Urine, sputum, or cerebrospinal fluid (CSF) - Infection
Imaging modalities that may be helpful in the workup include the following:
Chest radiography
Fluoroscopy of diaphragmatic movement
Computed tomography (CT) of the head, thorax, and abdomen
Magnetic resonance imaging (MRI)
Other studies that may be helpful include the following:
Electrocardiography
Nerve conduction studies
Endoscopy or bronchoscopy
esophageal acid perfusion test
Once the reason of Hiccups is diagnosed then the management is easy. It is divided in to two groups.
1)Pharmacological and 2) Non pharmacological.
Pharmacologic therapies include the following:
Chlorpromazine (drug of choice)
Haloperidol
Metoclopramide
Phenytoin
Valproic acid
Carbamazepine
Gabapentin
Ketamine
Baclofen
Lidocaine
Other agents reported to be beneficial are as follows:
Muscle relaxants (not benzodiazepines)
Sedatives
Analgesics (eg, orphenadrine, amitriptyline, chloral hydrate, and morphine)
Stimulants (eg, ephedrine, methylphenidate, amphetamine, and nikethamide)
Miscellaneous agents (eg, edrophonium, dexamethasone, amantadine, and nifedipine)
Nonpharmacologic therapies include the following:
a)Techniques affecting components of the hiccup reflex - Stimulation of the nasopharynx; C3-5 dermatome stimulation; direct pharyngeal stimulation; direct uvular stimulation; removal of gastric contents
b)Techniques leading to vagal stimulation - Iced gastric lavage; Valsalva manoeuvre; carotid sinus massage; digital rectal massage; digital ocular globe pressure
c)Techniques interfering with normal respiratory function - Breath holding; hyperventilation; gasping; breathing into a paper bag; pulling the knees up to the chest and leaning forward; continuous positive airway pressure; rebreathing 5% carbon dioxide
Mental distraction
Behavioral conditioning
Hypnosis
Acupuncture
Phrenic nerve or diaphragmatic pacing
Prayer
Surgical intervention (typically a last resort) may include the following:
Phrenic nerve ablation (unilateral or bilateral as appropriate)
Microvascular decompression of the vagus nerve if need be.
I hope it helps. Seek a gastroenterologist for further management and try non pharmacological manoeuvres meanwhile for the relief.
Take good care of your husband and don't forget to close the discussion please.
Regards
S Khan