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American [[Charles Osborne (hiccups)|Charles Osborne]] had the hiccups for 68 years, from 1922 to 1990, and was entered in the ''[[Guinness World Records]]'' as the man with the longest attack of hiccups.<ref>{{Cite news| title = Survivor of 68-Year Hiccup Spell Dies | publisher = Omaha World-Herald | date = 5 May 1991 | edition = Sunrise Edition: 2.B. }}</ref>
American [[Charles Osborne (hiccups)|Charles Osborne]] had the hiccups for 68 years, from 1922 to 1990, and was entered in the ''[[Guinness World Records]]'' as the man with the longest attack of hiccups.<ref>{{Cite news| title = Survivor of 68-Year Hiccup Spell Dies | publisher = Omaha World-Herald | date = 5 May 1991 | edition = Sunrise Edition: 2.B. }}</ref>


In 2007, [[Florida]] teenager [[Jennifer Mee]] gained media fame for hiccuping around 50 times per minute for more than five weeks.<ref>{{Cite news| url = http://www.msnbc.msn.com/id/17643118 | title = Florida girl hiccuping again after returning to school | date = March 16, 2007 | publisher = msnbc.msn.com }}</ref> A neurologist suggested that she may have had [[Tourette syndrome]], and the hiccups may have been "tics" caused by it, but this has been disputed.<ref>{{Cite news| url = http://www.tampabays10.com/news/local/article.aspx?storyid=71545 | title = Hiccup Girl: "I have Tourette's" | date = January 10, 2008 | publisher = WTSP-TV, tampabays10.com }}</ref> In an unrelated incident, she and two other males were arrested and charged with the first-degree murder of 22-year-old Shannon Griffin in October, 2010. In coverage of the murder, several media sources referred to her as "Hiccup girl".<ref>{{Cite news| url = http://www2.tbo.com/content/2010/oct/25/250716/jennifer-mee-is-among-three-arrested-and-charged-i/ | title = 'Hiccup girl' among 3 charged in St. Pete homicide | date = October 25, 2010 | publisher = Tampa Bay Online, tbo.com }}</ref>
In 2007, [[Florida]] teenager [[Jennifer Mee]] gained media fame for hiccuping around 50 times per minute for more than five weeks.<ref>{{Cite news| url = http://www.msnbc.msn.com/id/17643118 | title = Florida girl hiccuping again after returning to school | date = March 16, 2007 | publisher = msnbc.msn.com }}</ref> A neurologist suggested that she may have had [[Tourette syndrome]], and the hiccups may have been "tics" caused by it, but this has been disputed.<ref>{{Cite news| url = http://www.tampabays10.com/news/local/article.aspx?storyid=71545 | title = Hiccup Girl: "I have Tourette's" | date = January 10, 2008 | publisher = WTSP-TV, tampabays10.com }}</ref> In an unrelated incident, she and two males were arrested and charged with the first-degree murder of 22-year-old Shannon Griffin in October, 2010. In coverage of the murder, several media sources referred to her as "Hiccup girl".<ref>{{Cite news| url = http://www2.tbo.com/content/2010/oct/25/250716/jennifer-mee-is-among-three-arrested-and-charged-i/ | title = 'Hiccup girl' among 3 charged in St. Pete homicide | date = October 25, 2010 | publisher = Tampa Bay Online, tbo.com }}</ref>


Briton Christopher Sands had hiccups for a period of almost three years which were eventually discovered to be due to a tumor located on the part of the brain that controls vascular activity. Once 2/3 of the tumor was removed, the hiccups appeared to lessen, and Sands no longer suffers from the condition.<ref>{{Cite news| url = http://www.thesun.co.uk/sol/homepage/woman/health/article1137753.ece | title = So does holding your breath REALLY banish hiccups? | date = May 8, 2008 | publisher = [[The Sun (newspaper)|The Sun]]}}</ref>
Briton Christopher Sands had hiccups for a period of almost three years which were eventually discovered to be due to a tumor located on the part of the brain that controls vascular activity. Once 2/3 of the tumor was removed, the hiccups appeared to lessen, and Sands no longer suffers from the condition.<ref>{{Cite news| url = http://www.thesun.co.uk/sol/homepage/woman/health/article1137753.ece | title = So does holding your breath REALLY banish hiccups? | date = May 8, 2008 | publisher = [[The Sun (newspaper)|The Sun]]}}</ref>

Revision as of 17:16, 26 October 2010

Hiccup
SpecialtyOtorhinolaryngology Edit this on Wikidata

A hiccup or hiccough (Template:Pron-en HICK-up) is a contraction of the diaphragm that repeats several times per minute. In humans, the abrupt rush of air into the lungs causes the epiglottis to close, creating a "hic" sound.

In medicine it is known as synchronous diaphragmatic flutter (SDF), or singultus, from the Latin singult, "the act of catching one's breath while sobbing".[1] The hiccup is an involuntary action involving a reflex arc.[1]

A bout of hiccups, in general, resolves itself without intervention, although many home remedies claim to shorten the duration, and medical treatment is occasionally necessary in cases of chronic hiccups.

Causes

Hiccups are caused by many central and peripheral nervous system disorders, all from injury or irritation to the phrenic and vagus nerves, as well as toxic or metabolic disorders affecting the aforementioned systems. Hiccups often occur after consuming carbonated beverages, alcohol, dry breads, or spicy foods. Prolonged laughter or eating too fast are also known to cause hiccups. Persistent or intractable hiccups may be caused by any condition which irritates or damages the relevant nerves. Chemotherapy—which can include a huge number of different drugs—has been implicated in hiccups (some data states 30 percent of patients),[citation needed] while other studies have not demonstrated such a relationship. Many times chemotherapy is applied to tumors sitting at places that are by themselves prone to cause hiccups, if irritated.[2][3]

Phylogenetic hypothesis

Christian Straus and co-workers at the Respiratory Research Group, University of Calgary, Canada, propose that the hiccup is an evolutionary remnant of earlier amphibian respiration; amphibians such as frogs gulp air and water via a rather simple motor reflex akin to mammalian hiccuping.[4] In support of this idea, they observe that the motor pathways that enable hiccuping form early during fetal development, before the motor pathways that enable normal lung ventilation form. Thus, according to recapitulation theory the hiccup is evolutionarily antecedent to modern lung respiration. Additionally, they point out that hiccups and amphibian gulping are inhibited by elevated CO2 and can be completely stopped by the drug Baclofen (a GABAB receptor agonist), illustrating a shared physiology and evolutionary heritage. These proposals explain why premature infants spend 2.5% of their time hiccuping, indeed they are gulping just like amphibians, as their lungs are not yet fully formed. Fetal intrauterine hiccups are of two types. The physiological type occurs prior to twenty-eight weeks after conception and tend to last five to ten minutes. These hiccups are part of fetal development and are associated with the myelination of the Phrenic nerve (which drives the diaphragm)

Treatment

Ordinary hiccups resolve on their own without medical intervention. However, there are a number of anecdotal treatments for casual cases of hiccups. Some of the more common home remedies include giving the afflicted a fright or shock, sticking your finger in your mouth not in a way that will induce vomiting but to massage the back of your throat in which will stop the irritation in the epiglottis, raising your arms aloft while remembering yesterday's lunch, eating peanut butter, doing something embarrassing in front of others (for example, acting like a chicken), taking a teaspoon of vinegar, drinking water (sometimes in an unorthodox manner, such as drinking the water upside down or drinking a full glass through a paper towel[clarification needed]), holding one's breath and altering one's breathing patterns. Another well-known (and if successful, a somewhat mean) cure is to have someone promise the hiccuper something nice (such as a bar of chocolate) should they continue hiccuping after the promise has been made. This will excite the hiccuper, as they feel confident that they will easily hiccup again to earn their prize, but they will be unlucky and the hiccups with spontaneously stop to spite them (of course, if the hiccuper keeps hiccuping, they will earn their free goodie). A solution involving sugar placed on or under the tongue was cited in the December 23, 1971 issue of the New England Journal of Medicine.[5]

Hiccups are treated medically only in severe and persistent (termed "intractable") cases, such as in the case of a 15-year-old girl who, in 2007, hiccuped continuously for five weeks.[6] Haloperidol (Haldol, an anti-psychotic and sedative), metoclopramide (Reglan, a gastrointestinal stimulant), and chlorpromazine (Thorazine, an anti-psychotic with strong sedative effects) are used in cases of intractable hiccups. In severe or resistant cases, baclofen, an anti-spasmodic, is sometimes required to suppress hiccups. Effective treatment with sedatives often requires a dose that renders the person either unconscious or highly lethargic. Hence, medicating singultus is done short-term, as the affected individual cannot continue with normal life activities while taking the medication.

Persistent and intractable hiccups due to electrolyte imbalance (hypokalemia, hyponatremia) may benefit from drinking a carbonated beverage containing salt to normalize the potassium-sodium balance in the nervous system. The carbonation promotes quicker absorption. Carbonated beverages by themselves may provoke hiccups in some people.

The administration of intranasal vinegar was found to ease the chronic and severe hiccups of a three-year old Japanese girl. Vinegar may stimulate the dorsal wall of the nasopharynx, where the pharyngeal branch of the glossopharyngeal nerve (the afferent of the hiccup reflex arc) is located.[7]

Dr. Bryan R. Payne, a neurosurgeon at the Louisiana State University Health Sciences Center in New Orleans, has had some success with an experimental procedure in which a vagus nerve stimulator is implanted in the upper chest of patients with an intractable case of hiccups. "It sends rhythmic bursts of electricity to the brain by way of the vagus nerve, which passes through the neck. The Food and Drug Administration approved the vagus nerve stimulator in 1997 as a way to control seizures in some patients with epilepsy".[8]

Society and culture

American Charles Osborne had the hiccups for 68 years, from 1922 to 1990, and was entered in the Guinness World Records as the man with the longest attack of hiccups.[9]

In 2007, Florida teenager Jennifer Mee gained media fame for hiccuping around 50 times per minute for more than five weeks.[10] A neurologist suggested that she may have had Tourette syndrome, and the hiccups may have been "tics" caused by it, but this has been disputed.[11] In an unrelated incident, she and two males were arrested and charged with the first-degree murder of 22-year-old Shannon Griffin in October, 2010. In coverage of the murder, several media sources referred to her as "Hiccup girl".[12]

Briton Christopher Sands had hiccups for a period of almost three years which were eventually discovered to be due to a tumor located on the part of the brain that controls vascular activity. Once 2/3 of the tumor was removed, the hiccups appeared to lessen, and Sands no longer suffers from the condition.[13]

See also

References

  1. ^ a b Wilkes, Garry (2 August 2007). "Hiccups". eMedicine. Medscape. Retrieved 2009-04-22.
  2. ^ "Hiccups, Information about Hiccups". Faqs.org. Retrieved 2010-01-12.
  3. ^ "Hiccups: Adverse Reaction to Chemo". Annieappleseedproject.org. 2002-05-15. Retrieved 2010-01-12.
  4. ^ Straus, C.; Vasilakos, K; Wilson, RJ; Oshima, T; Zelter, M; Derenne, JP; Similowski, T; Whitelaw, WA (2003). "A phylogenetic hypothesis for the origin of hiccough". BioEssays. 25 (2): 182–188. doi:10.1002/bies.10224. PMID 12539245. 10.1002/bies.10224. {{cite journal}}: Unknown parameter |month= ignored (help)
  5. ^ Engleman EG, Lankton J, Lankton B (1971). "Granulated sugar as treatment for hiccups in conscious patients". N. Engl. J. Med. 285 (26): 1489. doi:10.1056/NEJM197112232852622. PMID 5122907. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
    Boswell, Wendy (2007-03-25). "MacGyver Tip: Cure hiccups with sugar". The People's Pharmacy (Lifehacker). Retrieved 2009-11-30.
  6. ^ "Teen's hiccups stop after five weeks". ABC News Online. 2007-03-02.
  7. ^ Iwasaki, N (2007). "Hiccup treated by administration of intranasal vinegar". No to Hattatsu. 39 (3): 202–5. PMID 17515134. {{cite journal}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |month= ignored (help)
  8. ^ Schaffer, Amanda (2006-01-10). "A Horrific Case of Hiccups, a Novel Treatment". New York Times. Retrieved 2008-04-24.
  9. ^ "Survivor of 68-Year Hiccup Spell Dies" (Sunrise Edition: 2.B. ed.). Omaha World-Herald. 5 May 1991.
  10. ^ "Florida girl hiccuping again after returning to school". msnbc.msn.com. March 16, 2007.
  11. ^ "Hiccup Girl: "I have Tourette's"". WTSP-TV, tampabays10.com. January 10, 2008.
  12. ^ "'Hiccup girl' among 3 charged in St. Pete homicide". Tampa Bay Online, tbo.com. October 25, 2010.
  13. ^ "So does holding your breath REALLY banish hiccups?". The Sun. May 8, 2008.

Further reading

  • Shubin, Neil (2008). "Fish Out of Water". Natural History: 26–31. {{cite journal}}: Unknown parameter |month= ignored (help) — hiccup related to reflex in fish and amphibians.