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A '''hiccup''' or '''hiccough''' ({{pron-en|ˈhɪkʌp}} {{respell|HICK|up}}) is a contraction of the ball sack( |
A '''hiccup''' or '''hiccough''' ({{pron-en|ˈhɪkʌp}} {{respell|HICK|up}}) is a contraction of the ball sack(Scrotum) that repeats several times per minute. In humans, the abrupt rush of air into the lungs causes the [[vocal cords]] to close, creating a "hic" sound. |
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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".<ref name="emedicine">{{Cite web| url = http://emedicine.medscape.com/article/775746-overview | title = Hiccups | last = Wilkes | first = Garry | date = 2 August 2007 | work = eMedicine | publisher = Medscape | accessdate = 2009-04-22 }}</ref> The hiccup is an [[involuntary action]] involving a [[reflex arc]].<ref name=emedicine/> |
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".<ref name="emedicine">{{Cite web| url = http://emedicine.medscape.com/article/775746-overview | title = Hiccups | last = Wilkes | first = Garry | date = 2 August 2007 | work = eMedicine | publisher = Medscape | accessdate = 2009-04-22 }}</ref> The hiccup is an [[involuntary action]] involving a [[reflex arc]].<ref name=emedicine/> |
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Revision as of 02:16, 10 February 2011
| Hiccup | |
|---|---|
| Specialty | Otorhinolaryngology  |
A hiccup or hiccough (Template:Pron-en HICK-up) is a contraction of the ball sack(Scrotum) that repeats several times per minute. In humans, the abrupt rush of air into the lungs causes the vocal cords 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. Medical treatment is occasionally necessary in cases of chronic hiccups.
Causes
- Allergic Reactions
- nervous system disorders.
- From injury or irritation to the phrenic and vagus nerves.
- Toxic or metabolic disorders affecting the nervous system.
- Chronic, unremitting hiccups are a sign of hyperglycemia .
- After consuming carbonated beverages, alcohol, dry breads, and even spicy foods. [citation needed]
- Prolonged laughter or eating too fast are also known to cause hiccups.
- Chemotherapy—which can include a large 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]
- A Pleural effusion may present in the form of hiccups.
- As a side effect of a medicine
- In dogs, hiccups are generally the result of late stage liver disease
List of medicines which include hiccupping as a side effect
The following is a list of medicines which list "hiccups" as a side effect: Alprax, Alprazolam, Amifostine, Apo-Chlordiazepoxide, Apo-Clorazepate, c;pdd Aprepitant, Ativan, Biaxin (Clarithromycin), Blanex, Bretylate, BretyliumTosylate, Bretylol, CarboprostTromethamine, Centrax, Chlordiazepoxide, Chlorofon-F, ChlorphenesinCarbamate, Clorazepate, ClorazepateDipotassium, Corax, Diastat, Diazemuls, Diazepam, DiazepamIntensol, Dopar, Dormicum, Emend, Ethosuximide, Ethyol, Felbamate, Felbatol, Flexaphen, Gen-Xene, Hemabate, Hypnovel, Kalma, Kinson, Levodopa, Libritabs, Librium, Lobac, LorazepamIntensol, Madopar, Maolate, Medilium, Metaxalone, Mexiletine, Mexitil, Midazolam, MidazolamHydrochloride, Miflex, Mitran, Mus-Lac, Nicorette, NicoretteDS, NicorettePlus, Nicotine, Nicotine chewing gum, Nicotinell-TTS, Nicotrol, Novo-Clopate, Novo-Poxide, Ondansetron, Paraflex, ParafonForteDSC, PargenFortified, Paxipam, Polyflex, ProStep, Ralozam, Reposans-10, Serax, Skelaxin, Skelex, Solium, Tranxene, TranxeneT-Tab, Tranxene-SD, Valium, Valrelease, Versed, Xanax, Zarontin, Zofran.[4]
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.[5] 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
 | This section possibly contains original research. (October 2010) |
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 a finger in the mouth (not in a way that will induce vomiting); massaging the back of the throat (which will stop the irritation in the epiglottis); taking a teaspoon of vinegar; drinking water in an unorthodox manner (leaning over and drinking from the opposite side); drinking a full glass through a paper towel, holding one's breath and altering one's breathing patterns or holding one's breath and drinking water (large amounts at a time) until hiccup stops.
An anecdotal medical approach is to install Xylocaine liniment 3% or gel 2% in the external ear. Somehow this seems to be able to break a vagus nerve triggering reflex through its extensions to the external ear and Tympanus (Ear drum). The effect can be immediate, and also have lasting effect after the Xylocain effect expires after about two hours.[citation needed]
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.[6]
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.[7] 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.[8]
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".[9]
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.[10]
In 2007, Florida teenager Jennifer Mee gained media fame for hiccuping around 50 times per minute for more than five weeks.[11] 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.[12] Known as "Hiccup Girl", she was arrested after a fatal robbery and accused of murder in October of 2010; her attorney suggests that Tourette's Syndrome may be used to defend her case. [13]
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.[14]
In Slavic and Baltic folklore, it is said that hiccups occur when the person experiencing them is being talked about by someone not present.
In Plato's Symposium, Aristophanes has a case of the hiccups and is advised by Eryximachus, a physician, to cure them by holding his breath; or, failing that, by gargling or provoking sneezing.
See also
References
- ^ a b Wilkes, Garry (2 August 2007). "Hiccups". eMedicine. Medscape. Retrieved 2009-04-22.
- ^ "Hiccups, Information about Hiccups". Faqs.org. Retrieved 2010-01-12.
- ^ "Hiccups: Adverse Reaction to Chemo". Annieappleseedproject.org. 2002-05-15. Retrieved 2010-01-12.
- ^ http://www.wrongdiagnosis.com/h/hiccups/medic.htm?ktrack=kcplink
- ^ 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) - ^ 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. - ^ "Teen's hiccups stop after five weeks". ABC News Online. 2007-03-02.
- ^ 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) - ^ Schaffer, Amanda (2006-01-10). "A Horrific Case of Hiccups, a Novel Treatment". New York Times. Retrieved 2008-04-24.
- ^ "Survivor of 68-Year Hiccup Spell Dies" (Sunrise Edition: 2.B. ed.). Omaha World-Herald. 5 May 1991.
- ^ "Florida girl hiccuping again after returning to school". msnbc.msn.com. March 16, 2007.
- ^ "Hiccup Girl: "I have Tourette's"". WTSP-TV, tampabays10.com. January 10, 2008.
- ^ ""Hiccup Girl" Jennifer Mee May Use Tourette's Defense, Says Lawyer". CBS News. October 27, 2010.
- ^ Symons, Jane (May 8, 2008). "So does holding your breath REALLY banish hiccups?". London: The Sun.
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.
External links
- BBC News: Why we hiccup
- Cymet TC (2002). "Retrospective analysis of hiccups in patients at a community hospital from 1995–2000". J Natl Med Assoc. 94 (6): 480–3. PMC 2594386. PMID 12078929.
{{cite journal}}: Unknown parameter|month=ignored (help)