Hiccups

Diagnosis

During a physical examination, a healthcare provider may perform a neurological assessment to check the functioning of the nervous system and identify possible causes of persistent hiccups. This examination typically includes checking:

• Balance and coordination

• Muscle strength and tone

• Reflexes

• Sight and sense of touch

If an underlying condition is suspected, further tests may be recommended to determine the cause.

Lab tests
Blood samples may be analyzed to check for health issues such as diabetes, infection, or kidney disease that could be linked to ongoing hiccups.

Imaging tests
Imaging studies can reveal structural or nerve-related issues that might affect the diaphragm or the nerves controlling it. These may include:

• Chest X-ray

• CT scan

• MRI

These tests help detect problems involving the phrenic nerve, which controls the diaphragm, or the vagus nerve, which plays a role in hiccup regulation.

Endoscopic tests
An endoscopy uses a thin, flexible tube with a tiny camera to examine the esophagus and windpipe. This helps identify any abnormalities or irritation that could be contributing to chronic hiccups.

Treatment

Most hiccups resolve naturally without treatment. However, if an underlying medical condition is causing them, treating that condition often stops the hiccups.

For hiccups lasting longer than two days, medical treatments or procedures may be necessary.

Medicines
Medications that may help manage persistent hiccups include:

• Baclofen

• Chlorpromazine

• Metoclopramide

Procedures
If medication does not provide relief, certain procedures may be considered, such as:

• Phrenic nerve block: An injection of anesthetic to block the nerve controlling the diaphragm.

• Vagus nerve stimulation: Surgical implantation of a small, battery-operated device that delivers mild electrical pulses to the vagus nerve. Originally developed for epilepsy treatment, this method has shown success in managing long-term hiccups.

With proper diagnosis and treatment, persistent hiccups can often be effectively managed and prevented from interfering with daily life.