Persistent hiccups: Why do they happen?

The challenge of having hiccups is a peculiar phenomenon. Many text messages and emails have been received at the various portals above in pursuit of the understanding of this problem and many solutions have been put forward. However, it is time perhaps to deal with the issue in a formal essay, hence this week’s effort at bringing some degree of understanding to it. Often, it is a mild affair that lasts only a few minutes. At other times, however, it may last for several hours and even days. When it stays for more than two days, it is described as a chronic condition. In the main, a definite cause cannot usually be attributable to the problem. More seriously sometimes, a troubling disease condition may be responsible.

A hiccup is in part, an irritation of the diaphragm with a spasm of its muscular component which produces the characteristic feature that becomes so concerning when it fails to stop after a few seconds. The diaphragm is a structure that is part muscle and part tendon, which separates the chest from the abdomen. The condition may follow an injury to the nerve that controls breathing or its irritation and these are conditions usually evident when the nature of the body is changing as in a pregnancy or during the development of a tumour like cancer of the pancreas. Other conditions that may cause that part of the body to get inflamed can be seen in a chest infection such as pneumonia. Another lung condition caused by incomplete healing from an inflammatory condition called pleurisy can also be responsible for it.

This is a rare medical condition and it is often very disturbing, even irritating with the capability of interfering very significantly with daily activities. It can also disrupt sleep and even make it rather difficult to eat, drink or sleep. And sometimes, its consequences can be serious with exhaustion, dehydration, confusion and weight loss. When hiccups have become chronic, the diagnosis is usually very straight-forward because it is very obvious to everybody around the sufferer. However, pinning down the underlying cause is often problematic. It takes a lot of time and effort and may not even be successful ultimately. That part of the brain that controls certain unconscious activities such as normal breathing can stop working in a normal pattern as can be seen after a stroke or a head injury. Some diseases that affect the central nervous system can also have the same effect.

Sometimes, this may be a symptom of a disease within the abdomen so that organs like the stomach, the oesophagus, the liver, the pancreas, the gall bladder as well as the small and large intestines may be individually responsible for bringing the condition about. As a result, individual disease conditions like peptic ulcer disease, hepatitis, pancreatitis, cancer of the pancreas and appendicitis can be associated with the malady. Apart from peptic ulcer, the remaining conditions are inflammatory diseases which are thought to bring their effects about by irritating the inner wall of the abdominal cavity, known as the peritoneum.

Sometimes, medications used in the treatment of some other disease conditions may be responsible for bringing it about. Some of these drugs are those used in the treatment of cancer. Besides those are steroids used in the treatment of various other diseases like certain skin and allergic conditions. Sometimes, this problem has been found as a consequence of certain operations performed on the stomach or even after relatively minor procedures like oesophago-gastro-duodenoscopy, OGD, a procedure that involves the insertion of a flexible fibre-optic endoscope through a person’s mouth and down the oesophagus right into the stomach and beyond that into the duodenum. It has also been observed in some people who have undergone brain surgery.

It affects eating by raising the possibility of halting swallowing or chewing even for a fraction of a second thereby making the person prone to choking. Choking on a solid meal can rapidly lead to asphyxia, loss of consciousness and death. In the same way, it interferes with sleep by preventing it; it makes a person to wake up intermittently during the night or not to fall asleep at all in the first place. Such an individual arrives the small hours of the morning actually sleepy, irritated and over time will develop inadequate motivation and waning energy levels. Work output is then adversely affected by causing diminished productivity and raising the risk of injury through accident and death.

Many people would suffer from hiccups at some point in their lifetime and this can occur multiple times. However, the chronic variety is quite rare and no serious research has consequently been devoted to developing a form of treatment for it. However, when it does occur, effort must be geared towards treatment of any identified underlying condition. In addition to that, a treatment plan consisting of adequate fluid intake must be adhered to. Since sleep is liable to be disturbed, arrangements can be made to allow the sufferer the opportunity of sleeping during the daytime, even if it means taking some time off from work to achieve that purpose.

Medications tailored to relax muscles and therefore treat this condition are available and should only be introduced when no obvious cause is evident. These include various drug classes like sedatives, anticonvulsants and tranquillisers. In some really troublesome cases, an operation on the nerve which controls the movement of the diaphragm may become necessary when drug treatment has failed.