Please suggest a treatment for persistent hiccups.

Hello,

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I have gone through your query as well as the reports (attachment removed to protect patient identity).

• On review, the endoscopic findings seem to be less convincing. The only issue found on the endoscopy is a mild hiatus hernia, a disease of the upper digestive tract. It may also contribute to chronic hiccups. There are a lot more causes of hiccups, including but not limited to, muscular spasm of the diaphragm, irritation of the nerves that run from the neck to the chest, etc. We need to rule out all the causes of hiccups including digestive system abnormalities.

• He is taking Ativan (Lorazepam). So, ask his physician if it is suitable to give him Chlorpromazine. That is very effective in most patients with hiccups.

• When there is a severe episode of hiccups, ask your father in law to sip water from a glass with a napkin on its top. He will have to suck hard through the napkin. Using this technique, the muscles of the diaphragm are used forcibly and the patient gets a relief.

Regards.

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