What are hiccups telling about your health. How long can hiccups last before becoming a concern. What are the potential underlying causes of persistent hiccups. How can you effectively treat hiccups at home. When should you seek medical attention for hiccups.

The Science Behind Hiccups: More Than Just an Annoyance

Hiccups are a common occurrence that most people experience throughout their lives. But what exactly causes this peculiar bodily function? Hiccups happen when the diaphragm and respiratory organs experience a sudden, involuntary spasm. This spasm is usually followed by the closure of the glottis (the slit-like opening between the vocal cords and larynx) and a characteristic sound similar to a cough.

While occasional hiccups are generally harmless, persistent or intractable hiccups can sometimes be a sign of underlying health issues. Understanding the science behind hiccups can help you determine when they might be more than just a minor inconvenience.

Types of Hiccups

• Occasional hiccups: Most common and harmless
• Persistent hiccups: Last more than 48 hours but less than 30 days
• Intractable hiccups: Last more than 30 days

Common Triggers for Hiccups: From Lifestyle to Medical Conditions

Hiccups can be triggered by various factors, ranging from everyday habits to more serious medical conditions. Dr. Timothy Pfanner, assistant professor of medicine at the Texas A&M Health Science Center College of Medicine, explains that “Anything that causes your stomach to become distended can cause hiccups.”

Lifestyle Factors

• Smoking: Constant swallowing of air can lead to hiccups
• Alcohol consumption: Irritates the esophagus and may trigger acid reflux
• Overeating: Causes stomach distension

Medical Conditions

• Acid reflux disease: A common culprit behind hiccups
• Ear infections: Irritation of the tympanic membrane can result in hiccups

Are certain people more prone to hiccups? Indeed, smokers and those who consume large amounts of alcohol tend to experience hiccups more frequently due to their habits’ effects on the digestive system and respiratory organs.

When Hiccups Become a Concern: Recognizing the Warning Signs

While most hiccups are harmless, there are instances where they can signal more serious health issues. Dr. Pfanner advises, “You should seek advice from your health care provider if your hiccups progress from happening every once in a while to becoming persistent or intractable.”

Hiccups lasting more than 48 hours should be taken seriously, as they could potentially indicate underlying health complications. But what specific conditions might persistent or intractable hiccups be associated with?

Potential Underlying Conditions

1. Cancer: Brain, lymph nodes, or stomach
2. Stroke
3. Nerve damage
4. Tumors in the neck or goiter
5. Heart muscle damage or pending heart attack
6. Inflammation around the heart

How can hiccups be related to such serious conditions? In many cases, the connection is not entirely clear. However, the persistence of hiccups can sometimes be a symptom of these underlying issues, making it crucial to consult a healthcare provider if hiccups last for an extended period.

The Link Between Hiccups and Acid Reflux: A Common Connection

Acid reflux disease is frequently associated with hiccups. This condition occurs when stomach acid flows back into the esophagus, causing irritation and potentially triggering hiccups. Understanding this connection can help in managing both conditions effectively.

How Acid Reflux Causes Hiccups

• Irritation of the esophagus
• Distension of the stomach
• Inflammation of the diaphragm

Can treating acid reflux help prevent hiccups? In many cases, yes. Managing acid reflux through lifestyle changes and medication can often reduce the frequency of hiccups in individuals with this condition.

Home Remedies for Hiccups: Quick and Easy Solutions

For occasional hiccups, several home remedies can provide quick relief. Dr. Pfanner recommends various methods to ease hiccup woes:

• Hold your breath (for a short period of time)
• Breathe into a paper bag
• Put a cotton swab in the back of the throat to induce a gag reflex
• Gargle with ice water
• Swallow granulated sugar
• Bite a lemon
• Pull your knees to the chest to compress it
• Press lightly on the eyeballs to activate the vagus nerve

Why do these remedies work? Many of these techniques either interrupt the hiccup cycle or stimulate the vagus nerve, which can help stop the diaphragm spasms causing hiccups.

Medical Interventions for Persistent Hiccups: When Home Remedies Aren’t Enough

While home remedies are often effective for occasional hiccups, persistent or intractable hiccups may require medical intervention. Healthcare providers may consider various treatment options depending on the underlying cause and severity of the hiccups.

Potential Medical Treatments

• Medications to reduce stomach acid
• Muscle relaxants
• Medications that affect nerve impulses
• In rare cases, surgical interventions

How do doctors determine the best treatment for persistent hiccups? They typically start by identifying any underlying conditions through a thorough examination and possibly diagnostic tests. The treatment plan is then tailored to address both the hiccups and any associated medical issues.

Hiccups in Special Populations: Cancer Patients and Others

Hiccups can be particularly troublesome for certain groups of people, such as cancer patients. In these cases, hiccups may be a side effect of the disease itself or its treatment.

Causes of Hiccups in Cancer Patients

• Tumor growth affecting the diaphragm or nerves
• Side effects of chemotherapy or radiation therapy
• Medications used in cancer treatment

How are hiccups managed in cancer patients? Treatment often involves addressing the underlying cause while providing symptomatic relief. This may include adjusting cancer treatments, prescribing specific medications for hiccups, or using non-pharmacological approaches.

Prevention Strategies: Minimizing the Risk of Hiccups

While it’s not always possible to prevent hiccups, certain lifestyle changes can help reduce their frequency, especially for those prone to recurrent hiccups.

Tips for Preventing Hiccups

• Eat slowly and avoid overeating
• Limit carbonated beverages
• Avoid smoking
• Moderate alcohol consumption
• Practice stress-reduction techniques
• Maintain good posture while eating

Can dietary changes really make a difference in preventing hiccups? For many people, yes. Paying attention to eating habits and avoiding triggers can significantly reduce the occurrence of hiccups.

The Psychological Impact of Chronic Hiccups: Beyond Physical Discomfort

While occasional hiccups are usually just a minor annoyance, chronic or intractable hiccups can have a significant impact on a person’s quality of life. The persistent nature of these hiccups can lead to various psychological and social challenges.

Potential Psychological Effects

• Sleep disturbances
• Difficulty concentrating
• Social embarrassment
• Anxiety and depression
• Impaired work performance

How can individuals cope with the psychological impact of chronic hiccups? Seeking support from healthcare providers, including mental health professionals, can be crucial. Developing coping strategies and potentially joining support groups can also help manage the emotional toll of persistent hiccups.

Hiccups in Children: When to Worry and How to Help

Hiccups are common in children, especially infants. While they’re usually harmless, understanding when hiccups might be a cause for concern in children is important for parents and caregivers.

Normal vs. Concerning Hiccups in Children

• Normal: Occasional hiccups, especially after feeding in infants
• Concerning: Frequent hiccups that interfere with feeding or sleeping
• Red flags: Hiccups accompanied by other symptoms like vomiting or difficulty breathing

How can parents help children with hiccups? For occasional hiccups, similar remedies used for adults can be applied, such as sipping water or changing positions. However, it’s crucial to consult a pediatrician if hiccups persist or cause distress.

The Future of Hiccup Research: Emerging Treatments and Understanding

As medical science advances, researchers continue to explore new treatments and gain a deeper understanding of the mechanisms behind hiccups. This ongoing research may lead to more effective treatments, especially for those suffering from chronic or intractable hiccups.

Areas of Current Research

• Neurological basis of hiccups
• Novel pharmacological treatments
• Non-invasive stimulation techniques
• Genetic factors influencing hiccup susceptibility

What potential breakthroughs might we see in hiccup treatment? While it’s difficult to predict specific outcomes, advancements in neuroscience and pharmacology hold promise for developing more targeted and effective treatments for persistent hiccups.

In conclusion, while hiccups are often a benign and temporary inconvenience, they can sometimes signal more serious health issues. Understanding the causes, recognizing when to seek medical attention, and knowing effective remedies can help manage this common bodily function. Whether you’re dealing with occasional hiccups or more persistent episodes, staying informed and attentive to your body’s signals is key to maintaining overall health and well-being.

What are my hiccups telling me? — ScienceDaily

Most of us can remember the Grey’s Anatomy episode where Meredith’s step-mom checks into the hospital for a case of hiccups that won’t go away. The diagnosis wasn’t pretty and it may have caused viewers to panic about their health every time they hiccupped.

Everyone gets hiccups in their life. The majority of the time they are completely harmless and are more of an irritant than a symptom of an underlying condition, but, if you experience hiccups that last more than 48 hours this could potentially signal serious health complications.

“You should seek advice from your health care provider if your hiccups progress from happening every once in a while to becoming persistent or intractable,” said Timothy Pfanner, M.D., assistant professor of medicine at the Texas A&M Health Science Center College of Medicine.

Hiccups happen when the diaphragm and respiratory organs experience a sudden, involuntary spasm. This spasm is usually followed by the closure of the glottis (the slit-like opening between the vocal cords and larynx) and a characteristic sound like that of a cough. Persistent hiccups are hiccups that last more than 48 hours but less than 30 days while intractable hiccups are classified as hiccups that last more than 30 days.

Occasional hiccups are mostly harmless

Pfanner added hiccups are normally seen in smokers and people who consume large amounts of alcohol. “Anything that causes your stomach to become distended can cause hiccups,” he said. “Smokers are prone because they are constantly swallowing air. Drinking alcohol can induce hiccups because it irritates the esophagus and may result in a flare-up of acid reflux.”

Acid reflux disease is a common culprit behind hiccups, and surprisingly, ear infections may cause them as well. When the tympanic membrane (the membrane in the ear that vibrates in response to sound waves) becomes irritated this can result in hiccups.

“This membrane can become irritated due to infection — especially if a hair makes its way into the ear and sits next to the membrane,” Pfanner said. “This is a very common cause for hiccups that don’t subside.”

If your hiccups last more than two days talk to your physician

“Generally, when someone is diagnosed with intractable hiccups, we start worrying that something more serious is going on internally,” Pfanner said. “However, since intractable hiccups are also a symptom of acid reflux disease it’s always important to discuss your symptoms with your physician.”

Cancer is never a word thrown around lightly, and according to Pfanner, intractable hiccups could be a symptom of certain cancers. “Sometimes we see intractable hiccups in patients diagnosed with cancers of the brain, lymph nodes or stomach cancer,” he said. “They can also indicate stroke. It’s still unclear why many of these incidents occur.”

Since hiccups convulse the muscles that control the diaphragm, patients who experience persistent or intractable hiccups can suffer nerve damage in the nerve that controls these muscles. “This may also point to a tumor in the neck or goiter,” Pfanner said.

Pesky hiccups that refuse to subside may even be symptoms of heart muscle damage or a heart attack. “Persistent or intractable hiccups can indicate inflammation around the heart or a pending heart attack,” Pfanner said. “That’s why we always want patients who are experiencing these type of hiccups to immediately consult their health care provider.”

Don’t panic

While hiccups can be tell-tale signs of serious health complications, common hiccups are more of a nuisance than a health risk.

To quickly ease your occasional hiccup woes, Pfanner recommends a few different methods. “You can hold your breath (for a short period of time) or breathe into a bag to ease hiccups,” he said. “Other methods include putting a cotton swab in the back of the throat to induce a gag reflex, gargling with ice water, swallowing granulated sugar, biting a lemon and pulling your knees to the chest to compress it. Pressing lightly on the eyeballs will also activate your vagus nerve and result in a reflex that hinders the spasm of hiccups. “

Story Source:

Materials provided by Texas A&M University. Original written by Lauren Thompson. Note: Content may be edited for style and length.

Hiccups and Heartburn

Cancer and its treatment can sometimes cause hiccups or heartburn. It’s important to know that other non-cancer problems and medicines can also cause them or increase the risk for them.

Hiccups

Hiccups (or hiccoughs) are spasms that affect a muscle between your lungs and stomach that is used when you breathe, called the diaphragm. A hiccup happens when the diaphragm is irritated and suddenly contracts between normal breaths.

Hiccups can be caused by irritation of the nerve that controls the diaphragm which can happen for different reasons, such as:

• Certain chemotherapy drugs used to treat cancer
• Other drugs that may or may not be taken for cancer-related problems, including steroids, anti-nausea medicines, and antibiotics
• Nerve or brain injuries
• Fluid in the lungs or near the heart
• Bloating and gas in the stomach area
• Low levels of certain electrolytes (blood chemistries) such as sodium, calcium, and potassium
• High blood sugar level
• Problems in the esophagus (the swallowing tube that goes from the throat to the stomach)
• Tumors or blockages in the esophagus, lungs, liver, pancreas, kidney, or colon
• Changes in temperature
• Stress and excitement
• Drinking certain types of liquids or eating certain foods.

In people with cancer, certain chemotherapy drugs can have hiccups as a side effect,

Hiccups are usually temporary and stop within minutes to hours. If hiccups last more than 2 days, they can be considered persistent; they are considered intractable if they last more than a month. Hiccups that last a long time can be a sign of a serious problem.

Managing hiccups

There is a medication that can be prescribed to help manage hiccups if needed. But usually they are very temporary and stop without any kind of treatment. There’s not a lot of research about ways to manage hiccups other than using medication your doctor prescribes, but here are some things people have found useful.

• Breathe slowly and deeply into a paper bag for 10 breaths at a time.
• Drink water slowly.
• Bear down gently as if having a bowel movement (called the Valsalva maneuver).
• Hold a teaspoon of sugar in your mouth and then swallow.
• Avoid forcing yourself to eat.

Heartburn

Heartburn is a burning sensation in the throat, chest, or upper abdominal (belly) area that often worsens after eating or when you lay down. Some people might notice it more in the evening or after going to bed at night. It’s sometimes called indigestion or acid reflux. It’s a common problem from having too much acid in the stomach that forces contents of the stomach up into the esophagus.

If heartburn happens frequently it is often called or diagnosed as gastroesophageal reflux disease (GERD). Sometimes, several years of heartburn can lead to ulcers or Barrett’s esophagus which is linked to an increased risk of cancer of the esophagus.

Causes of heartburn include:

• Increased production of stomach acid
• Drinking too much alcohol, caffeine, acidic juices, or carbonated beverages
• Treatments for cancer, such as certain chemotherapy drugs and radiation to the chest or upper abdomen
• Taking certain medications, such as aspirin and anti-inflammatories (Advil, Motrin, Aleve, ibuprofen)
• Eating high-fat foods
• Smoking
• Being obese
• Blockages or changes in structure of the esophagus due to narrowing or tumor growth

Managing heartburn

Your health care team may prescribe an over-the-counter antacid to help with heartburn. There are other medications that might be prescribed short-term. Talk with your health care team if you have heartburn, and if any recommended or prescribed medications are not working.

• Avoid tobacco
• Limit caffeine and alcohol
• If you are overweight, losing weight may help relieve symptoms
• Eat small rather than big meals
• Avoid eating less than 2 to 3 hours before bedtime

What caregivers can do for hiccups and heartburn

• Watch the patient to be sure that they’re able to drink enough liquid.
• Elevate the head of the bed for comfort.
• If medicine is given, watch for dizziness. The patient may need help getting up or walking.

Call the health care team if the patient

• Has nausea that isn’t managed even after taking medication
• Has trouble breathing, eating, or swallowing
• Has heartburn and develops a puffy or bloated stomach or constipation

Hiccups, dyspepsia and reflux

Understanding hiccups

Hiccups are sudden, involuntary contractions of the muscles in the chest that are involved in breathing including the diaphragm. When we hiccup air rushes into the lungs against closed vocal cords, making the characteristic hic sound. 

Most hiccups are harmless and stop within minutes or hours. An episode of hiccups might last up to 48 hours and not be a sign of anything serious. Hiccups that last between 48 hours and 1 month are referred to as persistent hiccups. Intractable hiccups are hiccups that last for more than 1 month.  

Almost 1 in 10 people with terminal cancer will have hiccups that are distressing or have a significant impact on their quality of life. Persistent and intractable hiccups also occur in people with non-cancer terminal illness, including stroke, Parkinson’s and MS.

Persistent, or intractable hiccups can be very frustrating and distressing. They can disrupt the person’s normal life by interfering with talking, eating, drinking and sleeping. They can also affect their mood and make their pain feel worse.

Serious complications of hiccups include:

• malnutrition
• fatigue
• dehydration
• disrupted sleep
• stress, anxiety or depression
• decreased quality of life.

 What causes hiccups?

There are many different causes of hiccups and someone with a terminal illness might have more than one risk factor. Causes include, but are not limited to:

• distention (stretching) of the stomach – can be caused by eating or drinking large volumes
• gastro-oesophageal reflux – stomach acid going into the oesophagus (gullet)
• altered blood levels of calcium, magnesium, sodium or potassium
• infection
• damage to the nerve that supplies the diaphragm (the phrenic nerve) – this could be caused by stroke, compression by a tumour or shingles
• liver disease, including tumours
• alcohol or smoking
• medicines including opioids, benzodiazepines and steroids
• stress and anxiety. 

Distension and gastro-oesophageal reflux are the most common causes of hiccups.

Medicines rarely causes hiccups, so don’t stop someone taking their medicines unless you’re advised to by their doctor or specialist nurse.  

What can I do to help someone with hiccups?

If there are no underlying causes for the hiccups, the most important thing to do is to help the person to avoid any triggers such as overeating or drinking alcohol. 

There are some practical things you can try to stop an episode of hiccups. There isn’t much evidence to show that they work but lots of people find that some of these techniques work well for them. Different techniques might work for different people. You can encourage someone to try any of the following:

• gargling cold water or swallowing crushed ice
• breathing into a paper bag
• interrupting normal breathing – for example holding their breath 
• drinking water from the far side of a cup
• pulling on their tongue
• drinking peppermint water
• swallowing a teaspoon of dry granulated sugar
• compressing the diaphragm by pulling the keens up to their chest
• swallowing water while closing their nose
• having a sudden fright.

Some people find complementary therapies such as acupuncture and hypnosis useful.

When should I ask for help with managing hiccups?

If hiccups last for more than 48 hours, or if you’re concerned about what’s causing them or the effects that they’re having, speak to the person’s GP or specialist. They can help assess and treat any reversible causes.

If no cause is found, they may be prescribed peppermint water or proton pump inhibitors (PPIs) such as omeprazole. 

Treatments should be reviewed after three days and if there’s no improvement a specialist palliative care professional can assess and prescribe other medicines, including dopamine antagonists. Peppermint water should not be used if the person is taking dopamine antagonists as they work in opposite ways. 

What are dyspepsia and reflux?

Dyspepsia (indigestion) isn’t one disease but describes a range of symptoms that affect the upper gastrointestinal tract (the stomach and the oesophagus). The symptoms are:

• pain or discomfort in the upper part of the abdomen (tummy)
• heartburn
• reflux
• nausea or vomiting
• feeling full quickly after eating
• bloating
• belching.

Dyspepsia can be very uncomfortable and have a significant negative effect on someone’s quality of life. 

Reflux (stomach acid going backwards into the oesophagus) can occur as part of dyspepsia or might be a symptom on its own. 

What causes dyspepsia?

Dyspepsia can affect anyone at any age. People with a terminal illness may be more likely to have dyspepsia.

Dyspepsia might not have any obvious cause. This is called primary or functional dyspepsia.

Secondary dyspepsia is when the symptoms occur as a result of an underlying condition, including:

• gastro-oesophageal reflux disease (GORD)
• peptic ulcer (an ulcer in the stomach or small intestine)
• inflammatory conditions such as Crohn’s disease
• cancer in the stomach or oesophagus
• infection with Helicobacter pylori (H. pylori) bacteria
• lymphoma affecting the stomach
• the stomach muscles not working properly (gastroparesis) caused by diabetes, renal failure or hypothyroidism
• medicines causing gastroparesis, including opioids, iron supplements, antibiotics and steroids.

What can I do to help someone with dyspepsia?

If you suspect someone has dyspepsia, speak to their GP or specialist nurse who can arrange further assessment to look for underlying causes and prescribe treatment. They might prescribe proton pump inhibitors (PPIs) such as omeprazole or h3 antagonists such as ranitidine if someone has pain or heartburn. Prokinetics such as metoclopramide help the stomach to work faster so can be helpful with symptoms of bloating and feeling full.

If there are no underlying causes (functional dyspepsia), the person might not need any treatment. There are things you can suggest to help them manage their symptoms. They could:

• eat smaller portions more frequently to avoid feeling full early
• sit up during meals
• raise the head of the bed or use pillows to be propped up in bed
• avoid foods that make their symptoms worse such as fatty foods and spicy foods
• avoid eating immediately before bed.

Useful resources

NICE Clinical Knowledge Summary: Hiccups  

Scottish Palliative Care Guidelines: Hiccups  

Palliative Care Adult Network Guidelines Plus: Gastro-oesophageal reflux and dyspepsia  

Palliative Care Adult Network Guidelines Plus: Hiccups  

What’s up with hiccups? – Harvard Health

Drug Therapy of Hiccups

Full update March 2017
Hiccups, the involuntary contraction of the diaphragm, are common.1 Hiccups are caused by anything that stimulates the hiccup reflex arc. Acute hiccup attacks last less than 48 hours, while persistent hiccups last longer. Intractable hiccups are defined as an attack lasting more than one month.1,2 Although the incidence and prevalence are not known, one retrospective chart review found that of 100,000 consecutive patient visits to a hospital, 55 were for hiccups.3 Persistent hiccups may be a sign of an underlying problem. Before initiating medications to treat hiccups, correctable causes for hiccups should be investigated. Examples of underlying causes of hiccups include CNS abnormalities (e.g., meningitis, intracranial tumors, etc), gastrointestinal issues (e.g., peptic ulcer, gastroesophageal reflux disease, abdominal abscess, etc), thoracic diseases (e.g., pneumonia, asthma, etc), abnormalities of the ears-nose-throat (e.g., rhinitis, otitis media, etc), toxic exposures or metabolic derangements (e.g., alcohol, electrolyte abnormalities, etc), psychogenic causes (e.g., stress, fear, excitement, etc), post-surgical causes (e.g., anesthetic agents, pharyngeal intubation, etc), and medications (e.g., corticosteroids, opioids, benzodiazepines, etc).1,2,4 Pharmacological therapy should only be used if persistent hiccups are causing distress. Although home remedies such as breath holding, swallowing a spoonful of sugar, or drinking pickle juice are sometimes tried, the evidence to support these methods is scant. The table below summarizes drugs which have been used in the treatment of hiccups. Most of the treatments can be used for seven to ten days but can be discontinued one or two days after hiccups cease. 4 If hiccups continue despite treatment, it is reasonable to consider a different medication.4 Of note, two different recent systematic reviews of the literature found no high quality data on which to base treatment recommendations.1,5

Abbreviations: GERD=gastroesophageal reflux disease; IM=intramuscular; IV=intravenous; PO=by mouth

*Most of the drugs below are used off-label for the treatment of hiccups. Dosing regimens will vary depending on the source*

Drug

Example Regimen(s)1,2,4

Comments
Antidopaminergic agents

Chlorpromazine

25 mg to 50 mg PO three to four times a day4,13

If symptoms persist after two to three days: 25 mg to 50 mg IM x113

If IM dose fails, try 25 mg to 50 mg IV administered as a slow IV infusion (max 1 mg/min) with the drug diluted in 500 to 1000 mL saline.13

Chlorpromazine is the only medication approved by the FDA for the treatment of intractable hiccups (it is not approved for this indication by Health Canada), but there are only observational data to support the use. 1,6

May reverse the abnormal depolarization in the hiccup reflex arc.2

Concern about QTc prolongation, hypotension (especially with IV doses), others.4

Concern about movement disorders with prolonged use.12

Monitor blood pressure with IV administration.13

Haloperidol

2 mg to 5 mg IM,13,14 then
1 mg to 4 mg PO three times daily14

May be a safer alternative to IV chlorpromazine (less hypotension).13

Limited information (case reports, case series) to support use.10

Concern about QTc prolongation.4

Concern about movement disorders with prolonged use.12

Metoclopramide

10 mg PO or 5 mg to 10 mg IV/IM three to four times daily

Lower quality, small, randomized, controlled trials and case series available to support the use.1,4

May reduce the intensity of esophageal contractions.2

Concern about QTc prolongation.9

Concern about movement disorders with prolonged use.1

Theoretically, domperidone (Canada only) should be effective, but there are no studies supporting its use. 1

GABA analogs

Baclofen

5 mg to 10 mg PO three times a day

Some experts consider baclofen a first-line therapy because during long-term therapy it’s less likely to cause adverse effects compared with antidopaminergic agents.1,2

Lower quality, small, randomized, controlled trials available to support the use.1

May reverse the abnormal depolarization in the hiccup reflex arc or affect GABA transmission.2

May cause drowsiness and dizziness.4

Gabapentin

900 mg to 1200 mg/day; in divided doses

Some experts consider gabapentin a first-line therapy because during long-term therapy it’s less likely to cause adverse effects compared with antidopaminergic agents.1

Only case series and case reports available to support the use.1

May enhance GABA transmission centrally.1

May cause drowsiness and dizziness.4

Antiepileptic agents

Carbamazepine

100 mg to 300 mg PO up to four times a day

Only case series and case reports available to support the use. 1

May inhibit excitatory sodium channels on central neurons.1

May cause dizziness, nausea, vomiting.12

Phenytoin

100 mg PO three times daily

Use based on expert opinion; limited evidence to support the use.1

May inhibit excitatory sodium channels on central neurons.1

May cause dizziness, drowsiness.12

Valproate

Dose titration up to 20 mg/kg/day

Only case series and case reports available to support the use.1

May enhance GABA transmission centrally.1,2

May cause dizziness, drowsiness, nausea, vomiting.12

Miscellaneous Agents2

Nifedipine

20 mg to 60 mg/day PO

Only case series and case reports available to support the use.1

May reverse the abnormal depolarization in the hiccup reflex arc.2

Amitriptyline

25 mg to 100 mg/day PO

Use based on expert opinion; limited evidence to support the use.1

Proton pump inhibitors (omeprazole, others)

GERD treatment doses11

One large case series of proton pump inhibitors showed benefit in patients with hiccups related to gastroesophageal reflux disease. However, there was no control group and it is not known if the hiccups were due to GERD or if hiccups were the cause of GERD.1

Other medications which have been tried for hiccups include midazolam, clonazepam, pramipexole, olanzapine, amantadine, sertraline, risperidone, methylphenidate, viscous lidocaine and methylcellulose.7,8

Treatment, causes, and how to cope

Hiccups lasting longer than 48 hours are defined as chronic hiccups.

Chronic hiccups are a rare medical occurrence that can interrupt daily life and cause health problems. Sleeping and eating adjustments are often needed to cope with the condition.

The cause is not always apparent, but chronic hiccups are often related to an underlying medical issue.

In this article, we look at what could cause chronic hiccups, along with steps that can be taken to treat them.

A hiccup is caused by an uncontrolled spasm of the diaphragm, followed by the vocal cords closing quickly and making a distinctive sound.

There is no clear cause of hiccups, but excitement, stress, or consuming specific food or drinks, such as fizzy soda, may trigger them.

Hiccups usually go away within a few minutes, but occasionally they may affect someone for hours. Hiccups lasting longer than 48 hours are classed as chronic and considered a serious medical condition.

In addition to being incredibly irritating, chronic hiccups often disrupt sleep and can make it difficult to eat or drink. They can sometimes have serious consequences, such as exhaustion, dehydration, and weight loss.

Although chronic hiccups have no clear cause, medication or a health condition could be to blame. While chronic hiccups are easy to diagnose, finding a possible underlying cause can take much longer and may not always be possible.

A hiccup is partly a spasm of the diaphragm, so conditions that irritate or inflame this part of the body, such as pneumonia or pleurisy, could be a factor in chronic hiccups.

The nerve that controls breathing may be damaged or irritated. Pressure could also have been placed on a nerve elsewhere in the body due to a change in the body, such as pregnancy or a tumor growing.

The part of the brain that controls unconscious actions, such as breathing, can stop working properly, perhaps after a stroke or head injury. Diseases affecting the central nervous system, such as multiple sclerosis, could have the same effect.

Chronic hiccuping may be a symptom of a gastrointestinal disease, which affects the stomach, gullet, large and small intestine, liver, gallbladder, and pancreas. Some examples include:

There have been some reports of people developing chronic hiccups after undergoing brain surgery and gastrointestinal procedures, such as gastroscopy. These reports suggest that medical interventions on parts of the body associated with hiccups could trigger the condition.

Some medications are linked to chronic hiccups. These include drugs used in combination, such as chemotherapy and corticosteroids, which are used to treat some conditions, including severe allergies and skin diseases.

As chronic hiccups are rare, there has been limited research into effective treatment and care.

Medication is usually effective in treating chronic hiccups, but further investigation into the underlying cause is necessary to determine how to prevent the hiccups from returning.

The United States Food and Drug Administration (FDA) approved chlorpromazine to treat chronic hiccups. Tranquilizers, muscle relaxants, and sedatives can also be used to disrupt the spasm creating the hiccup.

Sometimes, medication may not work, and surgery on the nerve that controls diaphragm movement may be necessary.

Share on PinterestThe disruption to sleep caused by chronic hiccups may lead to exhaustion.

Chronic hiccups can have a serious impact on daily life. Living with the condition can be very stressful, causing anxiety and disrupting normal routines. As a result, trying to maintain good mental and physical health is essential.

Explaining the impact of the condition to colleagues, friends, and family, as well as seeking their support, can help someone cope with stress.

Chronic hiccups can make it difficult to sleep or cause someone to wake up during the night. This lack of sleep can result in a lack of energy during the day, causing exhaustion if the condition persists for a long time.

Getting plenty of rest and taking a nap during the day if possible can help prevent exhaustion. Regular exercise is important for a healthful lifestyle, but people should avoid activities that could be too tiring.

Hiccuping can make it difficult to eat and drink, which can result in a lack of energy, dehydration, malnutrition, or weight loss. It may be easier to eat smaller amounts of food throughout the day rather than eating larger meals at regular times.

Hot, spicy foods and fizzy drinks can make hiccups worse, so people should avoid them. Keeping a bottle of water on hand and drinking small amounts regularly throughout the day can help ensure a person stays hydrated.

People should also be aware of the possibility of choking on food or drink. Taking small mouthfuls and chewing food thoroughly before swallowing can help prevent this from happening.

Share on PinterestA nasty taste in the mouth or pain when swallowing may be a sign of gastroesophageal reflux.

If chronic hiccups last for a long time, they can affect overall health.

One study into chronic hiccups found that hiccups often occur when people are hospitalized and given a general anesthetic before surgery.

When this happens, there is worry that loss of sleep and difficulty eating, which the condition causes, could slow the recovery process.

Chronic hiccups can cause gastroesophageal reflux, where stomach acid leaks up into the food pipe. This can lead to the following symptoms:

Medications for gastroesophageal reflux include antacids, a type of over-the-counter medication that helps to reduce the amount of stomach acid produced. Stronger prescription medications, such as proton pump inhibitors (PPI), are also available.

Using an extra pillow to raise the head in bed and avoiding food and drinks that trigger heartburn may also help.

Chronic hiccups are unpleasant and can have a significant impact on a person’s quality of life.

It is crucial to get plenty of rest, eat and drink small amounts regularly and be aware of possible complications to help cope with the condition. Fortunately, medication is usually effective in treating chronic hiccups.

It can be difficult to determine the underlying cause of the condition. Doctors should perform a range of physical examinations and tests to diagnose any health condition that could be responsible for chronic hiccups to prevent them from happening again.

Read the article in Spanish.

Here’s What to Do When Your Baby Has the Hiccups – Health Essentials from Cleveland Clinic

Your brand new baby has a serious case of hiccups. And while they’re a little bit adorable, you’re also wondering if there’s any cause for concern.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“Baby hiccups are very common, and they aren’t normally a problem,” says pediatrician Kylie Liermann, DO. “In fact, they usually bother parents more than the baby.”

To calm your new parent nerves a little, Dr. Liermann explains what causes baby hiccups and how to get rid of them so you (and baby) can breathe easier.

Why do babies get hiccups?

Hiccups are most likely caused by irritation to the diaphragm, the muscle at the base of the lungs. Sometimes, that muscle starts to spasm or cramp. That causes the vocal cords to clamp shut, creating that distinctive “hic!” sound you know and dread.

Developing babies can get hiccups even before they’re born, and many pregnant women have felt the telltale flutters in their bellies.

Hiccups are especially common in newborns and infants. “We don’t know exactly why, but hiccups may be caused by increased gas in the stomach,” Dr. Liermann says. “If babies overfeed or gulp air during eating, that could cause the stomach to expand and rub against the diaphragm, generating those hiccups.”

Hiccups and gastroesophageal reflux

Usually, hiccups don’t bother babies. But sometimes, hiccups are a sign of gastroesophageal reflux (GERD). Reflux causes stomach acid to back up into the baby’s esophagus.

If your baby has GERD, hiccups won’t be the only symptom, Dr. Liermann says. Infants with reflux also have signs such as:

• Coughing.
• Spitting up.
• Irritability and crying.
• Arching the back, especially during or after a feeding.

If you notice these signs, talk to your doctor about whether your baby might have reflux and how to manage it.

How to stop baby hiccups

If your baby doesn’t have reflux symptoms, don’t stress over hiccups, Dr. Liermann says. But if those little “hics!” are bothering you, there are some things you can try.

Change feeding positions

Try feeding your little one in a more upright position, Dr. Liermann suggests. Propping your baby up on a pillow so they aren’t lying flat may help them take in less air at mealtimes.

Burp more frequently

“Burping usually helps with hiccups,” Dr. Liermann says. Burp your baby during feeding to prevent hiccups from striking. Try taking a burp break after 2 or 3 ounces.

If you’re nursing, burp your baby before you switch sides. If your nugget already has hiccups, you can try to relieve them with some gentle pats on the back.

Reach for the binky

Pacifiers can sometimes stop hiccups in their tracks. “The sucking motion can help relax the diaphragm,” Dr. Liermann explains.

Give gripe water

Gripe water is an over-the-counter blend of herbs marketed as a treatment for colic and tummy troubles. Some parents find it helps with hiccups, too.

But above all, says Dr. Liermann: Don’t fret. “Hiccups stop on their own and don’t cause discomfort to babies. So don’t feel you need to treat them,” she says.

Gastroesophageal Reflux (for Parents) – Cook Children’s

At one time or another, many adults have had heartburn (an uncomfortable feeling
in the chest) after eating a big meal or spicy foods.

When these symptoms happen often or aren’t tied to certain ingredients, they
might be due to gastroesophageal reflux (GER), also called reflux.

But GER isn’t just a problem for adults — kids can have it, too, even
babies. In infants, it can cause vomiting and fussiness after feeding. And in older
kids and teens, GER can lead to heartburn, and stomach and chest discomfort.

Most kids outgrow GER over time but some will need medical treatment. Reflux
that causes problems like poor growth, vomiting, or damage to the esophagus is called
GERD (gastroesophageal reflux disease). GERD is more serious than
GER and is usually treated with medicine.

About GER

The burping, heartburn, and spitting up associated with GER are the result of acidic
stomach contents moving backward into the esophagus. This can happen because the muscle
that connects the esophagus to the stomach (the esophageal sphincter) relaxes at the
wrong time or doesn’t properly close.

Many people have reflux regularly and it’s not usually a cause for concern. But
with GER, reflux happens more often and causes noticeable discomfort. After nearly
all meals, GER causes heartburn (also known as acid indigestion), which feels like
a burning sensation in the chest, neck, and throat.

In babies with GER, breast milk or formula regularly refluxes into the esophagus,
and sometimes out of the mouth. Sometimes babies regurgitate forcefully or have “wet
burps. ” Most babies outgrow GER between the time they are 1 or 2 years old.

But in some cases, GER symptoms last. Kids with developmental or neurological conditions,
such as cerebral palsy,
are more at risk for GER and can have more severe, lasting symptoms.

Symptoms of GER

Heartburn is the most common symptom of GER in kids and teens. It can last up to
2 hours and tends to be worse after meals. In babies and young children, GER can lead
to problems during and after feeding, including:

• frequent regurgitation or vomiting, especially after meals
• choking or wheezing (if the contents of the reflux get into the windpipe and lungs)
• wet burps or wet hiccups
• spitting up that continues beyond a child’s first birthday (when it stops
  for most babies)
• irritability or inconsolable crying after eating
• refusing to eat or eating only small amounts
• failure to gain weight

Some of these symptoms may become worse if a baby lies down or is placed in a car
seat after a meal.

90,000 What is reflux – esophagitis? / Professional articles / Family clinic “Tanar”

Esophagitis is a common disease that affects the digestive system

If you suffer from insufficiency of the cardiac sphincter (this is a muscular valve that closes the gap between the stomach and the esophagus), then digestive juices and part of the food enter the esophagus. In the normal position, the sphincter should be tightly closed, it should only open when food or water enters the stomach from the esophagus.That is, in the event of a sphincter failure, it is constantly open, and the contents of the stomach, in which hydrochloric acid is present, can be freely thrown from the esophagus into the stomach.

If hydrochloric acid constantly acts on the lining of the esophagus, it will become inflamed. This disease is called reflux – esophagitis.

Symptoms of reflux esophagitis.

Symptoms of reflux – esophagitis: heartburn that worsens when you bend forward or when lying down.

Also, the symptoms of reflux – esophagitis are: hiccups, regurgitation, belching with air or food, pain behind the breastbone or “under the spoon”, which radiates to the heart, left shoulder and may resemble an attack of angina pectoris.

To identify the cause of the pain, it is worth visiting the clinic.

The diagnosis of reflux esophagitis can be confirmed using special research methods: fluoroscopy, esophagogastroscopy, esophagomanometry.

What causes cardiac sphincter insufficiency?

If you are pushing hard, love to overeat, lift heavy weights, abuse alcohol, or maybe just lean forward a lot.

Also, reflux esophagitis disease can appear against a background of diseases: hiatal hernia, chronic gastritis, stomach ulcer, duodenal ulcer, cholelithiasis, obesity.

To prescribe the correct treatment, you need to recognize the cause of the disease.

If you have cardiac sphincter insufficiency, do not lift weights more than five to six kilograms; do not wear tight belts and bandages; do not do physical exercises that involve bending forward, tightening the abdominal muscles; watch your daily bowel movements.

You need to sleep so that the head is raised, on a pair of pillows, it is also desirable that the entire upper body is in the raised position. This position of the body avoids the reflux of stomach contents into the esophagus.

Nutrition for reflux – esophagitis

• You need to pay close attention to the diet. Let it be fractional – five to six times a day.
• You need to eat in small portions, the last meal should be done no later than three to four hours before bedtime.
• You can’t go to bed right after lunch. You need to sit or walk for one hour: to accelerate the evacuation of food from the stomach into the intestines, which will accordingly reduce the reflux of acidic stomach contents into the esophagus.
• You can only eat foods that do not provoke the appearance of heartburn.
• A sick person must follow the doctor’s recommendations – which implies the rejection of some products, the introduction of their full-fledged substitutes into the diet.
• Also, you can not overeat, you need to refuse foods that cause bloating (fresh cabbage, sauerkraut, black bread, mushrooms, green peas, beans, some types of fresh fruits and berries, chocolate, hot spices, alcohol, soda).
• All of these foods increase intragastric and intra-abdominal pressure, which is why the contents of the stomach are thrown into the esophagus.
• You can track which specific vegetables, fruits, berries caused such a reaction, and limit their use. And it’s better – just don’t eat them fresh: you can cook compote from fruits, vegetables can be stewed or baked.
• You can’t eat late. You cannot go to bed after eating, you cannot perform actions that are associated with inclinations (washing, cleaning, etc.) after eating.). It is better to walk or sit after eating.

In case of exacerbation of reflux – esophagitis, the doctor may prescribe a more strict diet: “esophageal” table or diet No. 1 according to Pevzner.

Diet for reflux – esophagitis allows you to consume:

• eggs, soft boiled,
• sour cream,
• eat a little pureed low-fat non-acidic cottage cheese,
• various types of cereals, cooked in water, milk porridge
• eat mashed meat and fish soufflé,
• cook meatballs, steamed cutlets,
• Soak croutons and bread in water or tea,
• baked apples, grated apples
• low fat milk;
• low-fat fish varieties;
• yesterday’s bread;
• various compotes.

Do not eat foods such as:

• all types of alcoholic beverages;
• soda;
• all kinds of sour juices;
• fresh cabbage, sauerkraut;

90,043 mushrooms;

• black bread;
• legumes – green peas, beans;
• chocolate;
• spices, especially hot ones;
• marinade, smoked;
• fat.

During an exacerbation of the disease, give up the use of fresh vegetables and fruits – it is better to steam them, boil, bake.

When you find out – what specific foods provoke heartburn in you – also exclude them from your menu.

Observing a diet for reflux – esophagitis, take into account your individual characteristics – after all, various foods can provoke an exacerbation of the disease.

Treatment of reflux esophagitis

Taking medications – to neutralize aggressive stomach acid, protect the esophageal mucosa, increase the tone of the esophageal sphincter.A positive effect can be achieved by taking antacid (alkaline) drugs – maalox, megalak, phosphalugel. They have an anti-acid action, an enveloping action, an astringent action, which helps to achieve an anti-inflammatory effect.

Also, take antacids at night as the acidity of the stomach contents increases at night, and a long stay in a horizontal position contributes to the appearance of reflux.

Now pharmacies offer a huge selection of medicines for the treatment of this disease, but do not treat yourself, consult your doctor.

But, it is imperative to be treated: in the absence of a diet, treatment, it is possible that serious complications arise – stomach ulcers, bleeding, narrowing of the esophagus.

Also, you need to remember that after the treatment, you must follow what the doctor has prescribed for you: follow a diet, try to avoid stress, do not drink strong coffee and tea, it is also advisable to quit smoking, do not relieve pain with aspirin, avoid the use of medicines without a doctor’s prescription.

Try to get along with your illness. If you follow all the doctor’s recommendations, you can achieve a stable remission, which will minimize the inconvenience that the disease causes you.

Deputy Chief Physician of the TANAR Family Clinic Natalya Borisovna Vorobieva.

What foods should be added or excluded from the diet for heartburn?

When a person swallows food, it passes through the esophagus into the stomach. In this case, the sphincter in the stomach prevents food from being thrown back into the esophagus.However, if this sphincter malfunctions, stomach contents can re-enter the esophagus, causing heartburn. If this symptom appears more than 2 times a week for 3 weeks, it can be argued about the development of a chronic form of gastroesophageal reflux disease (GERD). If this condition is left untreated, it can lead to the development of cancer at the site of damage to the lining of the digestive tract. Many people with GERD are familiar with heartburn and nausea after eating. However, other common symptoms of GERD are also considered: hiccups, belching, wheezing or weak cough, sore throat, change in voice, hoarseness.

The unpleasant symptoms of GERD may worsen if a person lies down immediately after eating. Some also report an increase in the severity of such signs during the night. Since GERD is a digestive disorder, it is possible to trace the relationship between diet and symptoms of this pathology. So, there are products that enhance or, conversely, reduce the severity of these symptoms. The former include: meat, oils and foods high in fat, salt in large quantities, foods rich in calcium (milk, cheese).

For example, a study published in the journal Gut and Liver found an association between cow’s milk allergy and GERD symptoms in children. Researchers have found that children with cow’s milk allergy are likely to experience GERD symptoms when consuming this product. More research in this area is needed to confirm this association in adults, but scientists note that if a person experiences GERD symptoms on a regular basis after consuming cow’s milk products, they should be eliminated from the diet.

Another study published in Alimentary Pharmacology and Therapeutics found a link between high cholesterol foods and GERD symptoms. It found that individuals who ate more cholesterol, saturated fatty acids, and calories from fatty foods experienced more GERD symptoms than those who followed a healthy diet.

Among the foods that are also not recommended for GERD, there are chocolate, mint, soda, fruit juices, coffee, foods with a high acid content, such as tomato sauce, etc.

A 2013 study of over 500 volunteers found that certain foods can reduce the incidence of GERD symptoms. These include: foods high in protein (tuna, salmon, cashews, almonds, lentils), some fruits (apples, melons, peaches, citrus fruits) and vegetables (potatoes), as well as berries, eggs. An increase in fiber intake has also been associated with a decrease in the severity of GERD symptoms.

In addition to dietary changes, probiotic-rich foods should be included in the diet in the presence of GERD, since the normalization of the microflora of the gastrointestinal tract can help cope with digestive disorders in general.In addition, probiotics help fight bacteria H . p ylori , which is associated with the onset of symptoms of GERD. Another way to reduce the severity of these symptoms is considered to be the use of a decoction of elm bark. This product contains a large amount of mucus that coats the throat and stomach and, as a result, can reduce the damage to the mucous membrane of the digestive tract by stomach acid.

If diet correction does not help to cope with GERD, you can seek help from a doctor for drug therapy of this pathology.

Based on materials from www.medicalnewstoday.com

90,000 Simple heartburn? in Novosibirsk | CNMT

Heartburn, hiccups, belching after eating, which we often do not attach much importance to, can be manifestations of gastroesophageal reflux disease . If left untreated, this disease can cause serious complications. In what cases a banal symptom can indicate a serious illness and how to prevent illness, we will find out in more detail.

Reflux esophagitis, or gastroesophageal reflux disease , is a chronic disease that develops due to the frequently repeated reflux of stomach acid into the esophagus, a long muscular tube that connects the pharynx to the stomach.The most common manifestation of this refusal is heartburn.

All this leads to negative changes in the inner lining of the esophagus. Such pathological changes can also occur on the inner lining of the larynx, trachea, and pharynx. And if the disease progresses, these changes become irreversible, requiring surgical intervention.

What to look for

In addition to frequent heartburn and eructation that occurs after eating, especially when the trunk is tilted forward, other common symptoms are: rapid stomach satiety after eating, bloating, nausea, and vomiting.It is noteworthy that the manifestations of the disease can be not only from the digestive system. Some patients have extraesophageal symptoms. For example, chest pain, which can be regarded as signs of heart disease.

When the contents of the stomach enter the larynx, especially at night, patients begin to worry about dry cough, sore throat, hoarseness.

Gastric contents may be thrown into the trachea and bronchi, resulting in the development of obstructive bronchitis and even aspiration pneumonia.

Causes of the disease

The immediate reason that hydrochloric acid from the stomach is thrown into the esophagus, damaging its mucous membrane, is the weakening of the cardiac sphincter – the muscle at the border of the esophagus and stomach, which provides obturator function.

Among the factors predisposing to the onset of the disease, in the first place are stress, overeating and obesity, rapid weight gain or rapid weight loss, working in an incline, strenuous physical activity, lack of afternoon rest before physical exertion, eating just before bedtime, smoking.

The likelihood of developing the disease is higher in lovers of fatty, spicy foods, chocolate, coffee, sour fruit juices, alcohol, freshly baked bakery products, carbonated drinks.

Why the disease is dangerous

It would seem that heartburn and hiccups affect millions of people in the world. Is this a sufficient reason to see a doctor? It turns out, yes. If heartburn occurs only occasionally after a meal, this is indeed a normal physiological phenomenon. But if the above symptoms occur more than 2 times a week for two months, you should consult a doctor for an examination.

By the way, heartburn, slight nausea, belching and a feeling of fullness in the stomach while eating can be signs of gastritis and even ulcers – diseases that significantly impair the quality of life. And thanks to a timely visit to a doctor, their development can be prevented in time. One of the main and most dangerous complications of reflux esophagitis are erosion, ulceration and narrowing of the esophageal lumen, which gradually leads to difficulty in swallowing food and requires surgical intervention.

In 10% of cases, the disease leads to the appearance of Barrett’s esophagus, leading to degeneration of cells in the lining of the esophagus, increasing the risk of developing esophageal cancer.

Extraesophageal consequences of the disease are chronic processes in the nasopharynx, bronchitis, pneumonia, lung abscess, bronchial asthma. The acid contained in belching destroys the enamel of the teeth, thereby provoking the development of tooth decay.

Diagnostics

It is possible to diagnose reflux esophagitis at the earliest stage using esophagogastroduodenoscopy. Also used are esophagomanometry, fluoroscopy of the esophagus, gastroesophageal scintigraphy, daily monitoring of pH.If the result reveals signs of Barrett’s esophagus, a biopsy of the esophageal wall is performed, followed by histological examination.

Treatment

First of all, it is a change in lifestyle, diet and diet. Smokers will have to forget about their habit, and those who used alcohol will have to find another way to relax. The doctor will prescribe drug therapy using drugs that reduce acidity and normalize the motor function of the esophagus. At the initial stage of the disease, when there are no irreversible changes in the esophageal wall, it is necessary to tune in to a long course of treatment up to 6 months, and in some cases even longer.

Surgical treatment is carried out with severe clinical manifestations and ineffectiveness of drug therapy, the presence of Barrett’s esophagus and in emergency situations with bleeding due to rupture of the walls of the esophagus.

When Barrett’s esophagus is identified, surgical treatment is performed in two stages. First stage: endoscopic ablation of the esophageal mucosa. This is a minimally invasive operation leading to the destruction of the formed precancerous cells by high radio frequency waves.In place of the destroyed cancer cells, normal tissue is restored. The second stage: the creation of an antireflux cuff, which reduces the likelihood of the development of reflux of gastric contents into the esophagus. There are several types of ablation. In the CNMT, depending on the area of ​​damage, laser or argon plasma ablation is performed; if necessary, laparoscopic antireflux surgery.

Expert Advice

Here are some tips to help keep your esophageal sphinker and esophagus working properly:

• Do not exercise on a full stomach.
• Do not wear tight clothing around the waist (this may increase pressure on the stomach).
• Do not lie down immediately on the food box. It is necessary to remain active for 2 hours after eating (during this time, food has time to evacuate from the stomach). If you lie on your back after a heavy meal, it will be easier for stomach contents to enter the esophagus. Do not eat before bed. The head of the bed should rise 15–20 cm so that the acid remains in the stomach due to gravity.
• Don’t overeat.Due to the fact that there is a large amount of food in the stomach, pressure on the lower esophageal sphincter increases, as a result of which it opens.
• Stop smoking. Smoking relaxes the lower esophageal sphincter, reducing the amount of saliva in the mouth and pharynx, which neutralizes the acid, and damages the esophagus.
• Avoid foods that exacerbate symptoms, such as tomato sauces, mints, citrus fruits, onions, coffee, fried foods, and sodas.
• Do not drink alcohol. Alcohol relaxes the lower esophageal sphincter, and the esophagus may begin to contract unevenly, causing acid to rush into the esophagus and heartburn.
• Check the drugs you are taking. Some medications can make your symptoms worse. Do not interrupt the prescribed treatment without consulting your doctor.
• Contact your doctor in time and undergo the necessary examinations.

90,061 90,000 Doctor: Hiccups may be one of the first symptoms of coronavirus – Moscow City News Agency

Doctor: Hiccups may be one of the first symptoms of coronavirus

11.02 08:20

Tags:
Health
, Doctors
, Coronavirus

Hiccups in rare cases may be the first symptoms of coronavirus.The head of the Department of Nervous Diseases and Neurosurgery of the Sechenov University, Doctor of Medical Sciences Vladimir Parfenov informed about this to the Moscow City News Agency.

“Hiccups can cause not only a visit to the clinic, but also an emergency appeal for medical help. According to some reports, hiccups account for 55 out of 100 thousand cases of hospital visits through various channels. The most common cause of hiccups is damage to the gastrointestinal tract or nervous system.This year, several cases were also described where hiccups became one of the first symptoms of COVID-19. In the electronic library Pubmed on the topic “Hiccups. COVID-19 “there are seven publications in 2020,” Parfenov said.

He noted that there are no peculiarities of hiccups in COVID-19. Parfenov also explained that science knows about 100 possible causes of hiccups.

“If, in general, about 3% of people are worried about hiccups, then among patients with Parkinson’s disease this ailment is noted by almost every fifth, and among patients with reflux esophagitis – every tenth.Strokes, trauma and brain tumors can lead to hiccups, but in most of these cases, hiccups are combined with other symptoms of damage to the nervous system. Often the cause is stress and emotional distress, ”added Parfenov.

Heading:
Society

Link to material: https://www.mskagency.ru/materials/3086175

Hernia of the esophageal opening of the diaphragm

Department of Thoracic Surgery No. 1

Hernias of the esophageal opening of the diaphragm are quite common in gastroenterology.The likelihood of diaphragmatic hernia formation increases in proportion to age – from 9% in people under 40 years old to 69% in people over 70 years old. Most often, a hernia of the esophageal opening of the diaphragm is formed in women. Moreover, in half of the cases, the disease is asymptomatic and remains unrecognized. Sometimes patients are treated for a long time by a gastroenterologist for concomitant diseases that determine the leading clinical manifestations – chronic gastritis, cholecystitis, stomach ulcers.

About half of cases of hiatal hernia are asymptomatic or accompanied by mild clinical manifestations.Since a hiatal hernia naturally leads to the development of gastroesophageal reflux disease, a group of symptoms associated with indigestion arises. Patients with diaphragmatic hernia, as a rule, complain of belching of gastric contents or bile, a feeling of bitterness in the mouth, belching with air. Often there is regurgitation of recently taken food without prior nausea; regurgitation often develops in a horizontal position at night. The pathognomonic manifestation of a hiatal hernia is dysphagia – a violation of the passage of a food lump through the esophagus.Dysphagia with a hernia of the esophageal opening of the diaphragm often accompanies the intake of semi-liquid or liquid food, too cold or hot water; develops with hasty eating or traumatic factors. For a hernia of the esophageal opening of the diaphragm, heartburn, hiccups, pain and burning sensation in the tongue, and hoarseness are also characteristic. If gastric contents enter the respiratory tract, tracheobronchitis, bronchial asthma, aspiration pneumonia can develop. In the clinical picture of a hiatal hernia, anemic syndrome is often noted, associated with latent bleeding from the lower esophagus and stomach due to reflux esophagitis, erosive gastritis, peptic ulcers of the esophagus.Also, one of the signs of a diaphragmatic hernia may be pain syndrome, which is usually localized in the epigastrium, spreads along the esophagus or radiates to the interscapular region and back. Sometimes the pain can be shingles, resembling pancreatitis.

Diagnostics:

Treatment:

• Endoscopic balloon dilation.
• Esophagofundoplication, including with the use of endovidiosurgical technologies.

Branch services and prices

Gastroesophageal reflux with esophagitis – the causes of the onset of the disease, the first symptoms, methods of prevention and treatment of the disease from the doctors YugMed

The term “reflux” refers to the reflux of stomach contents into the esophagus.This phenomenon (the constant return of part of the eaten food) can cause inflammation of the esophageal mucosa – reflux esophagitis. The main symptom is persistent heartburn.

In the first three months of a child’s life, gastroesophageal reflux is characteristic and physiological. Young children have anatomical and physiological features that predispose to its development. This is an underdevelopment of the distal esophagus, low acidity of gastric juice, an insignificant volume and a spherical shape of the stomach, its delayed emptying.

Pathological gastroesophageal reflux in young children is characterized by frequent regurgitation and vomiting, accompanied by insufficient weight gain, anemia, and impaired general condition.

There are several reasons for this ailment: an increase in intragastric pressure, a decrease in the ability of the stomach to hold the contents, and the esophagus – to quickly evacuate the “lost” food back into the stomach. Normally, all bile should be secreted into the duodenum.However, with reflux, some of the bile that enters the stomach causes inflammation in the stomach. The child may say that he just has a stomach ache, sometimes you may notice belching or bad breath. Some children are constantly hungry or have no appetite altogether.

Anti-reflux mode

Due to the fact that gastroesophageal refluxes are often the cause of diseases of the esophagus and other organs, one of the ways to treat such diseases is lifestyle changes aimed at reducing gastroesophageal refluxes.

Anti-reflux mode includes:

• In the presence of excess body weight – its reduction.
• Lack of physical activity associated with bending, swinging the press, lifting weights and other exercises that increase intra-abdominal pressure.
• Exclusion or restriction of the consumption of foods with an acid-stimulating effect, in particular citruses, chocolate, baked goods, fresh white bread, black bread, broths, spices, mushrooms, fried and fatty foods, radishes, radishes.
• Refusal from carbonated drinks, coffee, strong tea, cold and hot food, overeating.
• Sleeping on a bed with the head end raised 15 cm.
• Sleep no earlier than two hours after eating.

More about pediatric gastroenterology at the YugMed clinic

90,000 Get diagnostics and treatment of gastroesophageal reflux disease in Moscow, price

Gastroesophageal reflux disease (GERD) – a chronic disease of the digestive system, in which the contents of the stomach and duodenum are constantly thrown into the esophagus.Since the contents have an acidic reaction, the mucous membrane of the esophagus and the overlying parts of the gastrointestinal tract is irritated all the time, which ultimately leads to its inflammation and damage. In the department of gastroenterology of the Clinical Hospital on Yauza, a detailed diagnosis of GERD is carried out, according to the results of which doctors prescribe the optimal treatment for each individual patient. If necessary, treatment is carried out with the involvement of other specialists of the Clinical Hospital on Yauza.

Causes and pathogenesis of gastroesophageal reflux disease

Between the esophagus and the stomach is a kind of muscular valve – the lower esophageal sphincter (LES).When it opens, it lets food into the stomach. Normally, there should be no backward movement of food: the sphincter in a closed state forms a reliable obstacle for this. However, in some cases, the LPS weakens and this leads to the development of GERD.

The following factors contribute to the weakening of the sphincter:

• Drinks containing caffeine
• taking certain medications (calcium antagonists, antispasmodics, nitrates, analgesics and others)
• smoking
• alcohol consumption
• pregnancy

The reflux of stomach contents into the esophagus can occur with increased intra-abdominal pressure, for example, due to obesity or during pregnancy.Also, an increase in intra-abdominal pressure can occur if a person swallows food quickly, while swallowing a lot of air. The abuse of animal fats, spicy foods, carbonated drinks leads to the fact that the pressure increases due to a long delay in food masses.

Diaphragmatic hernia, which is often observed in people over 50, also creates conditions for reflux, as does duodenal ulcer disease.

Symptoms of gastroesophageal reflux disease

GERD manifests itself with the following main symptoms:

• heartburn
• burp
• hiccup
• odinophagy – pain when swallowing and during the passage of food through the esophagus
• Difficulty swallowing (dysphagia)
• vomiting (if GERD is combined with duodenal ulcer)

Also, patients may complain of chest pain, palpitations, which resemble the symptoms of cardiovascular diseases.Attention should also be paid to the cough that occurs when acidic contents are thrown into the larynx.

Diagnostics and treatment of gastroesophageal reflux disease at the Clinical Hospital on Yauza

Examination of patients involves laboratory and instrumental diagnostics: complete blood count, esophagogastroduodenoscopy (EGDS) with determination of the presence of Helicobacter pylori infection (based on partner clinics). If necessary, a biopsy is performed for histological examination.

According to indications, X-ray of the esophagus, stomach, duodenum, esophagomanometry, chest X-ray, ECG, CT scan of the chest organs are performed.

Also, the gastroenterologist, if indicated, directs the patient for consultation with related specialists: cardiologist, otolaryngologist, endocrinologist, surgeon, pulmonologist.

A long course of GERD can lead to serious complications: erosion, ulcers and cancer of the esophagus, the development of bronchial asthma, so timely treatment is necessary.

The gastroenterologist of the Clinical Hospital on Yauza will prescribe the necessary therapy, including recommendations for changing the diet and lifestyle, and drug treatment. To prevent complications and relapses of the disease, it is recommended to be examined by a gastroenterologist every six months.

Cost of services

Prices for services You can look at the price list or specify by phone, indicated on the website.