Hiccups
Background
- Usually initiated by gastric distention from food, carbonated beverage, or air
- Also known as Singultus
Clinical Features
- Hiccups
Differential Diagnosis
Diagnostic Evaluation
- Clinical diagnosis
- Consider auditory canal exam (foreign body against TM can trigger hiccups)
- Consider CXR
Management
- Physical Maneuvers (stimulating pharynx blocks the vagal portion of the reflex arc)
- Remove foreign body from ear
- Swallow teaspoon of sugar
- Sip ice water
- Drink water quickly
- Meds
- Chlorpromazine 25–50mg IV; 25–50mg PO TID
- Metoclopramide 10mg IV or IM; 10–20mg PO TID x 10d
Disposition
- Discharge for uncomplicated hiccups