I have had chronic hiccups since March 2021 – usually every three days, lasting for three days and keeping me awake and tired at night. The attacks don’t stop until I get a spasm that clenches my jaw and forces me to breathe through my teeth until it subsides. My counselor suggests this may be related to my diagnosis of sensory-motor axonal neuropathy.
Robert Pugh, Abergavenny.
Hiccups are caused by a sudden, involuntary contraction, or spasm, of the diaphragm, the dome-shaped horizontal layer of muscle that separates the chest from the abdomen. The intercostal muscles between the ribs are also involved.
The spasm causes a sudden gasp in the air, which causes the glottis (the area between the vocal cords that connects your throat to your lungs) to close, resulting in “hiccups.”
This involuntary contraction is due to a reflex action involving several nerves, especially the diaphragm (which contracts your diaphragm and allows you to breathe) and the vagus (which is involved in important bodily functions such as digestion and breathing and reflexes such as coughing) . ).
The hiccups are usually caused by benign factors such as a large meal or fizzy drinks.
When it comes to persistent hiccups, there are many possible triggers, although they are mostly related to irritation or damage to the vagus nerve or diaphragm – for example, after surgery, as a complication of stroke, diabetes or chronic reflux (gastric acid). . can damage, irritate, nerves). ).
Hiccups are caused by a sudden, involuntary contraction, or spasm, of the diaphragm, the dome-shaped horizontal layer of muscle that separates the chest from the abdomen. The intercostal muscles between the ribs are also involved
In your longer letter, you mention that your gastroenterologist did extensive testing, including an MRI scan and a gastroscopy, an examination of the upper digestive tract.
From what you say, it sounds like neuropathy – or nerve cell dysfunction – is the likely cause in your case. The impact on your health should not be underestimated as the disruption in eating, drinking and sleeping can lead to fatigue and a bad mood.
The standard initial treatment for chronic hiccups is a four-week trial of a proton pump inhibitor such as omeprazole to suppress gastric acid secretion.
If the hiccups persist, the next phase is a two-week trial of baclofen, an anti-spasticity drug, or gabapentin, an anti-seizure drug.
And if that doesn’t work, the next option is metoclopramide, an anti-nausea drug (also useful for hiccups), for another two weeks.
The hiccups are usually caused by benign factors such as a large meal or fizzy drinks. When it comes to prolonged hiccups, there are many possible triggers, although they are usually related to irritation or damage to the vagus nerve or diaphragm.
If the hiccups persist after this, the next step is chlorpromazine (a sedative thought to act locally on the pace diaphragm or to calm the brain). A number of other medications have been reported to help with this condition, including other anticonvulsants and antidepressants (at doses lower than mood, they can calm nerve activity).
A study recently reported that the combination of olanzapine (an antipsychotic with an effect similar to that of chlorpromazine on hiccups) with baclofen is effective.
All of these options are prescription medications and should be taken under the supervision of your family doctor or your gastroenterologist. Careful testing of these medications, with the help of your doctor, may provide the relief you seek.
My mother (92) is bedridden after hip replacement surgery 18 months ago. She is too weak to be lifted from bed to a chair. Add glaucoma and Alzheimer’s and it’s amazing how sunny and bright she stays every day. I am her full time supervisor.
Before her operation, Mother had regular visits to the eye clinic, dentist and podiatrist, as well as one visit to the memorial clinic. If you can’t be there in person right now, we can’t help you. Maintaining mum’s health is important – why does it feel like she’s already written off?
GilPowell, Essex.
You have a difficult job as a full-time caregiver and nurse for your bedridden mother: I admire your resilience.
There was a time when a general practitioner would regularly visit a patient in your mother’s position and ask for the services needed to maintain the quality of life. The pressures now so evident in the NHS have resulted in the level of care being all but non-existent.
I have no doubt that your mother’s immobility makes it suitable for pedicures and home vision tests. It is the responsibility of your GP to arrange for your home pedicure evaluation and future visits should follow. Similarly, all patients over the age of 60 are entitled to free eye tests on the NHS. There are criteria for determining the need for a home visit, and your mother undoubtedly qualifies.
And given her history of glaucoma, she needs to have her eye pressure checked regularly to make sure she’s getting the right treatment. It’s worth visiting a local optometrist and asking about it.
Talk to your GP and if your application for these essential services is refused I recommend making a complaint to the Care Quality Commission through their website. Rest assured that if this happens, you will respond quickly and supportively.
Write to Dr. scramble
Write to Dr. Scurr to Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email drmartin@dailymail.co.uk – include your contact details. DR Scurr cannot respond to personal correspondence. Answers should be taken in a general context and always consult your GP if you have any health concerns.
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Crystal Leahy is an author and health journalist who writes for The Fashion Vibes. With a background in health and wellness, Crystal has a passion for helping people live their best lives through healthy habits and lifestyles.
