Hiccups
Acute severe hiccups should be investigated to exclude an underlying cause if they persist for more than 2 days.
Chronic idiopathic hiccups are uncommon, but are difficult to manage and can be distressing. They can lead to insomnia, exhaustion, or weight loss due to inability to eat.
Many treatments have been tried for hiccups, though most of the literature consists of case reports and small case series.
For general advice about managing functional gastrointestinal disorders, including patient support and psychiatric or psychological assessment, see Approach to managing functional gastrointestinal disorders.
Drugs reported to be beneficial in the treatment of hiccups include dopamine antagonists (eg metoclopramide, haloperidol, chlorpromazine) and gamma-aminobutyric acid (GABA) agonists (eg baclofenAdam, 2020, gabapentin). Stimulation of the soft palate with a moistened cotton bud for approximately 1 minute may be effective for persistent hiccups. Vagal nerve decompression or electrical stimulation can be effective for severe cases.