Overview
Chronic hiccup, defined as hiccupping lasting more than 48 hours, significantly impacts quality of life and often lacks a clear singular etiology, frequently associated with central nervous system or gastrointestinal disorders 1.Diagnosis
Persistent hiccups lasting >48 hours 1.
Commonly associated with esophageal disorders, particularly gastroesophageal reflux, and oncological conditions 2.
Diagnostic exploration may include evaluations for neurological and gastrointestinal pathologies 2.Management
First-line treatments: Chlorpromazine (FDA-approved), metoclopramide, baclofen, and gabapentin have shown promising results 12.
Adjunctive therapies: Phrenic nerve stimulation has been employed with some success 2.
Other approaches: Limited evidence supports the use of carbamazepine and haloperidol 2.Special Populations
Gastrointestinal disorders: Particularly gastroesophageal reflux is a notable comorbidity 2.
Oncological conditions: Associated with chronic hiccup in some cases 2.
No specific pediatric or geriatric guidelines provided in the abstracts.Key Recommendations
Initiate treatment with chlorpromazine for chronic hiccup due to its FDA approval and established use 1. (Evidence: Strong)
Consider metoclopramide, baclofen, or gabapentin as alternative first-line options based on reported efficacy 12. (Evidence: Moderate)
Explore underlying esophageal disorders and oncological causes through appropriate diagnostic evaluations 2. (Evidence: Moderate)References
1 Kohse EK, Hollmann MW, Bardenheuer HJ, Kessler J. Chronic Hiccups: An Underestimated Problem. Anesthesia and analgesia 2017. link
2 García Callejo FJ, Redondo Martínez J, Pérez Carbonell T, Monzó Gandía R, Martínez Beneyto MP, Rincón Piedrahita I. Hiccups. Attitude in Otorhinolaryngology Towards Consulting Patients. A Diagnostic and Therapeutic Approach. Acta otorrinolaringologica espanola 2017. link
3 Kranke P, Eberhart LH, Morin AM, Cracknell J, Greim CA, Roewer N. Treatment of hiccup during general anaesthesia or sedation: a qualitative systematic review. European journal of anaesthesiology 2003. link