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Chronic Hiccups.
Zachary Wilmer Reichenbach1,2, Gregory M Piech1, Zubair Malik3
1Department of Gastroenterology, Lewis Katz School of Medicine at Temple University Hospital, 3401 N. Broad St., 8th floor Parkinson Pavilion, Philadelphia, PA, 19140, USA.
Persistent hiccups, often linked to gastroesophageal reflux disease (GERD), require prompt evaluation. Proton pump inhibitors (PPIs) are a first-line treatment, with newer therapies showing promise for refractory cases.
Area of Science:
- Gastroenterology
- Neurology
Background:
- Hiccups affect nearly 4000 patients annually in the US.
- The hiccup reflex involves a complex pathway from peripheral receptors to the brainstem.
- Persistent hiccups can signify underlying pathologies, with GERD being a common cause.
Purpose of the Study:
- To review the pathophysiology of hiccups.
- To explore diverse etiologies and diagnostic workups for hiccups.
- To examine emerging pharmacological and interventional treatments for hiccups.
Main Methods:
- Literature review of studies on hiccup causes and treatments.
- Analysis of current therapeutic guidelines.
- Evaluation of novel treatment modalities.
Main Results:
- Proton pump inhibitors (PPIs) are recommended as first-line therapy.
- Gastrointestinal consultation is advised for suspected GERD-related hiccups.
- Central causes should be investigated if symptoms persist despite initial treatment.
Conclusions:
- Understanding hiccup pathophysiology is crucial for effective management.
- While PPIs remain a primary treatment, new therapeutic options are emerging.
- A systematic approach to diagnosis and treatment is essential for persistent hiccups.

