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15 16 Many drugs have been used, such as baclofen, chlorpromazine, metoclopramide, gabapentin, and various proton-pump inhibitors. Hiccups that are secondary to some other cause like gastroesophageal reflux disease or esophageal webs are dealt with by treating the underlying disorder. The phrenic nerve can be blocked temporarily with injection.5 procaine, or permanently with bilateral phrenicotomy or other forms of surgical destruction. Even this rather drastic treatment does not cure some cases, however. An anecdotal medical approach is to install lidocaine liniment 3 or gel 2 into the ear canal. Somehow this creates a vagus nerve-triggering reflex through its extensions to the external ear and tympanus (ear drum). The effect can be immediate, and also have lasting effect after the lidocaine effect expires after about two hours.
Stauss.) points out that hiccups and amphibian gulping are inhibited by elevated CO2 and may be stopped by gabab receptor agonists, illustrating a possible shared physiology and evolutionary heritage. These proposals may explain why premature infants spend.5 of their time hiccuping, possibly gulping like amphibians, as their lungs are not yet fully formed. 13 Fetal intrauterine hiccups are of two types. The physiological type face occurs prior to kerkrade twenty-eight weeks after conception and tend to last five to ten minutes. These hiccups are part of fetal development and are associated with the myelination of the phrenic nerve, which primarily controls the thoracic diaphragm.
The phylogeny hypothesis explains how the hiccup reflex might have evolved, and if there is not an explanation it may explain hiccups as an evolutionary remnant, held-over from our amphibious ancestors. 14 This hypothesis has been questioned because of the existence of the afferent loop of the reflex, the fact that it does not explain the reason for glottic closure, and because the very short contraction of the hiccup is unlikely to have a significant strengthening. Treatment edit hiccups are normally waited out, as any fit of them will usually pass quickly. Folkloric 'cures' for hiccups are common and varied, but no effective standard for stopping hiccups has been documented. Hiccups are treated medically only in severe and persistent (termed "intractable cases. Numerous medical remedies exist but no particular treatment is known to be especially effective, generally because of a paucity of high quality evidence.
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This may suggest that they evolved to allow air trapped in the kromme stomach of suckling infants to escape, allowing more milk to be ingested. The hypothesis suggests that the air bubble in the stomach stimulates the sensory limb of the reflex at receptors in the stomach, esophagus and along the diaphragm. This triggers the hiccup, which creates suction in the chest, pulling air from the stomach up and out through the mouth, effectively burping the animal. This theory is supported by the strong tendency for infants to get hiccups, the component of the reflex that suppresses peristalsis in the esophagus, and the existence of hiccups only in milk-drinking mammals. Phylogenetic hypothesis edit An international respiratory research group composed of members from Canada, france, and Japan proposed that the hiccup is an evolutionary remnant of earlier amphibian respiration. 12 Amphibians such as tadpoles gulp air and water across their gills via a rather simple motor reflex akin to mammalian hiccuping. The motor pathways that enable hiccuping form early during fetal development, before the motor pathways that enable normal lung ventilation form. Thus, the hiccup is evolutionarily antecedent tanden to modern lung respiration. Additionally, this group (C.
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Contents, signs and symptoms edit, a single or a series of breathing diaphragm spasms, of variable spacing and duration. A brief (less than one half second unexpected, shoulder, abdomen, throat, or full body tremor. Hiccups may present as an audible chirp, squeak, "hupp or if controlled, a quick inhaling gasp, sigh, or sniff. Hiccups may present as brief but distracting or painful, frequent or occasional interruptions in normal breathing, with sudden momentary pain of the throat, chest, and/or abdomen. Pathophysiological causes edit, coughing citation needed, swallowing air excessively. Gastroesophageal reflux 4, hiatus hernia 5, rapid eating 6, intense emotions such as fear, anxiety, excitement, joy, or euphoria citation needed carbonated beverages, alcohol, dry breads, and some spicy foods 7 Opiate drug use 8 laughing 9 Hiccups may be triggered by a number. In rare cases, they can be a sign of serious medical problems. Pre-phrenic nucleus irritation of medulla edit cns disorders edit nerve damage edit evolutionary causes edit Clearance of air from stomach edit a recent explanation by howes in 2012 suggests that hiccups may have evolved along with other reflexes developed in mammals that allow them. 6 Hiccups are only found in mammals, and are most common in infants, perricone becoming rarer as mammals age.
For other uses, see. A hiccup (also spelled spierpijn hiccough ) is an involuntary contraction ( myoclonic jerk) of the diaphragm that may repeat several times per minute. The hiccup is an involuntary action involving a reflex arc. 1, once triggered, the reflex causes a strong contraction of the diaphragm followed about.25 second later by closure of the vocal cords, which results in the classic "hic" sound. Hiccups may occur individually, or they may occur in bouts. The rhythm of the hiccup, or the time between hiccups, tends to be relatively constant. A bout of hiccups, in general, resolves itself without intervention, although many home remedies are often used to attempt to shorten the duration. 2, medical treatment is occasionally necessary in cases of chronic hiccups.
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