study of hiccups

1. NAME : UROOJ UMER
STUDENT : PHARM- D
UNIVERSITY : RIPHAH
INTERNATIONAL
UNIVERSITY

2. TOPIC
STUDY OF
HICCUPS

3. CONTENTS
 Hiccups
 Causes of hiccups
 Process of occurrence
 Steps involved in this process
 Nerves involved in this process
 Facts about hiccups
 Normal hiccups
 Treatment of normal hiccups
 Chronic condition
 Treatment of chronic hiccups
 Most chronic hiccup in history
 Treatment of hiccups ( diagnosis tests)
 Frequency of hiccups

4. HICCUPS
DEFINITION
 Hiccups are sudden involuntary
contractions of diaphragm muscle.
 An involuntary spam of respiratory or
diaphragm organs, with the sudden
closure of glottis and characteristic
gulping sound.

5. WORD HICCUP
 The medical term hiccups is
“singultus “which comes from
Latin word “sop” or “gasp”.
 Hiccup is also called
“singultus”(spasmodic affection
of diaphragm)

6. CAUSES OF HICCUPS
The causes of hiccups are not obvious .The common causes of hiccups are are follows:
 Eating too quickly and swallowing air along with foods.
 Eating too much spicy, fatty food and drinking too much brewages ( alcohol). This causes
stomach distend and irritation in diaphragm.
 Any disease that disturbs diaphragm ( pneumonia , liver or lung disease ).
 Disturbance in nerve pathways .
 Abdominal surgery .
 Strokes or brain tumor.
 Noxious fumes.
 Sudden changes in temperature.
 Fear and excitement.

7. STEPS INVOLVED
IN THIS PROCESS
It is a two step process:
 STEP 1
It is a muscle spasm that causes us to stuck in lots air. The
muscles that mostly found in diaphragm( above).
 STEP 2
Immediate closure of your airways that “blocks the air”, that
causes hiccup noise. The flap of skin that blocks the airways to
lungs is called glottis. It closes 35 milliseconds after you suck air.

8. CONT…
STEP 3
Glottis in the throat snaps shut.

9. NERVES INVOLVED
IN THIS PROCESS
“Nerves extending from neck to chest causes hiccup”
Elements of both CNS and PNS are found in thorax region and play
important role in this region.
 CNS
“The spinal cord represents the CNS in the thorax region and serves as
a link between body and brain”.
 PNS
“Many autonomic nerves and ganglion pass through the thoracic
region to innervate the internal organs.”

10. FACTS ABOUT
HICCUPS
The facts about hiccups are as follows:
 The medical term used for hiccup is “singultus”
 It is a two step process
 Process almost occurs in all mammals
 Infants hiccup more than infants
 Most effective home remedies result in more carbon dioxide
in bloodstream

11. NORMAL HICCUPS
 If we hiccup once every 30 seconds for 20
minutes, so we having our own hiccupping
system. Some people hiccup straight a week ,
some for only 20 minutes and some for 3 hours..
HICCUP COMMON IN MALES
 Hiccups are common in males than in females
because some are emotional and some of them
are physical.
 It is also due to eating too much and eating too
quickly

12. TREATMENT OF
NORMAL HICCUPS
The treatment of normal hiccups at home are as follows:
 Drink a glass of water
 Have someone frighten you
 Pull hard on tongue
 Bite a lemon
 Gargle with water
 Drink water from far side of the glass
 Use smelling salts
 Place one-half teaspoon of sugar on the back of the tongue

13. CHRONIC CONDITION
OF HICCUPS
SYMPTOMS OF CHRONIC HICCUPS
 Hiccough , chronic
 Hiccups ,persistent
 Intractable, persistent
 Singultus, intractable

14. CONTI…
1 . CHRONIC HICCUPS
Chronic hiccups that usually lasts for more time.
2 . INTRACTABLE HICCUPS
“The hiccups that lasts for more than a month are called intractable
hiccups”
 It mostly occurs in extraordinary rare cases
 The longest recorded intractable hiccups continued for 60 years
 It is recorded as 1 in 10000 people.

15. CONTI…..
3 . PERSISTENT HICCUPS
“Hiccups that lasts for more than 48 hours
( 2 days) are called persistent hiccups”
 They are also called protracted hiccups.
 These hiccups end with in a month
4. SINGULTUS, CHRONIC
 It is basically same as intractable hiccups
(singultus).
 The majority reported studies claimed an
intractable spasm of hemi diaphragm.

16. TREATMENT OF
CHRONIC HICCUPS
• The treatment of chronic hiccups are as follows:
 Baclofen , a muscle relaxant
 Chlorpromazine ( thorazine), a medicine used to treat psychiatric illness.
 Haloperidol , a type of tranquilizer
 Metoclopramide, used to treat problems in esophagus and GERD
 Anticonvulsant drugs , phenytoin , valproic acid , gabapentin and
carbamazepine
 Sedatives
 Pain medication
 stimulus

17. MOST CHRONIC HICCUP
IN HISTORY
 Charles Osborne (1894-1991) had
non stopping hiccups for almost 68
years , from 1922 to 5th June 1990
. According to the Guinness Book
of World Records, this is the
longest bout of the hiccups ever
recorded .

18. TEST FOR
TREATMENT
DIAGNOSIS TEST
These types of tests may be able to detect anatomical abnormalities that may be affecting the vagus
nerve, phrenic nerve or diaphragm. Imaging tests may include:
• Chest X-ray
• Computerized tomography (CT)
• Magnetic resonance imaging (MRI)
ENDOSCOPIC TEST
These procedures utilize a thin, flexible tube containing a tiny camera, which is
passed down your throat to check for problems in your esophagus or windpipe.

19. SURGICAL PROCEDURES
FOR TREATMENT
 INJECTION
If less invasive treatments aren't effective, your doctor may recommend an
injection of an anesthetic to block your phrenic nerve to stop hiccups.
 BATTERY-OPERATED DEVICE
Another option is to surgically implant a battery-operated device to deliver
mild electrical stimulation to your vagus nerve. This procedure is most
commonly used to treat epilepsy, but it has also helped control persistent
hiccups.

20. FREQUENCY OF
HICCUPS
• Male predominance exists in patients with non–central
nervous system (CNS)-related hiccups and those of
unknown origin. [4] About 82% of persistent or intractable
episodes also occur in men. An organic cause can be
identified in 93% of men and in 8% of women, resulting
in an overall organic incidence of 80%; the remaining 20%
of cases are considered psychogenic in origin.