From the Research
Persistent hiccups should be treated with a proton pump inhibitor (PPI) as first-line therapy, as the most common cause involves gastroesophageal reflux disease (GERD) 1. When dealing with persistent hiccups, it's essential to evaluate the patient for underlying medical conditions, as they may indicate a more serious issue.
- Simple home remedies like drinking cold water, holding your breath for 10-20 seconds, gargling with ice water, or breathing into a paper bag for a few minutes can provide immediate relief.
- If these fail, over-the-counter medications like simethicone (Gas-X) may help by reducing gas in the stomach. For persistent cases, a doctor might prescribe medications such as:
- Chlorpromazine (25-50mg orally every 6-8 hours)
- Baclofen (5-10mg three times daily)
- Metoclopramide (10mg three times daily) These medications work by either suppressing the hiccup reflex in the brain or relaxing the diaphragm muscle. The pathophysiology of hiccups involves a complex reflex arc between peripheral receptors and the brainstem, and any disruption along this pathway may produce hiccups 2. Identifying and treating the underlying cause—which could range from acid reflux to certain medications or neurological disorders—is crucial for long-term resolution. If hiccups persist beyond a few days or are accompanied by other symptoms like chest pain or difficulty swallowing, seek medical attention promptly. It's also important to note that there is limited evidence to support the use of one agent over another for treating intractable and persistent hiccups, and therapy selection should be specific to individual patients, their underlying comorbidities, etiology of hiccups, and take into account the individual properties of the drugs 3.