What are the causes of recurrent hiccups (singultus)?

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From the FDA Drug Label

Intractable Hiccups– 25 mg to 50 mg t.i.d. or q.i.d. If symptoms persist for 2 to 3 days, parenteral therapy is indicated. The recommended dosage for recurrent hiccups is 25 mg to 50 mg of chlorpromazine, taken three to four times a day. If symptoms persist for 2 to 3 days, parenteral therapy is indicated 1.

From the Research

Recurrent hiccups can be effectively managed with the Hiccup Relief Using Active Prolonged Inspiration (HAPI) technique, which has been shown to provide immediate relief in all cases, as reported in the most recent study 2. This technique involves inspiring maximally and then attempting to inspire with an open glottis for 30 seconds, followed by a slow expiration and resumption of normal respiration. The HAPI technique is a simple and viable method for hiccup relief, and its effectiveness has been demonstrated in patients with self-limited and prolonged hiccups. Other treatment options, such as chlorpromazine, baclofen, gabapentin, and metoclopramide, may also be considered, but the HAPI technique is a non-invasive and non-pharmacological approach that can be tried first. It is essential to note that recurrent hiccups can be caused by underlying conditions, such as gastroesophageal reflux, certain medications, central nervous system disorders, or metabolic conditions, and treating the underlying cause is crucial for long-term management. Lifestyle modifications, such as avoiding carbonated beverages, alcohol, and large meals, may also help prevent recurrences. If hiccups significantly impact quality of life or are accompanied by other symptoms, prompt medical evaluation is necessary to rule out serious underlying conditions, as reported in various studies 3, 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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