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A Cure for Hiccoughs??		 3/4
Welcome, This page is about Hiccups, A Cure for Hiccoughs aka Hiccups
Persistent hiccups (lasting more than 48 hours) are rare but are commonly caused by an underlying disease. Medication can stop persistent hiccups.

What are hiccups?

Hiccups (sometimes spelled hiccoughs) are caused by a sudden contraction of your diaphragm. This is the muscle under your lungs that helps you breathe in. Your glottis (the top of your windpipe) closes immediately after your diaphragm contracts which makes the typical 'hic' sound.

A hiccup is a reflex that you cannot stop. However, unlike other reflexes such as coughing and sneezing, hiccups do not seem to have any useful purpose.

Who gets hiccups?

Short bouts of hiccups
Most people have bouts of hiccups from time to time. In most cases they start for no apparent reason, last a short while, then stop. Sometimes they are due to:

  • a temporary swollen stomach caused by overeating or eating too fast, drinking fizzy drinks, or swallowing air.
  • a sudden change in temperature (very hot or cold food or drinks, a cold shower, etc).
  • alcohol.
  • excess smoking.
  • sudden excitement or emotional stress.

Persistent hiccups lasting more than 48 hours

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You are at: http://www.BrianNelsonConsulting.com/cancer-care-treatment/hiccoughs-hiccups.html   ud 08/25/2009 10:44 AM -0500
  This page is about Hiccups, A Cure for Hiccoughs

Hiccups

Persistent hiccups (lasting more than 48 hours) are rare but are commonly caused by an underlying disease. Medication can stop persistent hiccups.

What are hiccups?

Hiccups (sometimes spelled hiccoughs) are caused by a sudden contraction of your diaphragm. This is the muscle under your lungs that helps you breathe in. Your glottis (the top of your windpipe) closes immediately after your diaphragm contracts which makes the typical 'hic' sound.

A hiccup is a reflex that you cannot stop. However, unlike other reflexes such as coughing and sneezing, hiccups do not seem to have any useful purpose.

Who gets hiccups?

Short bouts of hiccups
Most people have bouts of hiccups from time to time. In most cases they start for no apparent reason, last a short while, then stop. Sometimes they are due to:

  • a temporary swollen stomach caused by overeating or eating too fast, drinking fizzy drinks, or swallowing air.
  • a sudden change in temperature (very hot or cold food or drinks, a cold shower, etc).
  • alcohol.
  • excess smoking.
  • sudden excitement or emotional stress.

Persistent hiccups lasting more than 48 hours
Persistent hiccups are rare.

  • In many cases, persistent hiccups are caused by an underlying disease. Over 100 diseases have been reported to cause hiccups. Some are common, such as acid reflux, and some are rare. You would normally have other symptoms apart from the hiccups.
  • In some cases of persistent hiccups there is no apparent cause. However, the persistent hiccups can become exhausting and distressing.

What is the treatment for hiccups?

For short bouts of hiccups
Most cases need no treatment as a bout of hiccups usually soon goes. Popular remedies that may stop a short bout of hiccups include:

  • sipping ice water.
  • swallowing granulated sugar.
  • biting on a lemon.
  • breath holding, breathing fast, or breathing into a paper bag.
  • gasping after a sudden fright.
  • pulling your knees up to your chest.

If you have persistent hiccups
If you have hiccups for more than 24 hours (or if you have frequently recurring short bouts of hiccups) then see a doctor to find out if there is an underlying cause. If the cause is not obvious the doctor is likely to examine you and do a number of test. If an underlying cause is found, then treatment of the underlying cause, if possible, may cure the hiccups.

For example, in one research study of 72 people with persistent hiccups it was found that 55 people had a condition of their upper gut. The most common condition was acid reflux (see separate leaflet called 'Acid Reflux and Oesophagitis'). In this study, treatment of the acid reflux with medication stopped the hiccups in 35 of these people.

Medication is sometimes needed to stop persistent hiccups. Various medicines have been used for this, For example, chlorpromazine or haloperidol are medicines which can relax' the diaphragm muscle or its nerve supply and may stop persistent hiccups. Other medicines sometimes used include: baclofen, gabapentin, and metoclopramide.

 

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A Cure for Hiccups (A Cure for Hiccoughs)  excerpts  from http://www.well.com/user/smalin/hiccup.htm

Introduction

Below is a collection of all the hiccup cures I've heard of. The cures are grouped by type, and the groups are ordered from simplest (involving no apparatus) to most complicated. If you have a cure for hiccups that's substantially different from any of these, please drop me an email and tell me about it.

My own unusual hiccup

Often, when I finish eating, I hiccup one or two times. It doesn't matter how much I eat, or when; sometime, when I get up in the middle of the night for a drink of water, I hiccup afterwards. It's sort of like my esophagus saying "we're done now." Sometimes, during a very big meal, these hiccups come during the meal--apparently, when my esophagus has a different idea than I do!

The gasp-hiccup

I rarely get long-lasting hiccups, but when I do, I've found a technique that stops them. What I do is not tense up during the hiccup. My throat stays open, and instead of the sound of a "hic," there's a sort of gasp. It seems like the way I do this is to sense when a hiccup is coming, a fraction of a second before it happens, and then I intentionally open my mouth and breathe in. I say "it seems like" because it's semi-automatic, and it's hard to tell whether my will is involved at all (though one reader has used a variation in the technique in which he "breathes in hard" at the time the hiccup is coming).

What I like about my gasp-hiccup is that it is not uncomfortable like a regular "hic!" hiccup; it's as if the hiccup has its natural follow-through. I imagine that a gasp-hiccup could be dangerous if I were eating, since it would be possible to inhale food into my windway.

I haven't include my gasp-hiccup technique in the list because it's not something everyone's able to do. A few people have written to say they'd tried it (and some of these have been helped) but I've never been able to teach anyone else how to do it in person, nor have I ever met anyone who could do it. If you learn how to do it from my explanation or have learned it on your own, please drop me a note; I'd like to hear from you. If you'd like to read another description of (what I believe is) the same technique, see Peter B. Harrison's page about it.

Caveat singultor

The list below is a compendium of folk remedies, medical techniques, and drugs of various kinds (prescription, over the counter, herbal, illegal). Some cures that seem especially ill-advised are included in the "not recommended" category, but this is not to suggest that the inclusion of a cure in some other category is intended as an endorsement or recommendation. I am not a medical doctor, and my advice is limited to the Treatment of Hiccups section at the end of this document.

You are at: http://www.BrianNelsonConsulting.com/cancer-care-treatment/hiccoughs-hiccups.html   ud 08/25/2009 10:44 AM -0500

Purely mental cures (no tools, no physical activity, no assistant)

  • Think of all the bald men you can.
  • Tell yourself "I'm not going to hiccup again."
  • Don't do anything; just wait for the next hiccup.
  • Close your eyes and visualize a neon sign, like a movie marquee; see the word "THINK" blinking on and off; concentrate on the sign and make the word blink as fast as possible.
  • Imagine a neon blue colour, coming from between your eyes, (also known as the third or psyhic eye) and directing it down the centre of your chest to the xiphisternum and then washing calmly across the diaphragm, from one side to the next and back continuously.

    Cures involving your breath

  • Laugh.
  • Swallow air.
  • Hyperventilate.
  • Induce a cough or sneeze.
  • Relax and breathe from your diaphragm.
  • Inhale and exhale once a second for two minutes. 
  • Do the Complete Breath as practiced in Hatha Yoga.
  • Blow on your thumb (as if you were blowing up a balloon).
  • Hold your breath (for 8 seconds, for as long as you can, etc.).
  • Inhale some air into your stomach, then let out as loud a belch as possible.
  • Cough and continue to blow until your lungs are empty; repeat three times.
  • Carefully inhale; pause briefly; carefully exhale; pause briefly; repeat this several times.
  • Breathe slowly and semi-shallowly through your mouth; relax your stomach and chest as much as possible.
  • Breathe in through your mouth as deeply as you can, as you you're going to sigh. Count to ten, then let your breath out with a sigh.
  • As soon as the hiccups start, put your head on the ground (so that your body is in an inverted V) and hold your breath for ten seconds. 
  • Plug your ears (so sound is partially blocked), take a deep breath and swallow 3-6 times straight, without taking a breath between swallows.
  • Sit somewhere quiet; make sure your posture is straight; breathe slowly and deeply, diaphragm-style, then breathe through your nose as slowly as you possibly can.
  • A second or two before you expect a hiccup, exhale completely, firmly constrict your diaphragm muscles, and hold that position for several seconds; then breathe normally.
  • Close your mouth and breath easily through your nose; swallow easily once; tell yourself: "The electrical system short you have experienced has been corrected and your hick-up is gone." 
  • Lie down flat on the floor, press both fists against your stomach (parallel to each other, so that each fist touches each wrist), and breath deeply. (Alternatively, have an assistant do the pressing.)
  • Lie down; stretch out as far as you can (fingers toward the wall above your head, toes pointed toward the wall below your feet); hold your breath as long as possible then breathe once quickly for a quick half of a second then hold your breath again.
  • Lie flat on your back, completely relax your body, letting the air out of your lungs (don't force it out, just relax and let it flow out) until there is no pressure on your diaphragm; wait until the hiccups cease.  (Once you've mastered this technique, you may be able to do it without lying down.)
  • Take as slow and as deep a breath as you can tolerate (it should take at least 10 seconds to inhale; longer is better); near the end of this breath, you will feel a kind of shudder in your diaghram; affter the shudder, go back to breathing normally (if you do not feel the shudder, repeat the process until you do).
  • Exhale all of your breath, squeezing the air out as thoroughly as you can and hold your breath. While holding your breath, swallow two or three times (depending on how good you are at holding you breath and swallowing). Swallowing hard helps but is not necessary. Swallowing can be done either dry, using saliva or using a small sip of water. If you feel like you may hiccup again, quickly partially exhale and swallow hard.
  • As soon as the hiccups start (ideally, after only two or three hiccups), take several deep breaths quickly (that is, hyperventilate), exhale most of the air in your lungs, hold your mouth and nose closed so you can’t breathe. Then (and, if you can time it, just before the next hiccup), try as hard as you can to inhale (but use your hands to prevent any air from entering). If you are successful, the next hiccup will cause you to hear a sound like a muted burp. After the last hiccup, sit quietly; wait about twenty seconds before taking your next breath, then breathe slowly.

    Cures you can do by yourself with no tools

  • Don't swallow.
  • Say "pineapple."
  • Stand on your head.
  • Make yourself vomit. 
  • Talk non-stop for ten seconds.
  • Scream for as long as you can.
  • (Women:) Stimulate your clitoris.
  • Count to twenty with your fingers in your ears.
  • Hold your head far back and stroke you throat.
  • Urinate; concentrate on both peeing and breathing. 
  • Gently rub your ear lobe until the hiccups are gone.
  • Massage right below your rib cage (on both sides).
  • Rub the back of your tongue to stimulate the gag reflex.
  • With your eyes closed, massage your eyeballs through your eyelids.
  • Run; keep running for at least 10 minutes after the hiccups have subsided.
  • Rub your soft palate with your finger or a cotton swab until you almost gag.
  • Hold your tongue with your thumb and index finger and gently pull it forward.
  • With one hand, apply pressure to the gums above your front teeth and to a point just below your nose.
  • Place the fingers of both hands together right below the center of your ribcage; press in and up at the same time.
  • Squeeze the end joint of your index finger with the thumb and index finger of the other hand firmly. Hold until the hiccups stop.
  • With your fingers, apply mild but firm pressure to the phrenic nerves at the position where they cross each side of the collarbone.
  • With your right thumb, press firmly on the "pressure point" (#18 on this diagram ) of your left hand (reverse if you're left-handed).
  • As possible after the first hiccup, rap yourself sharply on the solar-plexus (a few times in a row if necessary) with the side of your balled fist.
  • Take a finger full of hair from the crown of your head and as hard as you can stand (though not hard enough to pull the hair out) for 10 seconds. 
  • Pinch the back of your shoulder until it hurts (this works because the nerves in your shoulder and the nerves that control your diaphragm come from the same place).
  • Put your hands and elbows over your head and hold your breath (for a count of twenty, or for longer than the space between hiccups, or for as long as you can).
  • Just before your next hiccup, tighten your diaphragm, as if you are trying to burp. When the next hiccup occurs, it will cause you to burp instead, and the hiccups are over. Rarely, you may have to do it a second time. (Dick McBirney asks that you call it the "McBirney Technique.")
  • Close the eyes, press the thumbs against the eyeballs with enough pressure to be mildly uncomfortable, hold that for thirty seconds at least (do not exceed 3 minutes, as blood flow to the retina could be compromised in a very select group with a longer than 3 minute exposure) then rapidly release. Some advocate holding your breath while doing this (which is reasonable since few can hold their breath longer than 3 minutes thus saving providing an automatic protection against unduly compromising the retinal blood flow.)
  • Count the approx. number of seconds between each hiccup, i.e. normal interval between hiccups could be several seconds apart. With this information as a guide, now anticipate each hiccup and mimic the hiccups both in frequency, sound, and even body language, so that you are deliberately hiccupping 'in sync' with it, even better if you can exaggerate the mimicking activity -- like acting on stage? The hiccups should disappear after 5 to 6 deliberations, between 20 seconds to half a minute usually. (Peter Liu, who discovered this technique, has asked that it be identified here as the "Peter-Pierre Method.")

    Cures you can do with an assistant

     

  • These cures are listed on a separate page, since many of them don't work if the person with hiccups knows about them. (Assistant click here)

    Cures that involve a tool or prop

  • Chew gum.
  • Take a hot bath.
  • Jump out of a plane.
  • Read about hiccups online. :)
  • Immerse your face in ice water.
  • Breathe through a wet washcloth.
  • Smell the fumes from a lighted candle.
  • Put ice bags on both sides of your throat.
  • Breathe into (and out of) a paper bag for a while.
  • Massage the back of the roof of your mouth with a cotton swab.
  • Hang up side down on your bed and let the blood rush to your head.
  • Touch your uvula gently with the handle of a spoon (breath steadily to keep from gagging).
  • (For a baby with hicups) Press a quarter coin lightly in the diaphragm area for a few seconds.
  • Lie down on your back with your mouth wide open; let your head hang over the edge of a couch or bed; breathe deeply and slowly.
  • Light a match, blow it out, then put the tip in a little bit of water (sulfur in the match calms the throat). Variants: put the match out by touching it to the water, use a whole book of matches, drink the water after dousing the match(es).
  • Slide a well-greased length of thin, flexible rubber tubing through one nostril to the point where it just barely touches the back of the throat (be careful not to hurt the sensitive lining of the nose). (This is known as "nasopharyngeal airway insertion," and is believed to work by stimulating the vagus nerve.)
  • Sit in a chair where you can lean far back, such as a recliner; close your eyes; tilt your head back as far as possible; open your mouth wide; inhale as much air as possible, and visualize a hook in the lower part of your throat and a ring farther up (that the hook could catch onto), then inhale even farther and visualize bringing the hook up and hooking it into the ring (see diagram courtesy Tom Pennington).

    Cures that involve drinking some water

  • Drink three big gulps of cold water.
  • Pinch your nose shut while you drink water.
  • Gargle (this can also be done with mouthwash).
  • Take a big sip of water, bend over and swallow it.
  • Drink a glass of water while someone presses your ears closed.
  • Drink two glasses of water slowly, at about half your normal rate.
  • Inhale deeply, swallow water, then exhale; repeat this three times.
  • Drink water from the far side of a glass (so you're drinking upside-down).
  • Drink water slowly from a glass covered with a napkin, hanky or other fine cloth.
  • Hold your hands over your head, and have someone feed you a (10 oz.) glass of water.
  • Take a big gulp of water, lie down, and swallow the water while holding your nose shut. 
  • Take 15 - 20 swallows of the water while holding your breath with your nose pinched closed.
  • While applying pressure to the inside of the ear with your little finger, slowly take eight gulps of water.
  • Put a spoon in a glass of water; drink the water with the handle of the spoon resting on your forehead.
  • With your neck bent backward, hold your breath for a count of ten. Exhale immediately and drink a glass of water.
  • While holding a thin object (such as a pencil, chopstick, or straw) between your lips, drink a tall cold glass of water.
  • Sing along to your favourite CD while standing on your head and drinking a glass of water and wait for the hiccups to stop.
  • Plug your ears with your thumbs, squeeze your nostrils closed with your pinkies, and take several small sips of water from a glass.
  • SLURP a small amount of water from a full glass. (The SLURPING is the secret as it is the mix of air and water that stops the hiccup.)
  • Turn your left wrist clockwise until your palm is facing outward; from that position, pick up a glass of water and take three sips (over your wrist).
  • Hold your breath, pinch your nose closed, swallow repeatedly from a glass of water until you have a drowning sensation, then take a deep breath and relax.
  • Take three slow, deep breaths; hold the third breath while drinking a big glass of water through a paper towel for as long as you can or until the glass is empty.
  • Take eight sips of cool water without breathing; on the ninth sip take a deep breath (from the diaphragm); let it out slowly; wait a few seconds; repeat if necessary.
  • Put a knife in a glass of water (blade end into the glass); drink the water without breathing, while keeping the handle of the knife constantly pressing against your face.
  • Hold your left ear with your right hand and your right ear with your left hand and pinch the lobes slightly, have a friend hold a glass of water to your mouth and drink it.
  • Cover a glass of water with a coaster leaving a crack just large enough to drink the water through; take a deep breath then exhale completely; drink all the water without taking another breath.
  • Standing but relaxed (leaning against a counter helps you relax), drink a full glass of warm water while concentrating; breathe slowly if necessary, but do not stop drinking to breathe; repeat if necessary.
  • Fasten the spoon end of a teaspoon between the tines of a fork; place the handle end of the fork into a glass of water and rest the handle end of the spoon against your temple; drink (sip) from the glass of water.
  • Fill a plastic cup with water and place it on a table at around waist level; put your thumbs on your earlobes, bend down and pick up the cup by the rim with your pinkies; stand up straight, drink the entire glass, and put it back down. 
  • Put a glass of water(half to three quarters full) on the floor of your kitchen or bathroom; get get on your knees and bend down to the glass; place your top lip on the far side of the glass and tip the glass to start drinking; drink until your hiccups go away or you run out of water.
  • Take a deep breath; exhale as much as you can; slowly drink water from a glass until you cannot hold your breath anymore; stop drinking and start breathing again. (One reader suggests that the water be at room temperature, and that you drink the whole glass rather than drinking slowly.)
  • Intersperse drinking with breathing so that each inhalation and exhalation is interrupted by three or more swallows (that is, inhale a little, drink a little, inhale a little more, drink a little, etc., then exhale a little, drink a little, exhale some more, drink a little, etc.). The hiccups will stop immediately, but keep going for one minute or for a period greater that the period of your hiccup, whichever is longer.

    Cures that involve eating or drinking something (not drugs)

  • Eat kim-chee.
  • Drink vinegar.
  • Eat a dill pickle. 
  • Swallow dry bread.
  • Swallow crushed ice.
  • Drink dill pickle juice. 
  • Drink bitters and soda.
  • Eat a spoonful of mustard.
  • Swallow a teaspoon of sugar.
  • Eat pickled habanero peppers.
  • Eat two tablespoonsful of honey.
  • Eat a tablespoon of peanut butter.
  • Drink a shot of lemon (or lime) juice.
  • Eat a really sour candy (e.g. Warhead).
  • Eat a teaspoonful of Damson Preserves.
  • Drink ginger tea with honey for 10 minutes.
  • Drink a shot of lime juice with Tabasco sauce added.
  • Eat a lemon or lemon wedge (as if it were an orange).
  • Drink half a glass of pop and then make yourself burp.
  • Put bitters on a lemon wedge and then eat the lemon wedge.
  • Slowly eat a mandarin orange, sucking it against the soft palate.
  • Swallow a teaspoon full of sugar and strong vinegar in one gulp.
  • Swallow a spoonful of chocolate pudding (as if it were medicine).
  • Drink some soda (drink a second swallow if it doesn't work on the first one).
  • Squeeze a lime into a shot (not just a couple of drops) of bitters; down it quickly.
  • Sprinkle a lemon wedge with sugar, top it with 1/3 teaspoon of bitters, bite into it and suck it dry.
  • Put a spoonful of sugar in front of your lips, inhale and suck in the sugar so that it hits the back of your throat.
  • (This from a bartender) Two drops of bitters; 2 oz. (2 shots) of sweetened lime juice; and fill glass (8 oz.) with soda water; drink in one continuous motion; wait 30-60 seconds.
  • Pour a packet of Sweet & Low into the palm of your hand and lick it, bite into a freshly cut lemon wedge, and swallow a teaspoonful of Agnostura bitters. (The contributor, a bartender, asked that the name "T's Lick, Toss & Bite but Hick No More" be included with this cure.)

    Drugs, herbs, and drinks that are reputed to cure hiccups

  • Dill.
  • Rolaids. 
  • Marijuana.
  • Ignatia amara.
  • HICCUPS AWAY.
  • Magnesia phosphoricum.
  • Drink Alka Selzer in water.
  • Alcohol-free extract of catnip and fennel.
  • Take anything that would make you sneeze. 
  • A shot of burbon followed by several forced burps.
  • Pepto-Bismol Chewables (take two, cherry-flavored).
  • Put an Alka Selzer, salt, and lemon juice in a glass of water; drink.
  • Lidocaine drops in the ears combined with sleep-inducing cough medicine.
  • Take repeated small sips of a full beer with a short pause between sips (a second or less).
  • Quercus e glandibus (homeopathic remedy derived from acorns, manufactured by Schwabe, Germany).
  • Various prescription drugs, including Amphetamine, Amyl nitrite, Baclofen, Haldol (haloperidol), Reglan (metaclopromide), Diphenylhydantoin, Haloperidol, Orphenadrine, Ketamine, Carbamezapine, Metoclopramide, Quinidine, Atropine, Edrophonium.

    Cures that are not recommended, ineffective, or involve risk of injury or death ("Don't Try This At Home")

  • Smoke a cigarette.
  • Thorazine (chlorpromazine)
  • Have someone deliver a swift punch to your abdomen.

     

    Overview of Hiccups

    Names for Hiccups

    If you’re searching the Internet for information about hiccups, you should use all three of these names/spellings:

  • hiccups
  • hiccoughs (pronounced the same as the first)
  • singultus (the medical term)

    Causes of Hiccups

    Although the mechanisms underlying hiccups are not fully understood (though it is considered likely to be due to over-stimulation of the glossopharyngeal nerve, which serves the pharynx, posterior tongue, and parotid gland), there are several common, widely recognized causes of hiccups:

  • tickling
  • swallowing air
  • eating (esp. spicy food) or drinking (esp. carbonated or alcoholic)
  • talking or laughing
  • nervousness or anxiety
  • rapid change in body temperature or temperature of stomach contents

    There are also many less well known (and much less common) causes:

  • alcohol abuse
  • laparoscopic fundoplication
  • misalignment of vertebrae in neck
  • reflux (stomach contents irritating the esophagus)
  • a low concentration of sodium in the bloodstream (hyponatremia)
  • foreign bodies lodged against the eardrum, in the lungs, or in the esophagus
  • irritation of the diaphragm, glossopharyngeal nerve, phrenic nerve, or vagus nerve
  • irritation to membranes enclosing the heart (pericardium), including by a pacemaker
  • other neurological problems (including multiple sclerosis, encephalitis, meningitis, brainstem lesions)
  • etc...

    Hiccups often arise in the absence of any of the causes listed above, so you shouldn’t assume that just because you have hiccups, it’s due to one of those things (in fact, the odds are it’s not).

    Treatment of Hiccups

    Usually hiccups go away by themselves in a short time, and don’t require any treatment. Often, they respond to the simpler non-drug methods described here. If your hiccups last long enough to significantly interfere with sleep, eating, or normal activities, you should consider seeing a doctor, to whom you might want to mention the less common causes and prescription medications listed here.

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    Hiccoughs - Hiccups

    Hiccups occur when the flap of tissue that serves as the gateway to the lungs (glottis) closes suddenly and unexpectedly at the same time as the abdominal muscle that controls breathing (diaphragm) contracts. The glottis' spasmodic closure stops the column of air being drawn into the lungs and produces the characteristic hiccup sound.

     
     
     

    Hiccups

    		  
      Hiccups, or hiccoughs, are involuntary sounds made by spasms of the diaphragm. The diaphragm is a large sheet of muscle slung beneath the lungs that, together with the intercostal muscles, causes us to breathe. The muscular spasm of these muscles sucks air into the lungs, and the quick inhalation makes a structure inside the throat (called the epiglottis) slam shut. (The epiglottis is a flap of tissue that closes over the windpipe during swallowing to prevent the inhalation of food, fluids or saliva.) This sharp closure of the epiglottis causes the characteristic 'hic' sound of hiccups. Generally, hiccups resolve by themselves after a few minutes, but prolonged hiccups that last for days or weeks may be symptomatic of underlying disorders. Certain drugs, including epilepsy medications, can make a person more prone to hiccups.

    Symptoms
    The symptoms of hiccups include:
    • A sharp contraction or spasm of the diaphragm that is felt just below the breastbone.
    • Air is involuntarily sucked into the throat.
    • The closing epiglottis makes a 'hic' sound.
    • Hiccups usually stop after a few minutes.

    The cause is unknown
    The muscular activity of the diaphragm is controlled by nerves. Hiccups occur when particular stimuli trigger the nerves to send the diaphragm into spasms. It is not known why this occurs.

     Triggers of hiccups
    The cause of hiccups is often unknown and there may be no apparent trigger. Various triggers, particularly those that cause pressure on the diaphragm, are known to prompt an attack of hiccups in some people from time to time. Some of these triggers include:

    • Eating food too quickly
    • Hot or spicy foods
    • Indigestion
    • Overconsumption of alcohol
    • Fizzy drinks
    • Cigarette smoking
    • Stress
    • Bad odours
    • Pregnancy.

    Self-help strategies
    Hiccups are harmless and usually resolve by themselves in a few minutes. Some hiccup 'cures' include:

    • Hold your breath
    • Take deep breaths
    • Breathe into a paper bag
    • Eat a bit of fresh ginger
    • Suck on a lemon
    • Have a hot water and honey drink
    • Eat a spoonful of sugar
    • Drink a glass of water slowly
    • Eat ice
    • Gargle
    • Sit down and lean forward over your knees
    • Ask someone to give you a fright.

    Hiccups may be symptomatic of disease
    Hiccups that last for days, weeks or even years may be symptomatic of underlying disease. Certain lung or brain disorders can sometimes interfere with the functioning of the diaphragm and make the person prone to hiccups. Hiccups may also be a side effect of surgery or particular medications. Some of the diseases, conditions and drugs that may prompt frequent or prolonged attacks of hiccups include:

    • Oesophagitis (inflammation of the oesophagus).
    • An overactive thyroid gland.
    • Pleurisy (inflammation of the membrane surrounding the lungs).
    • Pneumonia (inflammation of the lungs).
    • Brain damage, such as stroke or tumour, that affects the area of the brain which controls the diaphragm.
    • Abdominal surgery.
    • Chest surgery.
    • Certain epilepsy medications.
    • Nicotine gum.

    Medical treatment
    Prolonged hiccups should be medically investigated. Treatment options may include:

    • Treatment for the underlying disorder
    • Changes to current drug dosages
    • Switching to another form of nicotine therapy
    • Anti-spasmodic drugs to calm the diaphragm
    • A tube inserted into the nose (nasogastric intubation)
    • A nerve block
    • Surgery, to sever some of the nerves servicing the diaphragm.

    Where to get help

    • Your doctor

    Things to remember

    • Hiccups, or hiccoughs, are involuntary sounds made by spasms of the diaphragm.
    • Hiccups are usually harmless and resolve by themselves after a few minutes.
    • In some cases, prolonged hiccups that last for days or weeks may be symptomatic of underlying disorders.
     
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    Marijuana for Intractable Hiccoughs
    by Lester Grinspoon, M.D.

    Everyone has experienced hiccoughs, but little is known about them. Ordinarily, hiccoughing is short-lived and benign and therefore of little clinical interest. But occasionally people suffer bouts of intractable hiccoughs, which become extremely uncomfortable and eventually create a health problem, making it difficult to sleep and even eat. Little is known about the treatment of this condition.

    I have suffered from prolonged hiccoughs occasionally. One episode in medical school lasted almost 72 hours. I could not attend classes and could not sleep. I was treated at the Brigham & Women’s Hospital (then the Peter Bent Brigham Hospital) to no avail. Eventually the hiccoughing stopped as unexpectedly as it had started. Several years later I learned from a letter in the New England Journal of Medicine that prolonged hiccoughs could be interrupted by placing a teaspoon of granular sugar on the tongue. This simple remedy worked for me usually but not always. About four years ago, during an episode when this method failed, I smoked some marijuana and found that the hiccoughs stopped immediately. Twice since then I have gotten the same relief after smoking marijuana.

    Until recently I have not been sure whether this was a consequence of some property of cannabis or due simply to chance or some psychological phenomenon. I had no idea whether it would be useful to anyone else who suffered from prolonged or intractable hiccoughs. But last week I read the following report from Ian Gilson and Mary Busalacchi in the British medical journal Lancet, Volume 351, Number 9098 - Saturday 24 January 1998, SECTION: Research letters:

    Marijuana for Intractable Hiccups

    A patient with AIDS and a history of oesophageal candidosis underwent minor ambulatory surgery. He was on indinavir, and he received perioperative intravenous midazolam and dexamethasone. The following morning he developed persistent hiccups. Chlorpromazine controlled the hiccups only during sleep. Oral nifedipine, valproate, lansoprazole, and intravenous lidocaine had no effect. Glabellar acupuncture on day six and nine terminated the hiccups for less than an hour. Removal of a hair from the tympanic membrane on day eight and irrigation of Marcaine into the external auditory canal on day nine gave only brief relief. On day eight the patient, who had not smoked marijuana before, smoked marijuana, and his hiccups stopped. They recurred on day nine and on day ten the patient again smoked marijuana; hiccups stopped immediately and did not recur. On day 14 he was found to have fluconazole-resistant oesophageal candidosis on oesophagoscopy, and was treated with oral itraconazole solution and oral amphotericin B.

    Intractable hiccups has been reported as an uncommon complication of AIDS; in the largest series, most cases were attributed to oesophageal candidosis and other oesophageal diseases.1 This patient did have oesophageal candidosis, but it was longstanding and his hiccups stopped before a change in treatment, so this is unlikely to be the cause of his hiccups. Midazolam2 and dexamethsone3 are the drugs most commonly associated with iatrogenic hiccups. The patient received both shortly before the onset of hiccups, and indinavir may have prolonged the effect of midazolam by inhibiting its metabolism. Although midazolam is contraindicated in patients on protease inhibitors, it and other proscribed drugs may be inadvertently administered if the potential for drug-drug interactions is not considered.

    Anecdotal reports support the use of marijuana in AIDS-related nausea and anorexia, and dronabinol is approved for treatment of AIDS wasting. Because intractable hiccups is an uncommon condition, it is unlikely that the use of marijuana will ever be tested in a controlled clinical trial, and blinding would be difficult. Despite federal policy which forbids the use of marijuana therapeutically,4 this report should be considered for hiccups refractory to other measures.

    1 Albrecht H, Stellbrink HJ. Hiccups in people with AIDS. J Acquir Immun Defic Syndr 1994; 7: 735

    2 de Mendonca MJT. Midazolam-induced hiccoughs. Br Dent J 1984; 157: 49

    3 Vasquez JJ. Persistent hiccup as a side effect of dexamethasone treatment. Hum Exp Toxicol 1993; 13: 32.

    4 Kassirer JP. Federal foolishness and marijuana. N Engl J Med 1997; 336: 366

     
    Information
     
     
    Patent Application:

    Patent Application of
    Larry R. Nolan for
    A DIETARY SUPPLEMENT FOR STOPPING HICCUPS

    Background--Field of Invention

    This invention relates to a dietary supplement, and more particularly, to a dietary supplement for use in stopping hiccups.

    Background--Description of Prior Art

    Presently, there are millions of people around the world who suffer from hiccups or hiccoughs. This is a common condition characterized by the repeated involuntary spasmodic contractions of the diaphragm, followed by sudden closure of the glottis, which checks the inflow of air and produces the characteristic sounds. Mild hiccups are most often a reaction to common digestive disturbances, however, there are times when people hiccup for no apparent reason. No one knows for sure why these episodes occur but experts do know that even infants hiccup and the reflex occurs intermittently throughout life. Chronic or consistent hiccups can be a sign of a more serious medical problem.

    Page (2)

    Virtually anything that affects the head, chest, or abdomen such as kidney failure, liver disease, cancer, nervous system problems, ulcers or heart attack can cause hiccups. The contraction of the diaphragm is caused by stimulation of the vagus nerve either by the brain or by irritation anywhere along the length of the nerve. The vagus sends a signal to the phrenic nerve which leads to the diaphragm. The diaphragm then spasms causing the hiccup. Depending on the severity of the condition, there are various home remedies, drugs, and surgery that are used to stop hiccups. The most common home remedies are breathing into a paper bag, holding one's breath, drinking water, eating sugar, or sucking on a slice of lemon. Two of the drugs used for severe cases are prochlorperazine, and chlorpromazine. Intractable hiccups may require surgery to cut the link between the phrenic nerve and the diaphragm, as a means of stopping the spasms. The home remedies may work sometimes but they are usually slow in stopping the hiccups. The drugs and surgery are expensive and may produce side effects. Accordingly, there is a need for an inexpensive and fast acting means of stopping hiccups with no side effects.

    Objects and Advantages

    (a) With the foregoing in mind, it is a primary object of the present invention to provide a dietary supplement for use in stopping hiccups.

    (b) It is another object of the present invention to provide a dietary supplement for stopping hiccups that is comprised of natural ingredients.

    (c) It is still a further object of the present invention to provide a dietary supplement for stopping hiccups that has minimal or no side effects and is safe for internal consumption.

    Page (3)

    (d) It is still a further object of the present invention to provide a dietary supplement for stopping hiccups that is inexpensive and fast acting.

    (e) It is still a further object of the present invention to provide a dietary supplement for stopping hiccups that is in full compliance with the Dietary Supplement Health and Education Act of 1994 (DSHEA).

    These and other objects and advantages of the present invention will be more readily apparent in the summary and description which follows.
    Summary of the Invention
    The present invention is directed to a dietary supplement for use in stopping hiccups. The dietary supplement is comprised of natural ingredients. Specifically, the dietary supplement composition of the present invention includes Key Lime concentrate, Lemon concentrate, and Lime Essential Oil. Key Lime, also known as Peruvian lime is a fruit known botanically as Citrus Aurantifolia and is present in the amount of.......

    (This information is a trade secret until the patent issues.)
    I have found that when Lemon concentrate, Key Lime concentrate and Lime Essential Oil are combined in accordance with determined proportionate ranges,
     

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