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Hiccups Clinical Presentation

  • Author: Garry Wilkes, MBBS, FACEM; Chief Editor: Steven C Dronen, MD, FAAEM  more...
 
Updated: Dec 09, 2015
 

History

No medical training is required to diagnose hiccups. For brief episodes that self-terminate or that respond to simple maneuvers, no investigation or follow-up care is necessary. In contrast, persistent and intractable hiccups frequently are associated with an underlying pathological process and may induce significant morbidity. The focus of the history, examination, and investigation is on identifying these causes and effects. A full systemic inquiry, surgical history, and comprehensive drug history may identify one of the many possible causes.

Hiccups that abate with sleep and temporally relate to stressful circumstances commonly are psychogenic in origin. Arrhythmia-induced syncope has been reported as both the cause and the effect of hiccups.[13] Gastroesophageal reflux also may either cause or result from hiccups. Weight loss, insomnia, and emotional distress may complicate prolonged episodes. Alcoholism and acute alcohol ingestion may contribute to the development of hiccups.

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Physical Examination

In view of the wide range of differentials, a full physical examination is necessary. A complete and focused physical examination may yield evidence of the following:

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Contributor Information and Disclosures
Author

Garry Wilkes, MBBS, FACEM Director of Clinical Training (Simulation), Fiona Stanley Hospital; Clinical Associate Professor, University of Western Australia; Adjunct Associate Professor, Edith Cowan University, Western Australia

Disclosure: Nothing to disclose.

Chief Editor

Steven C Dronen, MD, FAAEM Chair, Department of Emergency Medicine, LeConte Medical Center

Steven C Dronen, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Eugene Hardin, MD, FAAEM, FACEP Former Chair and Associate Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science; Former Chair, Department of Emergency Medicine, Martin Luther King Jr/Drew Medical Center

Disclosure: Nothing to disclose.

Robin R Hemphill, MD, MPH Associate Professor, Director, Quality and Safety, Department of Emergency Medicine, Emory University School of Medicine

Robin R Hemphill, MD, MPH is a member of the following medical societies: American College of Emergency Physicians and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

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