HICCUP IN ADULTS - AN OVERVIEW

Hiccup is a forceful, involuntary inspiration commonly experienced by fetuses, children and adults. Its purpose is unknown and its pathophys iology still poorly understood. Short hiccup bouts are mostly associat ed with gastric distention or alcohol intake, resolve spontaneously or with simple folk remedies and do not require medical attention. In co ntrast, prolonged hiccup is a rare but disabling condition which can i nduce depression, weight loss and sleep deprivation. A wide variety of pathological conditions can cause chronic hiccup: myocardial infarcti on, brain tumour, renal failure, prostate cancer, abdominal surgery et c. Detailed medical history and physical examinations will often guide diagnostic investigations (abdominal ultrasound, chest or brain CT sc an ... ). Gastric and duodenal ulcers, gastritis, oesophageal reflux a nd oesophagitis are commonly observed In chronic hiccup patients and u pper gastrointestinal investigations (endoscopy, pH monitoring and man ometry) should be included in the diagnostic evaluation systematically . Etiological treatment is not always available and chronic hiccup tre atment has classically relied on metoclopramide and chlorpromazine. Re cently, baclofen (LIORESAL) has emerged as a safe and often effective treatment.