Hiccups (hiccoughs) are the characteristic sounds produced by the involuntary contractions of the diaphragm terminated by sudden closure of the glottis. In the majority of patients, it is a self-limiting condition. The most common cause of hiccups is thought to be gastric distension after rapid ingestion of food, fluid or air. The causes of intractable persistent hiccups are listed below, with aetiology characterised by the hiccup reflex pathway.

Causes

Phrenic nerve irritation

  • Pharyngitis/laryngitis

  • Foreign body

  • Goitre

  • Oesophageal carcinoma

  • Lung tumour

  • Thoracic surgery

Diaphragmatic irritation

  • Asthma

  • Bronchitis

  • Lower lobe pneumonia

  • Empyema

  • Subphrenic abscess

  • Diaphragmatic hernia

  • Gastric distension

GI conditions

  • Gastritis

  • Irritable bowel disease

  • Pancreatitis

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