Side Effect: Hiccups

What are hiccups?

Hiccups are a result of continuous involuntary contractions of the diaphragm, followed by a sudden closure of the vocal cords. Hiccups typically occur intermittently and are usually benign and resolve on their own within a few minutes to hours. However, in some cases, hiccups can be extremely persistent and even debilitating, leading to discomfort, pain, and can have a significant impact on quality of life.

What do hiccups look like?

Hiccups are known by the characteristic "hic" sound. The sudden contraction of the diaphragm muscle causes a quick inhalation of air. This is then followed by a sudden closure of the vocal cords and this is what produces the “hic” sound. Hiccups can occur between 4 and 60 times per minute.

Who gets Hiccups?

The prevalence of hiccups in cancer patients is reported to be approximately 4-5%. Patients with cancer can experience hiccups, either as a result of the disease itself, or as a side effect of cancer treatment, or supportive care medications. For example, Common a common cause of hiccups can be from taking the steroid known as dexamethasone.

Other causes may include spicy food, smoking, or alcohol consumption. Reflux disease or heartburn, nervous disorders, sore throat or goiter (thyroid disorders), masses in throat (from tumors or cysts), stress, excitement can also be causes of hiccups.

How to prevent Hiccups

Preventing hiccups can be challenging since they often occur spontaneously and without warning. However, some methods that have been suggested to prevent hiccups include avoiding:

• overeating
• carbonated beverages
• smoking
• alcohol
• spicy foods

Hiccups can also be triggered by over excitement or anxiety.

How to treat Hiccups

Most cases of hiccups can be self-resolving or only need non-pharmacologic intervention. A myriad of physical techniques have been used, although none have been studied in clinical trials. Some of these techniques include:

• Breath holding
• Induce fright
• Rebreathing into paper bag
• Cold compress to face
• Carotid massage
• Drawing legs to chest (rolling into a ball)

If physical techniques are unsuccessful, there are a few pharmacological treatments available to manage hiccups. Some of the most commonly used medications include:

• Baclofen (Lioresal®, Gablofen®)
• Gabapentin (Neurontin®)
• Metoclopramide (Reglan®)
• Chlorpromazine (Thorazine®)