The hiccups

Clipboard of Dr. Claudio Italiano

Related links: Novelty: the patient with nausea patients with dyspepsia, Pain and symptoms in Gastroenterology stomach swells patients with achalasia
.It is a symptom trivial and frequent, sometimes without pathological significance, other times expression devious of glaring pathologies, particularly when it becomes persistent and unbearable and lasts more than 48 hours, implying an underlying metabolic or physical illness.

The hiccup is a sudden involuntary contraction of the muscles and inspirers of diaphragm, ending with the arrest of airflow inwards because of sudden closure of the glottis. It is due to a stimulation of one or more arc reflection of stimulations hiccups, i.e. vague and nerves nerves frenici nervous, whose centre is located at the top of the spinal cord.

Causes of hiccups
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The causes of stimulation of the arc reflection are manifold:

-Central causes of diseases, i.e. as tumors, s.n.c., vascular lesions, meningoencefaliti Parkinson, hysteria

-toxic, alcoholism, uremia, hyponatremia, diabetes

-irritation of no frenico for m. pleural, pericardial, mediastiniche;

-diaphragmatic or irritation for reflections on departure from iatali hernia, stomach disease (ulcer, cancer), intestines, peritoneum and other viscera.

-lesion esophageal variceal hemorrhage (oesophagitis, achalasia, carcinoma, obstruction)

-hairs or insects or foreign irritant the membrane of timpone;

-drugs: dexamethasone, metilprednisole, benzodiazepines, Alpha-methyldopa

-in postoperative in particular operation on the abdomen (peritoneum)
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Therapy.

Escudere abdominal disease (see approach to patient gastroenterologico) or thoracic and all specific causes when identified.

Sometimes goes well also use Grandma's remedies (!): make drink very small sips of water without catch your breath. These are the tricks to implement the dancers before a performance when you see the hiccup: try drinking small sips of water, remaining standing.

Administer antacids: es. aluminium hydroxide and magnesium oxide

In case of serious and persistent hiccups of Central origin can short spiky hair baclofen (lioresal 5-10 mgx3/die) or chlorpromazine (largactil 25-50 mg i.m.) or nifedipine (adalat from 10 or 20 mg/day). OBVIOUSLY EACH DRUG SHOULD BE ALWAYS YOUR DOCTOR TO PRESCRIBE!!

In case of hiccup post-operative surgical or shows the stimulation of the pharynx with catheter. Sometimes even induce vomiting or emptying the stomach with a nasogastric or perform maneuvers against irritation of the vague: pressure sopraorbitaria or carotid sinus massage, amphetamine breathing Centre (do breathing mixtures based on 5% CO2) under supervision of physician rotlung can have some beneficial effect.



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