Major Research Findings

Hiccups are a familiar experience for everyone, but their underlying mechanisms are poorly understood. 16 While acute hiccups can often be resolved with physical maneuvers, persistent and intractable hiccups lasting days or months are rarer, yet can be distressing and difficult to treat. 16 These hiccups can stem from various causes, including abdominal pain and hiccups due to abdominal adhesions, 11 phrenic nerve block, hiccups under general anesthesia, 5 hiccups during gynecological surgery under sedation, 9 persistent hiccups in the elderly, 17 intractable hiccups, 12 resistant idiopathic hiccups, 13 persistent hiccups induced by supratentorial infarcts, 4 persistent hiccups in advanced cancer patients undergoing palliative care, persistent hiccups in patients with acute myeloblastic leukemia, 1 persistent hiccups after arthroplasty, 10 obstinate hiccups due to dorsal medullary cavernous hemangioma, 2 hiccups during stroke rehabilitation, 7 persistent hiccups treated with myofascial trigger point dry needling, recurrent persistent hiccups due to opioid treatment, 3 intraoperative hiccups, persistent hiccups after arthroplasty, 8 intractable hiccups, 18 persistent and intractable hiccups, 21 hiccups following stroke, 14 intractable hiccups treated with combined cervical vagus nerve and phrenic nerve blocks, persistent hiccups after treatment of COVID-19 with dexamethasone, 6 and refractory hiccups. 15

Treatment Summary

A wide array of pharmacological and non-pharmacological interventions have been employed for treating persistent and intractable hiccups. 19 However, the efficacy and safety of these interventions are not well-established. 19 Studies have explored the use of gabapentin 17 , 13 , 1 , olanzapine 18 , baclofen 18 , 4 , chlorpromazine 5 , ephedrine 9 , lidocaine 9 , vinegar , fentanyl , amantadine 15 , acupuncture 14 , 8 , pulsed radiofrequency on the phrenic nerve 13 , cervical epidural block 12 , vagus nerve and phrenic nerve blocks , dexamethasone 6 , prednisolone 6 , metoclopramide 4 , diazepam 4 , levetiracetam 4 , and perampanel 4 as treatment options.

Benefits and Risks

Benefit Summary

Treating hiccups is crucial because they can significantly impact a patient's quality of life when they become persistent or intractable. 19 Treatment offers the potential to alleviate hiccups and improve a patient's quality of life. 17 , 13 , 1 Treatment can also mitigate the risk of complications associated with hiccups. 12

Risk Summary

Treatment for hiccups carries the risk of side effects. 19 For instance, chlorpromazine has sedative effects, which might negatively affect rehabilitation participation. 7 Opioid treatment can also lead to hiccups as a side effect. 3 Therefore, it's essential to discuss the risks of side effects with your doctor before undergoing treatment for hiccups. 19

Comparison Between Studies

Similarities in Studies

Many studies highlight the diverse range of treatment options available for hiccups. 19 , 21 However, there is a lack of conclusive evidence regarding the most effective or harmful treatments. 19 , 21

Differences in Studies

Different studies focus on varying types of hiccups and employ different treatment approaches. 19 For example, some studies examine the effectiveness of gabapentin for intractable hiccups. 17 , 13 Other studies investigate the efficacy of fentanyl for hiccups during surgery. Additionally, some research explores the benefits of acupuncture for hiccups following stroke. 14

Consistency and Contradictions in Findings

The effectiveness of hiccup treatments has not yielded consistent results. 19 , 21 Certain treatments might be effective for some individuals but not others. 19 Consequently, further research is needed to pinpoint the most effective and safe treatment approaches. 19

Practical Implications

In most cases, hiccups resolve spontaneously within a few days. 16 However, if hiccups persist or impact your quality of life, seeking medical advice is crucial. 19 A doctor can identify the underlying cause of the hiccups and recommend appropriate treatment. 19

Current Research Limitations

Research on hiccup treatments remains limited. 19 Specifically, robust evidence regarding the efficacy and safety of different treatments is lacking. 19 Therefore, further research is warranted. 19

Future Research Directions

Future research on hiccup treatments should prioritize the following areas: 19

• Conducting comparative studies to evaluate the efficacy of different treatment options
• Undertaking research to assess the safety of treatment approaches
• Pursuing research to identify the underlying causes of hiccups

Conclusion

While there are various treatment options for hiccups, the most effective and safe approaches remain uncertain. 19 If you experience persistent or debilitating hiccups, consulting a doctor is essential. 19

List of Treatments

gabapentin 17 , 13 , 1 , olanzapine 18 , baclofen 18 , 4 , chlorpromazine 5 , ephedrine 9 , lidocaine 9 , vinegar , fentanyl , amantadine 15 , acupuncture 14 , 8 , pulsed radiofrequency on the phrenic nerve 13 , cervical epidural block 12 , vagus nerve and phrenic nerve blocks , dexamethasone 6 , prednisolone 6 , metoclopramide 4 , diazepam 4 , levetiracetam 4 , perampanel 4