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Chronic hiccup is a rare disorder causing repeated inspiratory spasms over periods of 48 hours or more. The disorder affects approximately 1 in 100,000 individuals. Some patients are affected by persistent hiccups for days or even weeks, alternating with periods of remission. There are many known causes, among which the most prominent is esophagitis due to gastroesophageal reflux. The best treatment is etiologic. Hiccup associated with gastroesophageal reflux should be treated with antacids and inhibitors of the proton pomp, which are remarkably effective in most of cases. Surgery may be required to treat the reflux. In all cases, close monitoring of the esophagus is recommended. If the hiccups are associated with other causes, in particular in association with central nervous system problems, Baclofen appears to be the treatment of choice. Ideally patients should be managed by multidisciplinary teams with experience in complex disorders caused by thoracic and neurological pathologies. |