Treating Singultus

I rarely open essays with a quote, but this is just too perfect to pass up:

Singultus – spasmodic involuntary contraction of the diaphragm that results in uncontrolled breathing in of air; it is accompanied by a peculiar noise produced by a beginning inhalation that is suddenly checked by closure of the glottis.

Medical Dictionary

Three cheers to anyone who can diagnose this definition. Singultus is, in fact, another way to refer to hiccups.

Turns out, hiccups are poorly understood. And rather than try to understand them, many current studies on hiccups focus more on treating them. While I’ve certainly been plagued by more cases of the hiccups than most of my friends and family, I certainly cannot fathom the curse of month-long, intractable hiccups that refuse to be quieted. What are scientists saying?

First, it’s multidisciplinary.

That’s right, the study of hiccups is fully respectable for its breadth of discipline. Doctors should consider neurology (the brain), gastroenterology (the stomach), and pulmonology (the lungs), when faced with a particularly chronic case.

Treatment can be a stab in the dark.

There’s only one FDA-approved drug for intractable hiccups on the market. Dopamine-inhibiting drugs might help; so might anti-convulsants. Antipsychotic drugs may do the trick, but have risky side-effects. Various studies report acupuncture as a treatment. Regardless, anecdotal evidence is often relied on here for lack of knowledge, and most treatments are considered only “where simple physical manoeuvres, such as breath holding have failed” (Jeon et al. 2017).

It’s different than other esophageal plagues.

Belching can be treated as a behavioral disorder. Aerophagia (excessive swallowing of air) may require surgery. But hiccups is so poorly understood, it is treated more like a game of whack-a-mole: treat the cause if possible, and if cause is unknown, treat the symptoms.

Hiccups decrease quality of life.

Intractable hiccups that carry on for years are not only an anatomical mystery and a personal inconvenience; they may “caus[e] significant morbidity and discomfort in patients” (Grewal et al., 2018). Actually blocking related nerves is often a last resort, but there are an unlucky few on whom even this does not work.


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