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Hiccups - A new explanation for the mysterious reflex

[๐—›๐—ฒ๐—ฎ๐—น๐˜๐—ต ๐—œ๐—ป๐˜€๐—ถ๐—ด๐—ต๐˜๐˜€ - ๐—›๐—ถ๐—ฐ๐—ฐ๐˜‚๐—ฝ๐˜€]

Today weโ€™re going all spontaneous and will be talking about something OTHER than Covid, as a reminder that we have a whole big chunk of life we put on hold for the past year or so.

Hiccups. Yup, thatโ€™s what weโ€™re gonna talk about today.

Weโ€™ve all had them, both the literal and the figurative kind. Theyโ€™re nothing more than a slight nuisance to most of us, but it can get so bad that it drove some people to take their own lives.


Itโ€™s a condition called intractable hiccups.


Intractable hiccups are defined medically as hiccups lasting longer than a month.

Patients who have this condition experience disturbances to their sleep, eating ability and overall emotional stress.


Roy Duncan was such a man, and he took his life after suffering from 4 years of intractable hiccups. Before his death, he had up to 25 hiccups a minute, 24 hours a day. Thatโ€™s about 600 hiccups a day.


Ouch.


So what causes hiccups?


We were told all sorts of tales as kids, and it ranges from eating too fast to eating food without water. The scientific truth is, nobody really knows exactly how it is triggered. Pregnant ladies will tell you that even before a baby is born, the foetus can have hiccups in the womb. So this rules out theories that link it to food intake.


An interesting theory proposed links hiccups way back to the time of the dinosaurs, when mammals started to evolve. As mammals started to suckle as their main means of feeding, a lot of air went into the stomach. Hiccupping was proposed as a mechanism to remove air from the stomach, according to Daniel Howes in his research paper.

Anyway, as pharmacists we are naturally interested in the treatment options for such a peculiar condition. Iโ€™m pretty sure putting a bowl on top of your head while hitting it with chopsticks wonโ€™t cut it in this era.


According to Dr. Garry Wilkes in his 2017 study, some medicine (like Chlorpromazine and Haloperidol) that messes with our brains are the best for intractable hiccups. However if you are like me, we generally wonโ€™t want any brain-messing drugs just to cure our hiccups. A common medicine called metoclopramide (usually used to treat vomiting) can instead be effectively used to treat this condition.


Nonetheless, anybody with such a condition best see a doctor first to confirm if it is indeed the case of intractable hiccups. And hopefully, we can all get over our hiccups in life.


Spontaneously.


References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3504071/

2. https://emedicine.medscape.com/article/775746-medication

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