digestive disorders
Hiccups
Evaluation of Hiccups
Brief episodes of hiccups do not require evaluation by a doctor. For persistent hiccups, the following information can help people decide whether a doctor’s evaluation is needed and help them know what to expect during the evaluation. In people with hiccups, certain symptoms and characteristics are cause for concern. They include Neurologic symptoms (such as headache, weakness, numbness, and loss of balance) People who have hiccups and warning signs should see a doctor right away. People without warning signs should see a doctor if hiccups last more than 2 or 3 days. Doctors first ask questions about the person's symptoms and medical history. Doctors then do a physical examination. What doctors find during the history and physical examination often suggests a cause of the hiccups and the tests that may need to be done ( see Table: Some Causes and Features of Persistent Hiccups ). The history is focused on how long the hiccups have lasted, what remedies the person has tried, and whether the person has recently been ill or had surgery. Doctors also ask people whether they have any Symptoms of gastroesophageal reflux Swallowing difficulties Cough, fever, or chest pain Neurologic symptoms (such as headaches and/or difficulty walking, talking, speaking, or seeing) Doctors also ask people about their use of alcohol. The physical examination is focused on a full neurologic examination. A general examination usually does not reveal much, but doctors look for signs of chronic disease such as severe wasting away of muscle and fat tissue (cachexia). Doctors generally do not do any testing for people who have brief hiccups. People who have warning signs or whose hiccups are persistent and have no obvious cause should have testing. Doctors typically begin with blood tests, chest x-rays, and Electrocardiography . Other tests are done based on the other symptoms people have ( see Table: 