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Have chronic hiccups. No relief from thorazine, valium, raglan. How to treat this?

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Practicing since : 1962
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I have chronic hiccups. They are getting worse. At times I can't catch my breath and have to force myself to cough to get my breath back. Have tried Thorazine, Valium, raglan and others. At times I can't keep food down. Email: YYYY@YYYY
Posted Thu, 16 May 2013 in Digestion and Bowels
Answered by Dr. Charles S Narasi 4 hours later

Thank you for your query.

I am sure that your doctors have ruled out all the different causes of hiccups including problems with heart, lung and any tumors of the diaphragm, GERD etc.

Looks like you have tried all the drugs that are supposedly effective. I am sure the doctors have tried acupuncture or hypnosis also to control hiccups. If all the medical measures fail , there are surgical options.

One is implantation of vagus nerve stimulator in the upper chest. This can alter the nerve signals and control hiccups.Other option is injecting the phrenic nerve which controls the contraction of the diaphragm muscle called the nerve block. This can be effective and has been done in cancer patients.
There is also a drug Nefopam which is related to anti-parkinson drug structure, given intravenously abruptly stops hiccups. This was in some patients with leukemia. The problem is the availability of this drug.

Other drugs such as Carvedilol 6.25 mg. four times a day helped to suppress 2 years of hiccups in a patient with neurological problem.

I can't stress enough that they have to rule out all the underlying conditions that may cause hiccups including central nervous system disorders, gastrointestinal, thoracic, cardiac and toxic or drug related, post-operative or psychogenic disorders.

This is a very complex and difficult condition and it takes a lot of expertise and involvement of many specialists.

Hope I have given you some guide lines that you can discuss with your own doctor.

I wish you the very best.
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