What causes chronic hiccups in my 77-year-old father?

Question

Hi doctor,

My father is 77 years old. He had previous episodes of hiccups, and when he used to have Ulgel A, they would go away. For the past six days, he has been having hiccups. But now, he has been having hiccups continuously. He has been taking Baclofen 10 mg, Ulgel A, Mucaine gel, Perinorm, Rantac 150 for the past five days, and the hiccups have not stopped. Apart from having continuous hiccups, sometimes he gets water in his mouth from his stomach. For BP, he is taking TAH 40 mg, and for diabetes, he is taking Cetapin XR 500 mg in the morning and Metformin 250 mg at night. I kindly request you not to advise any lab tests for now, as it is dangerous to take him to the hospital during this pandemic. Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern about your father. Well, the treatment he is receiving is already more than enough. Tablet Baclofen and tablet Perinorm (Metoclopramide 10 mg) are two medications that cure hiccups.

But it is required to determine the underlying cause for his persistent hiccups before recommending a treatment. It would be best to understand that hiccup can occur due to 50 plus causes, including inflammation of the gastrointestinal tract, lung infections, diaphragm problem, pleurisy, cardiac ischemia, and inflammation of the pancreas, liver, gall bladder, and so forth. So the best way would be to investigate him further to rule out the cause.

But before recommending any further testing, we must narrow down the list of differentials on close inquiry and then suggest some target investigations to confirm the likely possibility. So I believe you got my point. So please provide me with the following information, and I will tell you the right investigations for him.

1) Does he have abdominal pain, diarrhea, constipation, abdominal swelling, abdominal pain, or redness

2) Did he lose weight?

3)How is his appetite?

4) Does he have chest pain, cough, difficulty breathing, pain in the chest on walking, or any prior heart or lung problem?

5) Does he smoke or take alcohol?

6) Is there any urinary problem?

7) Is there blood discharge from any orifices like mouth, anus, or urine?

8) Does he have acidity or reflux or food regurgitation in the food pipe?

9) Does he have difficulty in food intake, as food gets stuck into his food pipe?

Let me know the above-asked details, and I will suggest you the investigations. They may be as simple as some blood tests or a CT scan of the abdomen and chest or invasive testing such as endoscopy or colonoscopy.

Regards.