What causes prolonged hiccups?

Q: I am a 57 years old man suffering from prolonged hiccups for last three months. My weight is 80 kg. Initially, I started Baclofen medicine for the hiccups. The medication helped in reducing the hiccups for some days but then the hiccups started again. Then, I underwent an extensive medical investigations (including CT scan of brain and chest, angiography, endoscopy and sonography of abdomen) but nothing was diagnosed. Currently, I am taking medicines for controlling blood pressure and diabetes. I have been asked to do breathing exercises to rectify the irritation in diaphragm. My hiccups stopped once when I coughed and spat out the sputum. This gave me temporary relief for the next couple of hours, but the problem of hiccups recurred soon after. It is causing a lot of uneasiness and I am unable to concentrate on my routine work. What is the best treatment for my hiccups?

A:Hiccups can be caused by a number of reasons including gastroesophageal reflux, pharyngitis, asthma, laryngitis, irregular pulse, diaphragmatic irritation due to any abscess, cholecystitis , brain related causes, certain medications and stress. Apart from the investigations you have undergone, the following may be done:

• ENT check up
• Fluoroscopy for diaphragm movements
• Holter monitoring for arrhythmias
• Sputum test
• Consider various techniques for vagal stimulation to stop hiccups
• Meet a psychologist for relaxation techniques and thought diversion
• Lose weight
• Antacid and prokinetics to be tried for a few weeks.