Hiccough

Summary of diagnostic strategy model for abnormal hiccough

1. Q. Probability diagnosis

1. Food and alcohol excess Psychogenic/functional Postoperative

■ gastric distension

■ phrenic nerve irritation

2. Q. Serious disorders not to be missed

1. Neoplasia

■ oesophagus

■ lung Subphrenic abscess Myocardial infarction/pericarditis CNS disorders, e.g. CVA, infection

3. Q. Pitfalls

1. Alcohol excess Smoking Aerophagy GIT disorders

■ oesophagitis

■ hiatus hernia

■ cholecystitis

■ hepatomegaly

Rarities

Sudden temperature change Neck cysts and vascular abnormalities

4. Q. Seven masquerades checklist

A. Depression -

Diabetes -

Drugs x

Anaemia -

Thyroid disease -Spinal dysfunction possible

5. Q. Is the patient trying to tell me something?

1. Emotional causes always to be considered.

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