Prolonged hiccups are no laughing matter

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DEAR DR. DONOHUE: For three weeks, I have suffered with hiccups. They stop for an hour and then they come right back. My wife says I hiccup during sleep. I am getting tired of this. It’s hard to eat. It’s hard to work. It’s hard to do anything.

 I have tried hundreds of home remedies, but nothing has worked. What can I do? — L.S.

 ANSWER: A sudden, forceful contraction of the diaphragm muscle causes a hiccup. The diaphragm spreads horizontally across the body and separates the chest from the abdomen. It’s the principal breathing muscle. Its contraction draws air into the body and produces the “hic” of a hiccup. Unlike a cough, which serves to clear airways, no one has found any purpose for a hiccup.

 Overeating, carbonated drinks and alcohol often are responsible for setting off a chain of hiccups. Irritation of the phrenic nerve, the nerve that stimulates the diaphragm, is another cause of hiccups. Some serious troubles produce hiccups, but they are a distinct minority of potential causes. They include things like brain tumors, lung tumors, abdominal infections and inflammation of the pancreas.

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 Readers have provided me with a stack of remedies for the occasional bout of hiccups. I’ll mention some for readers’ sake. None is likely to do you any good. Holding the breath builds up carbon dioxide in the blood, and that sometimes ends a hiccup spell. Swallowing a spoonful of sugar irritates the throat and can stop hiccupping. Gargling with ice water is another trick that might work.

 You’ve passed the stage of ordinary hiccups. You’re into persistent hiccups — hiccups lasting longer than 48 hours. You’re not likely to get them to stop on your own. You need a doctor’s help. You’re approaching the time when continued hiccupping earns another designation — intractable. That occurs when they last for more than a month.

 A doctor can give you medicines such as chlorpromazine or metoclopramide. Sometimes more radical treatments have to be employed. Blocking the phrenic nerve with an anesthetic like lidocaine is an example. Crushing the nerve is another possibility.

 DEAR DR. DONOHUE: Every morning, on wakening, my eyes are glued together. I gradually can get them open, but it takes time. They don’t hurt or itch. My eyes are red when I open the lids. What can I do? I can’t see a doctor right now. — C.H.

 ANSWER: You describe blepharitis (BLEF-uh-RITE-is), an inflammation of the eyelid margins. Sometimes it’s the result of a staph infection. At other times, a process similar to dandruff of the scalp is involved. Blepharitis is a long-term affair, so you must be prepared for a long-term commitment in treating it.

 Soak a washcloth in warm water and apply it to the closed lids. Keep the soaks up for five to 10 minutes. You have to rewarm the cloth when it starts to cool. This loosens the eyelid crusts.

 Then dilute baby shampoo by putting a couple of drops of it in half a cup of warm water. With a cotton-tipped applicator saturated with the mixture, gently roll the applicator over the eyelid margins to remove adherent crusts. You have to do this every day, and it can take many months to get the condition controlled.

 DEAR DR. DONOHUE: My sister lost so much blood that she had to have three transfusions. The blood was coming from her digestive tract, and she didn’t realize it. Can’t blood be seen in bowel movements? — A.K.

 ANSWER: Blood coming from a long distance to the rectum — places like the stomach, the small intestine or the right side of the colon — is often incorporated into the stool and turns it tarry black. Blood near the rectum, the left side of the colon, might be seen as bright-red blood on the stool. The same holds for bleeding hemorrhoids.

 Quite often, no changes are seen in the stool. Simple, office-based tests can detect blood even when none is visible. That’s called testing for occult blood.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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