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Persistent Hiccups May Be Sign of Serious Medical Problem

Qyestion: Is there any over-the-counter medicine that will relieve hiccups? My husband gets them almost every hour. The spells last about four minutes, but it would be better if we could prevent them or cut the spells short.

Answer: Most people don’t take hiccups very seriously. Home remedies abound, including swallowing a teaspoonful of dry sugar, biting into a lemon wedge doused with Angostura bitters, tickling the palate with a cotton swab, breathing into a paper bag and drinking out of the wrong side of a glass.

But recurrent or long-lasting hiccups could be a symptom of something serious. They may be a complication of severe heartburn or hiatal hernia. Other possibilities include alcoholism, lung conditions, digestive disorders, nerve problems and side effects of certain medications. Obviously, your husband requires a careful medical workup to uncover the cause of his persistent hiccups.

If there is no serious problem making him hiccup, there are lots of medical treatments worth discussing with a physician. Stimulating the phrenic nerve may help. This is the idea behind the spoonful of sugar and cotton swab approaches. Eating crushed ice, pulling on the tongue or drinking a glass of water rapidly are further variations on the same principle.

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There are a few reports in the medical literature of success in stopping hiccups in hospitalized patients incapable of swallowing. The patient’s rectum was massaged with a gloved finger.

This approach sounds extreme, but it is less likely to have side effects than some of the prescription medications that have been used. The antidepressant amitriptyline, the blood pressure medicine nifedipine, the anti-Parkinson’s drug amantadine, the muscle relaxant baclofen and the heartburn medication metoclopramide have all been used with some success, but none is sure-fire.

Q. I’m at the age now where I look down and see my mother’s hands hanging out of my sleeves. Is there anything I can do to get rid of those little brown spots?

A. An agent called hydroquinone can bleach those spots, although it will take patience and persistence. It is found in over-the-counter creams such as Porcelana, Esoterica or Eldoquin, and at higher doses in prescription products such as Melanex or Solaquin-Forte. It is essential to use sunscreen, or any time outside will undo the bleaching.

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