Everyone has their pet theory about the best cure for hiccups, but Cochrane reviewers have blown them all away with the first systematic review concluding that there is no evidence to support any particular treatment.
In a nice piece of academic understatement, reviewers from the Cochrane Pain, Palliative and Supportive Care Group based at Oxford University say that “a wide range of pharmacological and non-pharmacological interventions have been used for the treatment of persistent and intractable hiccups.”
They noted, however, that there is little evidence as to which interventions are effective or harmful. And when they looked for evidence from good quality trials of treatments for intractable hiccups they found that there was very little in the literature – and the few studies that had been done were all based on acupuncture.
These trials – all by Chinese research teams - suggested that acupuncture may help relieve hiccups. The treatment usually involved inserting needles into the body and scalp for an hour a day for five to ten days.
However, the reviewers said the trials were prone to bias, did not use a placebo, and failed to report side effects.
There were no high quality studies investigating pharmacological interventions for persistent and intractable hiccups, although there have been several larger case series looking at the use of baclofen or gabapentin for the treatment of persistent and intractable hiccups, they noted.
The reviewers said persistent and intractable hiccups is uncommon, but it can be of serious detriment to a patient's quality of life. The condition is more common in patients with advanced cancer, but little is known about the aetiology or underlying mechanism.
More than 100 causes of persistent and intractable hiccup have been put forward, with the more common ones including gastric distension, drinking alcohol or carbonated beverages, hot or cold drinks, anxiety and stress.
Other possible causes include lesions of the CNS, diaphragmatic irritation and irritation of the vagus nerve. Hiccups may also be triggered by benzodiazepine derivatives and corticosteroids, they add.