LETTER
Intractable Hiccups and Gastroesophageal Reflux Disease
M. Ammar Hatahet, MD
15 December 1997 | Volume 127 Issue 12 | Page 1135
TO THE EDITOR:
I read with interest the brief communication by Brzana and Koch [1] describing 10 patients with intractable nausea who were found to have gastroesophageal reflux. One of my patients presented with intractable hiccups that did respond to traditional medical therapy. Results of physical examinations, laboratory evaluation, and abdominal radiography were all normal. Upper gastroendoscopy revealed severe reflux and esophagitis. The hiccups responded well to omeprazole. Schreiber and colleagues [2] described a similar case, in which gastroesophageal reflux caused intractable hiccups. An interesting fact is that hiccups in infants are strongly associated with reflux [3].
I agree with the authors that atypical symptoms of gastroesophageal reflux disease may present a diagnostic challenge. Thus, it should be kept in the differential diagnosis and be worked up if symptoms cannot be explained otherwise.
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Author and Article Information
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Wayne State University; Detroit, MI 48201
1. Brazana RJ, Koch KL. Gastroesophageal reflux disease presenting with intractable nausea. Ann Intern Med. 1997; 126:704-7.
2. Schreiber LR, Bowen MR, Mino FA, Craig TJ. Hiccups due to gastroesophageal reflux. South Med J. 1995; 88:217-9.
3. Feranchak AP, Orenstein SR, Cohn JF. Behaviors associated with onset of gastroesophageal reflux episodes in infants. Clin Pediatr. 1994; 33:654-62.
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