Introduction: Chronic hiccup, defined as repetitive hiccup spells during more than 48 h, is an uncommon and neglected pathological condition, in which preliminary findings suggested an upper digestive origin.
Methods: We prospectively included 184 rebel chronic hiccups in this clinical and endoscopic study. Our rule of thumb was to consider upper digestive findings as first-rank in imputability and thus to treat them in priority. If treatment failed or no abnormality was found in the upper digestive tract, a neurological survey was done and baclofen tried.
Results: We thus discovered upper digestive abnormalities in 80% of the patients and the treatment rule yielded 66% of success, including 48 complete remissions and 116 partial remissions. There were 20 failures, generally due to untreatable neurological diseases such as brain tumors.
Conclusion: A diseased esophagus is frequently the cause of chronic hiccup.
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