Persistent hiccup as a presentation form of the disease for gastro-esophageal reflux

Abstract

The persistent hiccup (singultus) is the one that shows up as a prolonged attack or recurrent attacks during a determinant period of time, generally, more than 48 hours. It uses to resolve without a pharmacological treatment, but it could be necessary a treatment and posing its etiological study. This infrequent entity is presented in a man, aged 63 years, with a history for three years, appearing mainly after the food intake and persisting for several minutes or hours, every day. The singultus’s causes may be gastrointestinal (gastro-esophageal reflux, hiatal hernia, esophagitis, gastric ulcer, pancreatitis, esophageal carcinoma, hepatica masses, ascites, abdominal surgery), neurological, vascular, thoracic, metabolic, toxic, medicine, and others. We performed a questioning and a meticulous physical examination, an electrocardiogram, thorax and abdominal X-rays, blood analyses, abdominal ultrasound, superior endoscopy, thoracic and abdominal tomography, in addition to esophageal manometry and the therapeutic test with Omeprazol, diagnosing a gastro-esophageal reflux disease. We prescribed a treatment based on popular measures, and medication for the main symptom with chlorpromazine (25 mg tablets): 1 tablet each 8 hours, achieving a clear improvement of the symptom until the moment when the etiological cause was diagnosed and a specific treatment for the gastro-esophageal reflux disease was ordered with omeprazole (20 mg): 1 capsule each 12 hours and domperidona, reaching the disappearance of the symptom that caused the patient´s initial consultation.