HICCUP, HICCOUGH: CAUSES AND TREATMENT

Hiccup is sudden, unintentional contraction of the diaphragm muscle. The diaphragm lies at the base of the lungs and is essential for normal respiration. Phrenic and vagus nerves that control the diaphragm play an important role in its function.

Excessive eating and drinking, as well as consumption of carbonated beverages may irritate the diaphragm and cause hiccups. Also sudden temperature change (i.e. hot – cold showers and hot – cold drinks) and emotional stress have been found to play a role on its onset. Hiccups can also be psychogenic or idiopathic. Some drugs (benzodiazepines, barbiturates, alpha methyldopa, etc.) may cause hiccup.

Though usually a mild self-limited disorder, hiccup may be persistent and related to serious underlying illness such as neoplasms, congenital malformations, multiple sclerosis, vascular lesions, hyponatremia, hypocapnia, hypokalemia, hyperglycemia, uremia, goiter, hepatitis, cholecystitis, pneumonia, aneurysm, peptic ulcer, inflammatory bowel disease, pancreatitis, glaucoma and hernia. Should hiccups become persistent, medical evaluation is mandatory.

Simple remedies for the cure of hiccups of benign origin:

1. Hold your breath

2. Pull your knees up to chest and lean forward

3. Bite a lemon

4. Drink a glass of ice-cold water

5. Eat a teaspoon of dry granular sugar

6. Avoid emotional stress and think of something pleasant

7. Relax and repeat in ten minutes.

Modern medicine provides a number of effective drugs to treat hiccups.

ANASTASIA MOSCHOVAKI, M.D.

Department of Internal Medicine, Athens Medical Center, Greece

• Office: 10 Fragopoulou Str. 14561, Kifissia

• Tel./Fax : +30 210 6252770

• Hospitalization - emergencies: +30 6945575287

• E mail amoschovaki@yahoo.gr

•  http://frequentmedicaldisorders.blogspot.com

CHRONIC FATIGUE SYNDROME AND WEAKNESS, CAUSES AND TREATMENT: ANSWERS TO FAQs

In this article, there is a selection of questions and answers concerning chronic fatigue syndrome. These questions were asked and answered in interviews I have given to Greek newspapers (ΒΗΜΑ, ΠΑΡΟΝ, ΚΑΘΗΜΕΡΙΝΗ etc) and TV stations (ALPHA, ATHENS TV, ΚΑΝΑΛΙ 10, SKY, ALTER etc).

1. What is chronic fatigue syndrome?

This syndrome consists of severe fatigue symptoms lasting more than six months. This fatigue affects both physical and mental functioning.

2. How is chronic fatigue distinguished from common weakness?

Chronic fatigue is persistent or relapsing whereas common weakness lasts for less than a week. Simple measures, such as sleep and healthy diet, are often sufficient, in case of common weakness.

3. What causes chronic fatigue?

The chronic fatigue syndrome could be associated with the following:

• Alcohol abuse

• Insomnia

• Drugs such as benzodiazepines

• Over-fatigue

• Menopause

• Malnutrition

• Anemia

• Hypotension

• B12 deficiency

• Infectious diseases

• Biochemical disturbances

• Cardiovascular diseases

• Endocrine disorders

• Thyroid disease

• Autoimmune disorders

• Sleep apnea

• Depression

• Psychosis

• Anorexia nervosa

This type is called secondary chronic fatigue syndrome.

For idiopathic syndromes, no specific cause can be found.

If four or more of the following criteria are present for more than six months, the syndrome is called idiopathic chronic fatigue syndrome:

• Impaired memory or concentration unrelated to drugs or alcohol use

• Unexplained muscle pain

• Polyarthralgia

• Sleep disturbances

• Post exertional malaise lasting over 24 hours

• Sore throat not caused by infection

• Tender cervical or axillary nodes.

If these criteria are not fully met, then the disease is called idiopathic chronic fatigue. Idiopathic syndromes come with a variety of implications such as immunologic disturbances, neurologic disturbances, abnormal gene expression and psychological disturbances.

4. What is the treatment?

Patients with secondary chronic fatigue syndrome have a secondary correctable or specifically treatable cause. Special treatment is the cornerstone of therapy.

In case of idiopathic syndromes, treatment includes exercise programmes, cognitive therapy and special drugs.

ANASTASIA MOSCHOVAKI, M.D.

Department of Internal Medicine, Athens Medical Center, Greece

• Office: 10 Fragopoulou Str. 14561, Kifissia

• Tel./Fax: +30 210 6252770

• Hospitalization - emergencies: +30 6945575287

• E-mail: amoschovaki@yahoo.gr

•  http://frequentmedicaldisorders.blogspot.com