Reichenbach Zachary Wilmer, Piech Gregory M, Malik Zubair
Department of Gastroenterology, Lewis Katz School of Medicine at Temple University Hospital, 3401 N. Broad St., 8th floor Parkinson Pavilion, Philadelphia, PA, 19140, USA.
Center for Substance Abuse Research (CSAR), Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
Curr Treat Options Gastroenterol. 2020 Jan 23;18(1):43-59. doi: 10.1007/s11938-020-00273-3. Print 2020 Mar.
Nearly 4000 patients will be admitted to hospital in the US this year for hiccups. Hiccups are controlled by a complex reflex arc between peripheral receptors and the brainstem. Any disruption along this pathway may produce hiccups. Typically, hiccups resolve spontaneously but in certain pathologies symptoms may persist. Persistent hiccups may be considered a sign of underlying pathology. The most common cause involves GERD.
Based on etiologies, studies have shown that first-line therapy should use a proton pump inhibitor (PPI) and involve appropriate gastrointestinal consultation. If symptoms persist, other etiologies such as central causes need to be explored.
We review the pathophysiology of hiccups including multiple causes and the appropriate work up for each. We review several studies examining new treatments, both pharmacological and interventional, that may help patients. Initial therapy should still involve a PPI but several new therapies may be beneficial.
今年美国将有近4000名患者因打嗝入院。打嗝由外周感受器和脑干之间的复杂反射弧控制。该传导通路中的任何中断都可能导致打嗝。通常，打嗝会自行缓解，但在某些病理情况下症状可能会持续。持续性打嗝可能被视为潜在病理的征兆。最常见的原因是胃食管反流病（GERD）。
基于病因学研究表明，一线治疗应使用质子泵抑制剂（PPI）并进行适当的胃肠咨询。如果症状持续，需要探究其他病因，如中枢性病因。
我们综述了打嗝的病理生理学，包括多种病因以及针对每种病因的适当检查。我们回顾了几项研究，这些研究探讨了可能有助于患者的新的药物和介入治疗方法。初始治疗仍应使用PPI，但几种新疗法可能有益。
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