Constant hiccups?

Bestfriends14

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Hello,

My PALS has started to hiccup constantly. It's been going on for about a month and is loud and occurs 20-30 times a day, from the minute he wakes up until bed.

Anyone know what this could mean? I have read that it could be UMN related but not sure if that's true.

Thanks
 

KarenNWendyn

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Just an educated guess, but the hiccups probably represent spasms of the diaphragm and swallowing more air. How’s his swallowing, and how are his PFTs? Decrease in these could correlate with more hiccups. I’ve also noticed more frequent hiccups. I wonder if taking Baclofen and Magnesium (MagOx 400 mg daily) might help him if he is not already taking.
 

Bestfriends14

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His PFT showed that he went down 6 points from April- 93 down to 87. We'll try the magnesium.and see if that helps. I can't imagine it feels good to be swallowing all this extra air. Swallowing is still good, though, thankfully.
 

lgelb

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Hiccups can be associated with GERD, which in turn can relate to weakness of the glottis, the opening between the vocal cords. When you cough or swallow, you close and then reopen the glottis without having to think about it. But, when those muscles aren't working normally, air and pressure can end up in the wrong places.

You guys might want to try to track what he's eating and in what order, maybe experiment a little (e.g. start with softer foods and work your way up) and make sure he's getting enough liquid before and after food. You could also try papaya chewable tablets or juice.

If it doesn't improve with those measures, the next time you are at clinic, a pulmonologist can weigh in on what his glottal function looks like to the naked eye. If there is severe compromise (which the odds are still against if he's not coughing or choking), aspiration could result and so that would affect an early recommendation for a feeding tube.
 

affected

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We found hiccups to be spasms (like really big fasciculations) of the diaphragm. Chris was UMN dominant
 

Bestfriends14

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We were just at clinic on Wednesday and the respirologist said everything looks good but that his previous PE could have contributed to his lower PFT numbers. We go back in November to check numbers again and see where we stand. Hopefully that was what is the cause of the lower numbers and not the damn ALS working its magic. I guess, though, that would not explain the hiccups, which could be fasciculations as mentioned I do not foresee them going away if it is, in fact, diaphragm twitches.

Thanks everyone.
 

Nikki J

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I don’t hiccup but for months after my pneumonia I had very strong isolated diaphragmatic twitches ( or spasms if you prefer). They scared me but breathing has remained fine and they went away. In my case I believe they were connected to the pneumonia. I hope his do as well
 

Bestfriends14

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Ok, well that makes me feel better. Phew! Let's hope that his does the same. Thanks, Nikki.
 

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I've experienced random hiccups almost since diagnosis 4 yrs ago--sometimes one alone, sometimes a few in a row, but never a long spell. They can be quite loud. I've assumed it was the diaphragm responding to defective motor neuron input.

Ed
 

Bestfriends14

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Karen, Wayne has been on magnesium for a few days now at 1 X 500 mg daily and it has helped a lot. His hiccups are much fewer and much more quiet. For those PALS who do have the issue with hiccuping, we give the magnesium a big thumbs up for reducing them. Wayne hiccuped loudly and forcefully (pre-magnesium) with food in his mouth, which could have been a huge issue as he could have choked. The magnesium can help avoid potential situations such as choking.

Thanks again.
 

KarenNWendyn

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I took a wild guess and lucked out on that recommendation. Magnesium relaxes muscle. Glad it’s working. 👍
 
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