Health

DR ELLIE CANNON: Why does my poor husband get hiccups every time he eats?

My husband suffers from severe hiccups every time he eats. It’s been going on for quite a while, and mainly happens when he eats bread or potatoes. 

The hiccups last for several minutes, and it’s quite embarrassing if we’re in company. Is this something he needs to worry about? He refuses to see a GP.

Hiccups are due to involuntary spasms or contractions of the diaphragm muscle, which sits below the lungs and over the stomach, separating the upper and lower abdomen.

The spasm causes air to be sucked into the lungs, and this quick inhalation makes a structure inside the throat called the epiglottis slam shut – the epiglottis is a flap of tissue that closes over the windpipe when swallowing to prevent the inhalation of food, drink or saliva. 

It’s the sudden closure of the epiglottis that causes the characteristic ‘hic’ sound.

Hiccups are due to involuntary spasms or contractions of the diaphragm muscle, which sits below the lungs and over the stomach, separating the upper and lower abdomen, says DR ELLIE CANNON. (Stock image)

The initial spasm is a result of something irritating the nerves that control the diaphragm – for instance, eating too fast or taking fizzy drinks can make the stomach expand rapidly and have this effect, due simply to the proximity of the stomach to the diaphragm.

A bout of hiccups that lasts a few minutes isn’t considered a problem – it’s just part of being human. 

They may seem associated with a specific food, so avoiding those foods, or being mindful to eat them slowly, can be an easy fix. But there are lots of conditions that can lead to persistent hiccups, including acid reflux. 

They can be a side effects of medications including morphine-like painkillers. Rarely, persistent hiccups can be related to very serious conditions such as a stroke or a head injury.

When hiccups persist, doctors may want to run tests. Acid reflux can be controlled with over-the-counter medicines.

There are plenty of home remedies that we have all heard of for hiccups – such as holding your breath – but none of them is proven to work. Often hiccups just stop in their own time.

One reader’s lesson for us all… 

A few weeks back, a man wrote to me saying he’d been suffering a ‘droopy eye’ and double vision – and asked if it could be a side effect of his statin medication.

I pointed out that while statins aren’t typically linked to such problems, in my experience, sight disturbance like this is a serious issue and may need investigation. 

I suggested that a visit to the GP and referral to neurology would be warranted.

Last week, the same reader wrote again to let me know how things had progressed.

He’d been seen by a neurologist and had been diagnosed with a condition called ocular myasthenia gravis, a problem with the muscles of the eye. 

As the reader quite rightly pointed out, while ‘scary’, the condition can be controlled with medication.

He added: ‘The moral is that if you suffer double vision, even for a short time, see your doctor.’ 

I couldn’t have said it better myself.

 

I broke my arm in October. For the past two months I’ve been suffering pain where the break was – it goes up and around my arm, and down my back to the shoulder blade, and sometimes up into my neck. 

Sleeping has been difficult and paracetamol and ibuprofen don’t help. I don’t know what to do.

After breaking a bone, the pain can persist in the location of the fracture and in the nearby joints, muscles and nerves.

After a significant break, physiotherapy is usually offered, to build back strength in the muscles and a full range of movement in the joint again. 

This is important both for regaining full function and for pain management.

This would normally have been arranged by the fracture clinic or orthopaedics team dealing with the break. 

But physiotherapists can be accessed in some areas without consulting a GP, so ask your local clinic receptionists about a self-referral.

An examination would normally be necessary to determine what is going on pain-wise. It might be the case that arthritis, unrelated to the fracture, is the cause of pain, too.

A telephone call is the usual first step now in general practice but this should, in cases such as this, lead to a face-to- face appointment.

Calls and messages to the GP surgery do get missed, so anyone not hearing back should try again to be seen. 

This would be particularly important for pain that is preventing sleep and causing someone to take lots of painkillers and sleeping tablets.

A story like this should raise the alarm bells with a doctor.

I’m a 67-year-old, reasonably healthy woman. But occasionally I suffer a burst blood vessel in my right eye. 

It doesn’t really hurt or affect my vision but it looks absolutely horrendous. It just seems to be happening more often – six times in two years. My blood pressure is normal and my optician says nothing’s amiss. 

Should I see a specialist?

A burst blood vessel in the eye is known as a subconjunctival haemorrhage. In the first instance, seeing an optician to rule out eye diseases is really important. 

But, while these burst vessels look dramatic, with the white of the eye going red very noticeably – they are usually harmless.

Coughing excessively, straining or vomiting, all of which can sudden raise blood pressure, might be a cause.

But many patients I see have not had anything like this.

The eye is usually not painful when this happens and this is very important – a sore, red eye would imply other much more serious conditions. It may feel a bit irritated, though, as if some dust is in the eye.

If these are happening recurrently without an obvious cause, such as a chronic cough, for example, some investigations may be worthwhile. High blood pressure can sometimes be associated with these burst blood vessels. 

To ensure blood pressure is genuinely not high, a series of readings should be taken over a few weeks.

This can be done via the GP practice nurse, or healthcare assistant. Many practices offer self-measurements in the waiting room. 

Another option is to buy a cheap home monitor. These can cost as little as £20 and are available from pharmacists or the British Heart Foundation website, bhf.org.uk.

I’ll keep wearing masks, whatever the law says

Pictured: Health Secretary Sajid Javid

Pictured: Health Secretary Sajid Javid

As expected, mask-wearing will soon no longer be mandatory – but a number of Ministers, including our new Health Secretary Sajid Javid, have said they’ll keep wearing theirs out of choice.

Predictably, they’ve been accused of sending mixed messages. I couldn’t disagree more.

A month ago, I wrote in this column that I’d like to see masks in hospitals and GP surgeries for good. 

We know that masks and social distancing all but stamped out flu last winter, and if it became the norm to wear a mask in medical settings we could prevent thousands of fatal infections.

The vast majority of you, I’m delighted to report, agreed wholeheartedly. 

People in East Asian countries wear masks in public, particularly if they feel they might have a respiratory infection – it’s simply seen as good manners.

What’s so hard to understand about that?


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