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December 1993

Hiccups and Digital Rectal Massage

Author Affiliations

Haifa, Israel

Arch Otolaryngol Head Neck Surg. 1993;119(12):1383. doi:10.1001/archotol.1993.01880240123018

We read with great interest the excellent article by Loft and Ward entitled "Hiccups: A Case Presentation and Etiologic Review,"1 and we mention a simple, and usually safe physical maneuver, it is digital rectal massage, for the treatment of intractable hiccups, which has not been mentioned by the authors.

We2 and others3 have recently described two patients with intractable hiccups who failed to respond to several physical maneuvers and drug therapy. Then, digital rectal massage was performed, resulting in abrupt cessation of the hiccups. Subsequently, we performed this maneuver successfully in an additional five patients with intractable hiccups before performing other potentially dangerous maneuvers, like carotid sinus massage, Valsava maneuver, and ocular compression, and also before proceeding with pharmacologic agents.

The rectum is supplied with sympathetic and parasympathetic nerves carrying both motor and sensory fibers.4 Sensory innervation of the rectum occurs through parasympathetic fibers that are

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