Hiccup Stopper

Welcome back. There’s a new device for stopping hiccups. I’m hesitant to blog about it since my post will come off as an advertisement, what’s worse, a promotion for something I’ve never tried.

The new device for stopping hiccups from the University of Texas (from news.uthscsa.edu/hiccaway-ut-health-san-antonio-physician-develops-device-to-relieve-hiccups/).

In my defense:
-The evaluation of the device was recently published in a Journal of the American Medical Association.
-The device was invented by a neurosurgeon affiliated with the University of Texas Health Science Center at San Antonio.
-Its development, testing and evaluation proceeded with colleagues at the Health Science Center and collaborators at Shiraz University of Medical Sciences, Iran; Sanatorio Pasteur, Argentina; and University of Zürich and Klinik Arlesheim, Switzerland.
-The device is being marketed by a Colorado company under a license agreement with the university.
-The funder had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or decision to submit the manuscript for publication.

And one more thing. Testing, which I’ll describe, reportedly had super results.

Hiccups?
A hiccup is an involuntary contraction of the diaphragm, the major muscle of respiration, located between our lungs and abdomen. When the diaphragm spasms, we inhale suddenly, our vocal cords and larynx snap closed causing the characteristic hiccup sound, and our lungs take in air quickly.

For most of us, hiccups are an occasional annoyance that passes in a few minutes. For those affected longer or by frequent reoccurrence, they impact quality of life. Hiccups can be serious problem, especially for post-surgical patients, patients with brain and stroke injury and cancer patients (apparently some chemotherapies cause hiccups).

There are numerous remedies to stopping hiccups, such as holding your breath, breathing into a paper bag or eating a spoonful of sugar. Many are supported by centuries of anecdotal evidence, though none has any scientific basis. And that’s what makes the new device special.

Science-Based Hiccup Remedy
The Forced Inspiratory Suction and Swallow Tool (FISST) is a rigid drinking tube that’s been patented and branded HiccAway. 

The straw-like device has a cap at the bottom with a pressure value adjustable for adult or child. Forcefully suctioning and swallowing water from a half-filled cup usually stops hiccups in 1 or 2 attempts. (Graphic from jamanetwork.com/journals/jamanetworkopen/fullarticle/2781196)

With an inlet valve adjustable for adult or child, FISST requires significant suction to draw water from a cup into the mouth. The high negative pressure requires contraction of the diaphragm, triggering the phrenic nerve that regulates the diaphragm. When water reaches the mouth, the brain wants to swallow it, so it closes the epiglottis. The epiglottis is the flap of cartilage behind the tongue that folds to cover the larynx when we swallow, preventing food and liquid from entering the windpipe and lungs. This stimulates the vagus nerve, which regulates internal organ functions and certain reflex actions, including coughing and swallowing. The vagus nerve blocks signals to the vocal cords and eases the hiccups.

Surveying FISST Users
FISST was offered to volunteers through an online Kickstarter campaign. Globally, 674 people volunteered to receive the device. Of those, 290 gave written consent to participate and were provided an online questionnaire, which 249 completed (51% female, 79% white).

The questionnaire had participants compare FISST with home remedies on a scale of 1 to 5 (1-strongly favor home remedies, 5- strongly favor FISST). The primary outcome was the subjective effectiveness of FISST compared with home remedies. The secondary outcome was overall satisfaction with FISST.

Of the 249 surveyed participants, 70% had hiccups at least once a month, 66% had hiccups lasting less than 2 hours. FISST stopped hiccups in nearly 92% of cases and was rated favorably compared with home remedies across demographics, hiccup frequencies and hiccup durations. The mean subjective effectiveness score with FISST was 4.58 (standard deviation, 0.90); the mean satisfaction was 4.57 (standard deviation, 1.61), with 91% of participants rating FISST more feasible than home remedies. No adverse effects were reported.

Evaluation of Forced Inspiratory Suction and Swallow Tool by the participants’ demographic characteristics compared with home remedies (46 participants did not rate effectiveness) (from jamanetwork.com/journals/jamanetworkopen/fullarticle/2781196).

Wrap Up
Although the study showed FISST to be an easy-to-use tool to stop hiccups that users rated superior to home remedies, the researchers recognized the lack of a control group and the subjective nature of the scoring system were significant study limitations. They expected future testing to assess FISST in randomized clinical trials.

I’m going to guess that may not happen. The company under a license agreement with the university has already contracted with a major supermarket chain to sell the tool. Thanks for stopping by.

P.S.
Study of FISST evaluation in JAMA Network Open journal: jamanetwork.com/journals/jamanetworkopen/fullarticle/2781196
Article on study on EurekAlert! website: www.eurekalert.org/pub_releases/2021-06/uoth-tds061821.php
Initial University of Texas Health San Antonio news release on hiccup device invention: news.uthscsa.edu/hiccaway-ut-health-san-antonio-physician-develops-device-to-relieve-hiccups/
26 ways to get rid of hiccups: www.healthline.com/health/how-to-get-rid-of-hiccups