Question: I heard that hiccups could be a sign of serious complications in PWAs—what's the deal?

Answer: Brief episodes of hiccups are generally no more than an annoyance, but hiccups lasting over 48 hours can be a symptom of a serious medical condition. They can result from yeast infections of the esophagus or stomach, herpes or CMV ulcers in the esophagus, digestive system lymphoma, or brain lesions caused by toxoplasmosis, lymphoma or progressive multifocal leukoencephalopathy (PML).

Q: What procedures should a doctor use to diagnose the cause?

A: First, a thorough history and physical that concentrates on your gastrointestinal and neurological systems might identify the problem. If they don't, you may need an upper endoscopy and/or X-rays of the esophagus and stomach or, as a last resort, an MRI of the brain to look for lesions.

Q: Until the cause can be determined and treated, are there ways to get relief from the symptoms?

A: Your physician could give you baclofen, metoclopramide, promethazine, or Thorazine orally. If they are not effective, intramuscular Thorazine may work.