By Edward T. Bope MD, Rick D. Kellerman MD, Robert E. Rakel MD
Conn's present remedy 2011 is an easy-to-use, in-depth advisor to the newest advances in therapeutics for universal lawsuits and diagnoses. Drs. Edward T. Bope, Rick D. Kellerman, and Robert E. Rakel current the services and information of hundreds of thousands of expert foreign leaders at the complete variety of evidence-based administration recommendations. With insurance of contemporary advancements in go back and forth medication, sleep apnea, and immunization practices, in addition to standardized diagnostic issues and medical advice tables, you should have entry to the knowledge you would like, in print and on-line at www.expertconsult.com. entry the absolutely searchable contents on-line at www.expertconsult.com. bring potent remedy after making right diagnoses via discussions of significant diagnostic standards in each one bankruptcy. Get the simplest, such a lot sensible and exact recommendation from said specialist individuals. follow top practices from around the globe from insurance of administration tools utilized by overseas specialists. remain present with fresh advancements in go back and forth drugs, sleep apnea, immunization practices, and lots more and plenty extra. recognize the total diversity of therapies via assurance of the newest info on recently-approved and soon-to-be-approved medicines. faucet into the counsel of specialists for functional and exact suggestion on prognosis and administration. locate the solutions you would like extra simply with standardized present Diagnostic issues and present remedy medical advice tables. appropriately code for compensation utilizing an updated ICD-9 record of universal ailments and codes. Conn's present remedy presents swifter entry to the most recent healing remedy
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Nefopam for severe hiccups. N Engl J Med 2000; 343:1973–2204. Dunst MN, Margolin K, Horak D. Lidocaine for severe hiccups. N Engl J Med 1993;329:890–1. Hernandez JL, Fernandez-Miera MF, Sampedro E, et al. Nimodipine treatment for intractable hiccups. Am J Med 1999;106:600. Howard SR. Persistent hiccups. Br Med J 1992;305:1237–8. Kolodzik PW, Eilers MA. Hiccups (singultus): review and approach to management. Ann Emerg Med 1991;20:565–73. Newsom Davis J. An experimental study of hiccup. Brain 1970;93:851–72.
Causes of biochemical disease include drug-induced dyspepsia, carbohydrate malabsorption, and metabolic disturbances. Etiology indentified; treat appropriately Decrease air swallowing (stop smoking, carbonated beverages, and chewing gum; eat and drink more slowly, treat heartburn) Avoid causative agents (lactose, fructose, sorbitol, high fiber, starches, caffeine, mint, chocolate) Simethicone (Mylicon) has not proved to be helpful. Enzyme preparations such as lactase and pancreatic enzymes if deficiency is suspected Bacterial a-galactosidase (Beano)7 in legume-rich diets Antibiotics for small intestinal bacterial overgrowth Prokinetics such as metoclopramide (Reglan) for dysmotility syndromes Avoid narcotics and anticholinergics.
The dietary history may reveal a close association with specific foods such as certain vegetables and fruits, legumes, or foods containing lactose or fructose. The history may also elicit underlying anxiety or psychiatric illness. The physical examination should include a detailed abdominal inspection and a search for signs of endocrine or neurologic processes as well as nutritional deficiency. Laboratory testing should be aimed at excluding organic disease and may include a complete blood count (CBC), complete metabolic profile (CMP), amylase, erythrocyte sedimentation rate, thyroid-stimulating hormone, and stool studies.