# Intractable hiccup leading to life-threatening malnutrition: case report

## TL;DR

A man with long-term hiccups experienced severe weight loss and malnutrition, but improved with feeding strategies, highlighting the need for better nutritional management in such cases.

## Contribution

This case report highlights malnutrition as an underrecognized complication of chronic hiccups and suggests gastric feeding as a potential solution.

## Key findings

- A 63-year-old male with intractable hiccups experienced 37% weight loss and functional decline.
- Enteral nutrition via PEG-PEJ led to 15 kg weight gain and recovery over six months.
- Gastric feeding was feasible during a hiccup relapse when jejunal access was lost.

## Abstract

Intractable hiccups, lasting over a month, can severely impair quality of life and, in rare cases, significantly limit the ability to maintain adequate oral nutritional intake. We report a 63-year-old male with a 5-year history of intractable hiccups, 30 kg weight loss (37%), muscle wasting, and functional decline. Extensive diagnostics found no clear cause, and multiple therapies failed. Severe oral intake difficulties prompted initiation of enteral nutrition via PEG with jejunal extension (PEG-PEJ), resulting in a 15 kg weight gain and functional recovery over 6 months. One year later, during a hiccup relapse, the jejunal tube was dislodged. With gastric access intact, we transitioned to gastric feeding, which was well tolerated despite persistent hiccups. This case underscores that malnutrition may be a significant and underrecognized complication in chronic hiccups, with no established nutritional strategies described. Our experience suggests gastric feeding may be feasible in such patients. Further research is needed to guide management.