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Non-Pharmacological Hiccup Termination — SCE Palliative Medicine MCQ

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EasyNausea & VomitingNon-Pharmacological Hiccup TerminationSCE Palliative Medicine

A 65‑year‑old man with advanced colorectal cancer has intractable hiccups causing nausea. Multiple antiemetics have failed to relieve his symptom. Which non‑pharmacological manoeuvre may terminate his hiccups and thereby alleviate his nausea?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Pharyngeal or vagal stimulation (e.g. swallowing granulated sugar, rapidly sipping ice‑cold water, or gentle nasopharyngeal stimulation)

Simple vagal or pharyngeal stimulation techniques—such as swallowing granulated sugar, rapidly sipping ice‑cold water, or gentle nasopharyngeal stimulation—are established non‑pharmacological methods that may disrupt the hiccup reflex arc and relieve intractable hiccups, and are recommended in UK palliative‑care contexts when medications fail ([nhs.uk](https://www.nhs.uk/symptoms/hiccups/?utm_source=openai)). Lying flat, hyperventilation, ocular pressure, or strenuous activity have no evidence of efficacy and may be ineffective or counterproductive. These home‑remedy measures are low‑risk, immediately accessible, and align with UK clinical teaching for symptom relief in advanced disease.

Reference: NHS Hiccups guidance (NHS.uk, reviewed 23 June 2023); Scottish Palliative Care Guidelines (“Hiccups” non‑pharmacological management), https://www.nhs.uk/symptoms/hiccups/