Monday, February 1, 2010

A study of ONE FREAKING PATIENT!

I'd like to thank my reader, Dr. T., for submitting this gem. It may be 20 years old, but hey, people still get the hiccups.

And again, it's from Haifa, Israel. For reasons that remain mysterious, an unusual proportion of oddball research seems to be from there. A review of my past posts will show several Haifan studies.


Termination of intractable hiccups with digital rectal massage.

J Intern Med. 1990 Feb;227(2):145-6

Odeh M, Bassan H, Oliven A.
Department of Internal Medicine, Bnai Zion Medical Center, Haifa, Israel.

A 60-year-old man with acute pancreatitis developed persistent hiccups after insertion of a nasogastric tube. Removal of the latter did not terminate the hiccups which had also been treated with different drugs, and several manoeuvres were attempted, but with no success. Digital rectal massage was then performed resulting in abrupt cessation of the hiccups. Recurrence of the hiccups occurred several hours later, and again, they were terminated immediately with digital rectal massage. No other recurrences were observed. This is the second reported case associating cessation of intractable hiccups with digital rectal massage. We suggest that this manoeuvre should be considered in cases of intractable hiccups before proceeding with pharmacological agents.


PMID: 2299306 [PubMed - indexed for MEDLINE]

38 comments:

Celeste said...

I think I'd rather have the hiccups.

Pink said...

What Celeste said.

evilsciencechick said...

I'll bet you could solve a lot of conditions that way.

Patient - Doctor, my arm hurts!

Doctor - OK, I'm going to stick my fingers up your bum. Do you feel better? I could do it again.

Patient - nononono! I mean, yes, I feel fine! Just fine! Pain gone completely!

Skleris said...

I forwarded this to my wife. She hates it when I have the hiccups. Given the solution, she'll now either be more forgiving or giving. ;)

The Tentio Man said...

Haifa- the city that gave us research on reading on the toilet, penile shockwave therapy, and now this. People there must be even more bored than I thought. Hey guys- it's only an hour to Tel Aviv.

Maha said...

I wonder what polluted stream of consciousness led the researchers from hiccups to sticking fingers in bums. But then again, maybe I don't want to know.

Cheryl said...

Imagining the scenario:

Dr1: "Do ya think vagal stimulation might inhibit hiccups?"

Dr2: "Only one way to find out!"

Pt: "What the hay?"

Dr1 & Dr2: "Now we can publish and get our instructor off our backs!
But we sure hope we won't have to present this at a seminar!!!"

Queen of Crafts, Current Events, and Such. said...

I am all for vagus stimulation, and all .....but geeeeeesh!!! I would rather try some thorazine first.......... myself

Anonymous said...

can't help but think there is an off-chance possibility (50:50 since this is ONE patient) that the patient was gay and enjoyed the "treatment".. not saying he was, and not saying he wasn't (not that there's anything wrong with that).. but could be!!

Anonymous said...

Amazingly, not just one, but THREE "researchers" put their name on that. I'm thinking the "desperate to publish" scenario must have been at work.

w8ng2retireRPH said...

you know how they say if someone scares you, you'll get rid of the hiccups. this guy was probably scared out of his mind.

Josiah O. Morris said...

evilsciencechick had a good thought. What if this was employed in the ER when seekers show up?

I'll even take one for the team and go spend a little time in Haifa and publish a study suggesting the cessation of lower back pain (etc.) by rectal manipulation.

"I'm sorry to hear you're allergic to everything except Vicodin, which I won't be prescribing for you today, but we can treat you! Current research suggests that rectal manipulation will alleviate your pain!"

The danger here, I would imagine, is that with the elimination of the majority of this kind of seeker, a different, creepier type would likely emerge.

(haha, verification word is "coned")

CristinaRN said...

I'll suggest that cure to one of the ER med students one day. Hehehe.

Albinoblackbear said...

We stick our fingers in people's bums for enough reasons already.
Please LORD can this not become evidence based practice???

Cogitator said...

Is there a way to induce hiccups in my wife?

And does it have to be a finger?

Anonymous said...

Cogitator- thank you for sharing way too much information about your sexual preferences with the rest of us.

theangrypharmacist said...

Would a boot be equally efficacious?

Classof65 said...

Don't take me there!!!!

Science Marches On said...

The authors (two of them, at least) managed to get a second publication out of this:

Odeh M, Oliven A. (1993)Hiccups and digital rectal massage. Arch Otolaryngol Head Neck Surg. v119(12):1383


Which extends your story about the "least publishable unit" - they've gotten 2 papers out of 1 finger.

Candice said...

Anonymous- Get the finger out of your ass and live a little.

Cogitator's comment was funny!

;)

thegooddrlaura said...

This isn't new. It's the oldest hiccup remedy in the books: scare the hell out of somebody!

P.S. How do we know the guy didn't get the hiccups again? He probably just refused to tell anybody... EVER AGAIN!

Moose said...

What, what, in the butt.

terri c said...

Did each of the three authors apply the treatment to the patient?

ERP said...

I think that should have been called a "case study" and not given a title that suggests "original research".

Old MD Girl said...

My husband usually just tries to scare the hiccups out of me. I guess this is another way to do that?

Anonymous said...

prostrate exam, hiccups gone. two for the price of one.

Anonymous said...

This article won its authors the Ig Nobel Prize in Medicine for 2006. See http://improbable.com/ig/winners/#ig2006. The Ig Nobel Prizes honor scientific research that, in the words of its founders, "cannot or should not be reproduced."

Archie

The Mother said...

I had an attending (surgical) who was convinced that he could cure hiccups by ramming an NG tube down the patient's throat.

I guess he actually needed to read this study.

Anonymous said...

Re-reading the abstract, it says, "Digital rectal massage was then performed." It doesn't actually specify what the original motivation for performing this act was. (For that matter, it also doesn't specify exactly whose rectum was massaged by whose digit.)



Odeh: We've tried everything, and this guy just won't stop hiccuping.

Oliven: Oh, well, no point in wasting any more time. Will you do that thing with your finger that I like so much?

Odeh: Right here? In front of him?

Oliven: I can't wait any longer! Do it now!

Odeh: Hey, look! He stopped hiccuping!

Miss Kismet said...

And they say doctors don't have the "personal touch" these days.

med student said...

Haha I was googling blepharospasm recently when my eyelid was twitching unexplainably and for some incomprehensible reason this article is linked in the wikipedia page! I can't believe someone else found it too!

http://en.wikipedia.org/wiki/Blepharospasm

outre said...

Good thing they didn't get far.

Otherwise... Rx rejected for lack of previous step therapy. Requesting documentation of failed digital rectal massage therapy to cover Pillhertzlex

Just found you over the weekend DRG, hilarious. Keep on writing.

Anonymous said...

wow. by what mechanism does this work?

Dragonfly said...

Maybe the researchers were trying to get "meaning" from it. I.e they had to do the massage (assuming it was them that did the DRM) and so they felt the need to get it published. Then it wasn't just something gross that they had to do, but it is good for their careers. Making them all respected in the medical fraternity and whatnot. Oh wait.

Cogitator said...

Thank you Candice, it was indeed supposed to be funny.

Cheap Meals, Good Food said...

In massage therapy school we took neuromuscular certification courses (which is pretty medically based and well documented).

The cure for hiccups using neuromuscular techniques was to massage the uvula.

I was _not_ one of the brave ones to volunteer for 'practice' of this technique.

I'd rather have a finger up my ass.

Although I did like the use of q-tips on eyelids to massage the eye muscles to release eye strain. That actually felt kind of good.

M

Anonymous said...

Maybe someone heard of an impending chlorpromazine shortage or had forgotten that it must be diluted to be administered IV and had to consider the fastest, most efficacious way 'at hand'.

student dr. blaze said...

o.m.g. i'm presently sitting in the cafe at the medical school, wondering just how many fingers may be up asses in these buildings. *shudder* scarily, it explains a *lot*.

 
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