this post was submitted on 27 Mar 2025
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Academia Gone Wild

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Transcription:

Termination of intractable hiccups with digital rectal massage. By M. Odeh, MD; H. Bassan; and A. Oliven. Published February 1990 in the Journal of Internal Medicine.

Abstract. 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.

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[–] [email protected] 32 points 3 days ago* (last edited 3 days ago) (4 children)

Initiating a vasovagal response to treat hiccups can in some cases result in transient asystole and potentially even death in those with cardiac compromise. This treatment method should be used with caution. As hiccups are often related to vagus irritation and tone issues, though, this might work by "resetting" a threshold.

Or a translation for you non medical types: Don't randomly go digging around in people's butts to cure hiccups or you might kill them.

[–] [email protected] 16 points 3 days ago* (last edited 2 days ago) (2 children)

kill them? this is way more intense than i expected in a thread about butt fingering.

[–] [email protected] 9 points 3 days ago (1 children)
[–] [email protected] 6 points 2 days ago* (last edited 2 days ago)

i can't decide if this is hilarious or terrifying.

[–] [email protected] 4 points 2 days ago

Right? Fisting maybe.

[–] [email protected] 11 points 3 days ago

Cure my hiccups and prostate massage, or death. This is a can't lose situation

[–] [email protected] 8 points 3 days ago (1 children)

In layman’s terms could you explain what the chain of events are that could lead to death.

You can be somewhat technical I watch a lot of MedLifeCrisis and ChubbyEmu 😂.

[–] [email protected] 12 points 3 days ago* (last edited 3 days ago) (2 children)

It's incredibly rare but here's the gist: simulating the rectum can cause autonomic vagal stimulation. The vagus nerve is also related to the cardiac system. It can cause a loss in vascular tone and a drop in blood pressure. This can result in unconsciousness(which we call vasovagal syncope) and arrhythmias. If you have other underlying problems and are fragile this can result in death very rarely. Most people will only feel lightheaded or faint. Some people have felt sudden dizziness when bearing down on the toilet: that's a vasovagal reflex. The vagus, along with the phrenic nerve, also is what is involved in the diaphragm and causes hiccups. This treatment is essentially trying to stimulate the vagus. We have a similar treatment for atrial fibrilation where we tell people to hold their breath and bear down like they're trying to poop. Its designed to reset the heart and stop the AFib. That's called the Valsalva maneuver. Also used to treat hiccups.

[–] [email protected] 6 points 3 days ago (1 children)

Thanks. That makes sense now. The only thing I struggled with was vascular tone, which I now understand to mean the blood vessels can have excessive vasodilation causing the drop in BP.

Interestingly I’ve had a poor or two like this where I thought I was about to pass out. Is this something explicitly brought on by the action of popping? As both times it happened to me I was normal and then all of a sudden I started to sweat profusely and the urge to empty my bowels came on in mere seconds.

Never thought I’d be discussing bowel movements online.

[–] [email protected] 8 points 3 days ago* (last edited 2 days ago) (1 children)

It's actually very common to experience that a few times. And it's related to what's physically happening to the nerves. It's just very rare for people to die from it. It's considered to be generally safe. The whole point of the treatment in the paper is to cause that exact feeling.

But yeah, look up the symptoms of vasovagal reflex and you'll find they match up to that to a T.

[–] [email protected] 5 points 3 days ago

Thank you. This was an interesting chat and it makes understanding the original post a little easier for me.

Have a nice day!

[–] [email protected] 3 points 3 days ago (1 children)

So then if this was going to happen, it could happen by someone pooping?

[–] [email protected] 9 points 3 days ago* (last edited 3 days ago)

Yes, it's a big part of stories of people dying on the toilet while constipated. Vasovagal syncope without any real danger is very common on the toilet. You really have no need to see a doctor if you experience it. It's only if you have serious underlying conditions that make it dangerous.

[–] [email protected] 4 points 3 days ago (1 children)

Now is this a large enough issue to warrant a soft reminder for the public on a tasteful tee shirt?

[–] [email protected] 5 points 3 days ago* (last edited 3 days ago)

It's rare but common enough in digital disimpaction that it's included in basic nursing education. Namely why we really don't like doing it as nurses and try to make the MDs do it. You need to be highly qualified to dig out poop. Hilariously, some MDs will then get a consult and have a GI specialist do it because they also don't want to. Shit sometimes they make the surgeons do it so now you have anesthesia in on the loop.

[–] [email protected] 25 points 3 days ago

How long until we find out he was faking it just for a nice massage?

[–] [email protected] 13 points 3 days ago

Abstract unclear, prostate vibrated into jelly by Lovense toy.

[–] [email protected] 12 points 3 days ago

60 year old man pioneers new way to get someone to massage his rectum!

[–] [email protected] 11 points 3 days ago
[–] [email protected] 5 points 3 days ago

So how could one induce intractable hiccups?... Just out of curiosity, of course.