Brazil's President Jair Bolsonaro has been fighting persistent hiccups for days but no treatment seems to work, it was reported Tuesday.
Doctors consulted by Brazilian media speculate the condition may stem from medication administered to the President in the past few days when he underwent surgery for dental implants.
Last Thursday during his live broadcast, Bolsonaro complained that I've been hiccuping for a week, maybe I can't express myself well in this life. On Monday, when he had a meeting with Supreme Federal Court (STF) Chief Justice Luiz Fux he was still suffering from the ailment. And Tuesday night, in conversation with his supporters, he warned: spoke again about the subject: Guys, I'm speechless, folks. If I start talking a lot, the hiccup crisis returns. The hiccups are already back.
The condition seems to be rare. Flavio Quilici, professor of gastroenterology at PUC Campinas, has told G1 that the situation is very uncomfortable and is related to the diaphragm, one of the main muscles in breathing. “You remember the muscle between the chest and the abdomen, which is the diaphragm. When this diaphragm relaxes, it makes you throw the air up and the glottis, which is the passage that opens for the stomach or lungs, closes, and makes that very characteristic noise.”
Quilici says that hiccups are common, always due to irritation from the enervation that passes through the diaphragm. However, the persistence of the discomfort for several days is very rare. “Ten days is enough,”, according to the doctor, who admitted Bolsonaro's surgery might have been indeed related to the hiccups.
“For him to stay so long, it can be an oesophagal complication, which is reflux disease. And he also had a fact that is the abdominal surgery and, sometimes, the oral ones, can lead to this stimulus,” Quilici said.
According to Maíra Marzinotto, a gastroenterologist at the Specialized Center for Digestive System at Hospital Alemão Oswaldo Cruz, any irritation near the diaphragm can cause hiccups. In the case of Bolsonaro, dental implant surgery may be related to hiccups, since the vagus nerve has ramifications that go from the ear canal to the diaphragm. “Not everyone who has a problem with the vagus nerve will develop a hiccup, but it can happen,” says Marzinotto.
Some medications, she said, can also cause a hiccup attack. “There are some medications that can cause hiccups, especially some anaesthetics. However, they are stronger anaesthetics, used in general surgery, and not in local surgery, with dental procedures,” she added.
The idea is to always look for the cause of the hiccup because using a medication to control the hiccup is medicating a consequence, so the problem will persist, she went on.
Despite this, she believes that the persistence of the symptom in the president's case justifies the use of medication. “The dental procedure can justify it, but I believe it is already taking a little longer than expected. Maybe it was time to take some medication to try to control the hiccups,” the specialist suggested.
In extreme cases, a pacemaker can be installed to correct the rhythm of the diaphragm and control hiccups, she also explained.