title: Use of vinegar to relieve persistent hiccups in an advanced cancer patient.
abstract: BACKGROUND
  This case report describes a patient whose persistent hiccups significantly improved with the use of vinegar.
  
  
  METHODS
  A patient with an adenocarcinoma of the colon and hepatic metastases developed hiccups the day following chemotherapy with FOL-FOX (folinic acid (leucovorin), 5-fluorouracil, oxaliplatin). Hiccups continued for seven days with no improvement from a number of commonly used pharmacological agents (chlorpromazine, metoclopramide, haloperidol, and baclofen). Relief was finally obtained after sipping vinegar. CASE MANAGEMENT AND OUTCOME: Hiccups occurred several times during the following chemotherapy cycles but the patient completed the treatment using vinegar when they recurred without stopping any drugs. Hiccups stopped or decreased in intensity or in rate per minute after sipping vinegar.
  
  
  CONCLUSIONS
  Hypotheses have been developed for the molecular and physiological mechanisms underlying sour compounds' effectiveness in relieving hiccups. Further studies should explore the potential role of vinegar in relieving hiccups in advanced heavily treated cancer patients.
authors.affiliation: 1 Department of Public Health and Community Medicine, University of Verona , Verona, Italy .
authors.forename: Silvia
authors.initials: S
authors.lastname: Gonella
authors.forename: Flavia
authors.initials: F
authors.lastname: Gonella
mesh_terms: D019342:Acetic Acid / Q000494:pharmacology / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use*; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use; D006606:Hiccup / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D002955:Leucovorin / Q000009:adverse effects / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000009:adverse effects / Q000627:therapeutic use; D000077150:Oxaliplatin
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D019342:Acetic Acid; D002955:Leucovorin; D005472:Fluorouracil