Hiccups and heartburn are uncommon yet bothersome side effects that can occur in cancer patients during treatment or palliative care. These symptoms may arise due to the disease itself, certain therapies, or other contributing factors like medications and dietary habits. While typically temporary, they can significantly impact a patient’s comfort and quality of life if not properly managed.
Hiccups in Cancer Patients
Hiccups occur when the diaphragm becomes irritated and contracts suddenly between normal breaths, producing a characteristic gulping sound. Though usually harmless and short-lived, persistent hiccups can be a sign of underlying complications in cancer patients.
Reasons for Hiccups in Cancer Patients
The exact cause of hiccups may not always be clear, but several factors associated with cancer and its treatment can trigger them:
- Presence of fluid in the lungs or around the heart
- Elevated blood sugar levels
- Alcohol consumption
- Side effects of certain chemotherapy drugs
- Use of non-cancer medications such as antibiotics, antiemetics, and steroids
- Tumors or blockages in organs like the esophagus, liver, lungs, pancreas, kidney, or colon
- Injuries to the head, nerves, or brain
- Consumption of specific foods or liquids
- Bloating and gas in the stomach
- Cancerous or non-cancerous tumors pressing on the diaphragm
- Impaired kidney function
- Esophageal disorders
- Strokes
- Low levels of sodium, calcium, or potassium
- Sudden temperature changes
- Emotional stress or excitement
Treatment for Hiccups
Most hiccups resolve spontaneously within minutes to hours and require no treatment. However, hiccups lasting more than 48 hours are considered persistent or chronic, and those lasting over a month are termed intractable. Only about 10% of advanced cancer patients experience prolonged hiccups, but when they do, it can severely disrupt sleep, eating, and overall well-being.
Effects of Prolonged Hiccups in Cancer Patients
- Extreme fatigue
- Difficulty consuming food or fluids
- Anxiety or emotional distress
- Sleep disturbances
- Impaired concentration and memory
- Irritability
- Respiratory difficulties
- Pain (especially in patients with mesothelioma)
- Weight loss
- Reduced quality of life
Here are a Few Ways to Manage Hiccups
- Drink small sips of water slowly
- Take deep breaths, hold for a few seconds, then exhale slowly
- Try acupuncture (targeted needle insertion at specific points)
- Gargle with water
For persistent hiccups, doctors may prescribe medications. However, these may not work for everyone and can cause side effects such as confusion, low blood pressure, nausea, drowsiness, and urinary retention. Always consult your healthcare provider for personalized management.
Heartburn in Cancer Patients
Some cancers and treatments cause stomach contents to flow back into the esophagus, leading to heartburn—a burning sensation in the chest, throat, or upper abdomen. Symptoms often worsen after meals or when lying down, and are commonly reported in the evening or at night.
Frequent heartburn may indicate GERD (Gastroesophageal Reflux Disease). Long-term reflux can lead to complications like ulcers or Barrett’s esophagus, which increases the risk of esophageal cancer.
Acid Reflux After Chemotherapy
Chemotherapy targets rapidly dividing cells, including healthy cells lining the gastrointestinal tract. Damage to this lining allows corrosive stomach acid and bile to irritate the esophagus, causing acid reflux and heartburn. Common symptoms include:
- Chest pain or burning
- Sore throat
- Cough
- Bitter taste in the mouth
- Difficulty swallowing or breathing
Read more about Side Effects of Chemotherapy
Reasons for Heartburn in Cancer Patients
- Excessive stomach acid production
- High intake of alcohol, caffeine, acidic juices, or carbonated drinks
- Smoking or tobacco use
- Chemotherapy drugs and other medications (e.g., aspirin, ibuprofen)
- Radiation therapy to the chest or upper abdomen
- High-fat or high-cholesterol diet
- Obesity
- Esophageal narrowing or tumor growth causing blockages
Treatment for Heartburn
Heartburn can often be managed with over-the-counter antacids and lifestyle modifications. Always follow your doctor’s advice regarding medication use.
Best Self-Care Ways to Manage Heartburn
- Quit all forms of tobacco (cigarettes, gutka, khaini, etc.)
- Limit caffeine and alcohol intake
- Lose weight if overweight to reduce abdominal pressure
- Eat smaller, more frequent meals instead of large ones
- Chew food slowly and mindfully
- Avoid tight clothing during meals
- Do not eat 1–2 hours before bedtime
- Sit upright or elevate your upper body if heartburn occurs
- Avoid lying down immediately after eating
- Limit or avoid trigger foods: spicy dishes, chocolate, fried and fatty foods, pastries, cream, tomatoes, citrus fruits, strong tea, soft drinks, and alcohol
When to Contact Your Health Care Team?
Seek immediate medical attention if you experience any of the following:
- Nausea that persists despite medication
- Difficulty breathing, eating, or swallowing
- Heartburn accompanied by a bloated or puffy stomach
- Constipation
- Heartburn occurring more than twice a week
- Ongoing reflux despite following medical advice
- Chest pain with sweating, shortness of breath, or arm/jaw pain (could indicate heart issues)
- Symptoms that persist or worsen after treatment
- Decreased appetite
- Unintentional weight loss with heartburn
- Blood in vomit, cough, or stool