Gentian root bitters for the rapid suppression of post-propofol singultus: a case report.

Abstract

Persistent singultus (hiccups) can be distressing and challenging to manage in the postoperative setting. While pharmacological interventions such as metoclopramide are commonly used, their effectiveness is often limited. Gentian root (Gentiana lutea) contains intensely bitter secoiridoid compounds known to stimulate vagally mediated reflexes and has a long history of use for digestive complaints. We report a case of a 70-year-old male who developed persistent hiccups following minor urologic surgery under propofol anesthesia. The hiccups were unresponsive to metoclopramide. The patient then self-administered a small amount (~20 mL) of traditional gentian schnapps, resulting in complete cessation of hiccups within 1 min. The effect was reproducible upon two subsequent recurrences later the same day. No further episodes occurred after the third administration. This case raises the hypothesis that bitter taste receptor activation in the oropharyngeal and gastrointestinal tract may modulate the hiccup reflex arc. While spontaneous resolution or the effect of alcohol cannot be excluded, the rapid and reproducible response suggests a possible therapeutic role for bitter-tasting botanical preparations in functional singultus.