Q: Do you have any suggestions for how to get rid of hiccups? They have persisted for two days.

A: A reader offered this somewhat challenging cure for persistent hiccups: “My husband had hiccups for four days and finally went to the doctor when his ribs starting hurting. The doctor told him to use an enema suppository. The hiccups were gone within 24 hours. I hope this helps someone else.”

There is actually some science to support this remedy. Emergency physicians described a case of hiccups that lasted more than three days (Journal of Emergency Medicine, February 2017). The patient had not been able to eat, drink or sleep. The doctors presented several “pharmacological interventions.” They also offered the patient a digital rectal massage. Here is their description of the outcome:

“Before undergoing DRM, we observed our patient hiccupping 40 times in 1 minute. Our patient was placed in a lateral recumbent position with his hips flexed. A gloved lubricated index finger was passed into his rectum. Rectal massage was carried out in a slow, clockwise fashion with moderate steady pressure being applied. On initiation of DRM, hiccupping ceased immediately. The DRM was continued for 30 seconds.” One hour later the patient was sent home. There were no further hiccup attacks reported.

For people who would like to learn about other hiccup solutions, we offer our eGuide to Favorite Home Remedies. It can be found under the Health eGuides tab at www.PeoplesPharmacy.com. In addition to hiccup treatments, we offer simple solutions to common ailments such as arthritis, coughs, cramps, indigestion, insomnia and warts.

Hiccups that don’t go away with home remedies require medical attention. They could be a sign of something serious.

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Q: I used St. John’s wort tincture daily for moderate depression for several years when I lived in Minnesota. It was especially helpful with seasonal affective disorder.

The photosensitivity side effect didn’t bother me for a while, but I eventually reached a point where light felt too bright to my eyes, and I had to stop taking the herb. I concluded that the photosensitivity side effect is cumulative, increasing with duration of use.

I personally think that SJW is most helpful when used in northern climates with many overcast days in the winter. So it could be useful during short gloomy days in a place with long winters, like the U.K. I would not recommend taking it in a place with long hot summers. Am I correct about this?

A: The use of the herb St. John’s wort remains quite controversial. A meta-analysis involving 27 clinical trials and over 3,000 patients concluded that “For patients with mild-to-moderate depression, St John’s wort has comparable efficacy and safety when compared to SSRIs” (Journal of Affective Disorders, March 1, 2017). The authors note, however, that the studies were relatively short and the “Evidence on the long-term efficacy and safety of St. John’s wort is limited …”

There is research suggesting that this herb can make the retina sensitive to light (Photochemistry and Photobiology, November-December 2012). This could lead to the kind of damage you experienced. St. John’s wort can also interact with many other medicines to reduce their effectiveness. Given such downsides, we would discourage the use of this botanical medicine for depression.