**Question:** A man with intermittent hiccups feels that he is about to die because he is suffering from gastric cancer. All his radiological investigations prove the contrary. Which is the most probable diagnosis?

A. Panic Disorder
B. Gastric Cancer
C. Hypochondriasis
D. Gastroesophageal Reflux Disease (GERD)

**Correct Answer: C. Hypochondriasis**

**Core Concept:**
Hiccups are involuntary, sudden, and brief contractions of the diaphragm and intercostal muscles, causing spasms in the glottis, producing the characteristic sound of a hiccup. In this case, the man experiences intermittent hiccups and associates them with severe abdominal distress and fear of death due to gastric cancer.

**Why the Correct Answer is Right:**
The correct answer, Hypochondriasis (now called Illness Anxiety Disorder), is a psychiatric condition characterized by excessive preoccupation with having a serious illness despite no objective evidence for such a condition. In this scenario, the patient's fear of gastric cancer is irrational and unjustified by medical evidence.

**Why Each Wrong Option is Incorrect:**

A. Panic Disorder: This is a psychiatric disorder characterized by sudden, severe fear or anxiety that often triggers physical symptoms. While the patient feels severe distress, the cause is not psychiatric anxiety but rather irrational fear of gastric cancer.

B. Gastric Cancer: The man's symptoms are due to his irrational fear of gastric cancer rather than the actual disease itself.

D. Gastroesophageal Reflux Disease (GERD): GERD is a gastrointestinal disorder characterized by acid reflux leading to heartburn, regurgitation, and chest pain. In this case, the patient's symptoms are unrelated to GERD.

**Clinical Pearl:**
In cases where patients present with vague symptoms and their distress is related to a severe illness like gastric cancer, it is essential to address their irrational fears and reassure them. A thorough psychiatric evaluation and management can help alleviate their distress and improve their overall well-being.