Hiccups are involuntary contractions of the diaphragm — the muscle that separates your chest from your abdomen and plays an important role in breathing. Each contraction is followed by a sudden closure of your vocal cords, which produces the characteristic “hic” sound.
Hiccups may result from a large meal, alcoholic or carbonated beverages or sudden excitement. In some cases, hiccups may be a sign of an underlying medical condition. For most people, a bout of hiccups usually lasts only a few minutes. Rarely, hiccups may persist for months. This can result in weight loss and exhaustion.
Why Do Hiccups Happen?
Hiccups can happen for a lot of reasons — some of them are physical, and some emotional. That’s because the actual irritation happens in the nerve connecting the brain to the diaphragm. Some common causes include:
- Eating too much or too quickly
- Feeling nervous or excited
- Drinking carbonated beverages or too much alcohol
- A sudden change in temperature
- Swallowing air while sucking on candy or chewing gum
What is The Symptoms of Hiccups ?
Hiccupping is a symptom. It may sometimes be accompanied by a slight tightening sensation in your chest, abdomen or throat.
What is the Causes of Hiccups ?
The most common triggers for hiccups that last less than 48 hours include:
- Drinking carbonated beverages
- Drinking too much alcohol
- Eating too much
- Excitement or emotional stress
- Sudden temperature changes
- Swallowing air with chewing gum or sucking on candy
Hiccups that last more than 48 hours may be caused by a variety of factors, which can be grouped into the following categories.
Nerve damage or irritation
A cause of long-term hiccups is damage to or irritation of the vagus nerves or phrenic nerves, which serve the diaphragm muscle. Factors that may cause damage or irritation to these nerves include:
- A hair or something else in your ear touching your eardrum
- A tumor, cyst or goiter in your neck
- Gastroesophageal reflux
- Sore throat or laryngitis
Central nervous system disorders
A tumor or infection in your central nervous system or damage to your central nervous system as a result of trauma can disrupt your body’s normal control of the hiccup reflex. Examples include:
- Multiple sclerosis
- Traumatic brain injury
Metabolic disorders and drugs
Long-term hiccups can be triggered by:
- Electrolyte imbalance
- Kidney disease
Hiccups are usually temporary, but in rare cases, they can stick around — for a while. It’s usually because of damage or aggravation to the nerves connected to the diaphragm. Everything from a hair touching your eardrum to a sore throat can affect these nerves, and in more serious cases, a tumor, goiter, or cyst in the neck can damage them.
Hiccups that last a while can also be because of central nervous system disorders like encephalitis or meningitis, or metabolic disorders like diabetes or kidney failure. Drugs like steroids or some tranquilizers can trigger long-term hiccups, too.
And even certain procedures, especially ones that require anesthesia, can give you hiccups. If you’ve been hiccupping for more than 2 days, or if they are severe enough to interfere with eating, breathing, sleeping or are causing you distress, you should make an appointment with your doctor.
Also, talk to your doctor immediately if you have any kind of stomach pain, fever, shortness of breath, vomiting, or cough up blood with your hiccups.
How to Make Hiccups Stop ?
If you’re hoping that hanging upside down or having a friend scare you will get your hiccups to stop, we hate to disappoint you. But there’s no scientific proof that these remedies work.
However, some experts think holding your breath or breathing into a paper bag might do the trick; both techniques make carbon dioxide build up in your lungs, which might relax the diaphragm.
If all else fails, and your hiccups continue for several days or more, your doctor may try different medications to see if she can put an end to those uncomfortable hiccups. Good luck!
Q. Why do I get hiccups, and what can I do about them? I know they’re not serious, but they sure are aggravating.
A. Hiccups are one of those minor maladies of man that they don’t teach you about in medical school. But they can affect a person’s life — particularly when they start at the wrong time. The first time I realized this was when hiccups started just as I was in the middle of giving a lecture to medical students. You want your lectures to be memorable, and this one may have been — not for what I said, but for the way it came out of my mouth.
We know what hiccups are, but not why they occur. Each of us has a flat plate of muscle just beneath our lungs, separating our chest from our abdomen. It’s called the diaphragm, and it helps us breathe: when it moves downward, it causes the lungs to pull in air through the nose and mouth. And when it moves upward, it forces air out of our lungs. The movement of the diaphragm is directed by the brain, which sends signals down nerves that end in the diaphragm. A hiccup occurs when the brain sends a signal for the diaphragm to shift forcefully downward, suddenly pulling a lot of air into the back of the throat. The sudden change in pressure causes a narrow area in the throat to temporarily snap shut, causing the “hic” sound of a hiccup. Why the brain sends the signals that cause hiccups, however, is a mystery.
Several factors can trigger the short bouts of hiccups that many people periodically experience: (1) a stomach full of too much food, alcohol, or air; (2) sudden changes in temperature; (3) smoking cigarettes; (4) excitement, stress, or other heightened emotion (like when giving a lecture).
What to do? Fortunately, most episodes of hiccups go away after just a few minutes. When they are more persistent, doctors recommend various treatments — although most of these are closer to folklore than scientifically proven therapies:
- stimulating the back of the throat by poking it with a long cotton swab, pulling on your tongue, swallowing a spoonful of dry granulated sugar, gargling, sipping ice water, or biting on a lemon
- rubbing the back of the neck
- interrupting your normal breathing cycle by holding your breath, breathing into a paper bag, or pulling your knees up to your chest and leaning forward
- having someone prepared to distract you when hiccups return, by scaring you or telling you a really good joke.
Sometimes, hiccups last much longer than you’d like, despite these measures. Next month we’ll discuss what to do then.
How to Diagnose Hiccups and Treat Hiccups ?
Diagnosis of Hiccups
During the physical exam, your doctor may perform a neurological exam to check your:
- Balance and coordination
- Muscle strength and tone
- Sight and sense of touch
If your doctor suspects an underlying medical condition may be causing your hiccups, he or she may recommend one or more of the following tests.
Samples of your blood may be checked for signs of:
- Kidney disease
These types of tests may be able to detect anatomical abnormalities that may be affecting the vagus nerve, phrenic nerve or diaphragm. Imaging tests may include:
- Chest X-ray
- Computerized tomography (CT)
- Magnetic resonance imaging (MRI)
These procedures utilize a thin, flexible tube containing a tiny camera, which is passed down your throat to check for problems in your esophagus or windpipe.
- Chest X-rays
- CT scan
Treatment of Hiccups
Most cases of hiccups go away on their own without medical treatment. If an underlying medical condition is causing your hiccups, treatment of that illness may eliminate the hiccups. The following treatments may be considered for hiccups that have lasted longer than two days.
Drugs that may be used to treat long-term hiccups include:
Surgical and other procedures
If less invasive treatments aren’t effective, your doctor may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups.
Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it has also helped control persistent hiccups.
Lifestyle and home remedies
Although there’s no certain way to stop hiccups, if you have a bout of hiccups that lasts longer than a few minutes, the following home remedies may provide relief, although they are unproven:
- Breathe into a paper bag
- Gargle with ice water
- Hold your breath
- Sip cold water
If you have chronic hiccups, lifestyle changes may help:
- Avoid carbonated beverages and gas-producing foods
- Eat smaller meals
When long-term hiccups don’t respond to other remedies, alternative treatments, such as hypnosis and acupuncture, may be helpful.