Hiccups: Causes, treatment, and complications

Hiccups happen when a person’s intake of air becomes momentarily blocked. It can happen for no apparent reason. It is usually a minor nuisance, but prolonged hiccups can indicate a serious medical problem.

When a hiccup forms, it is because of a sudden, involuntary contraction of the diaphragm at the same time as a contraction of the voice box, or larynx, and a total closure of the glottis. This results in a sudden rush of air into the lungs, and the familiar “hic” sound.

The glottis is the middle part of the larynx, where the vocal cords are located.

Hiccups are medically known as synchronous diaphragmatic flutter or singultus (SDF). They can occur individually or in bouts. They are often rhythmic, meaning that the interval between each hiccup is relatively constant.

Most people have hiccups from time to time, and they usually resolve without treatment within a few minutes.

Rarely, there may be prolonged or chronic hiccups, which can last a month or more. Hiccups that last over 2 months are known as intractable hiccups.

If a bout lasts longer than 48 hours, this is considered persistent, and the person should see a doctor. It could be a sign of a more serious medical condition. This tends to be more common in men than in women.

The longest recorded case of hiccups lasted 60 years.

Fast facts on hiccups

The exact cause of hiccups remains unclear, but chronic hiccups are linked to a wide range of medical conditions, including stroke and gastrointestinal problems.

Most cases resolve without treatment, but prolonged hiccups can lead to complications such as insomnia and depression.

If hiccups last for longer than 48 hours, the person should see a doctor, who may prescribe muscle relaxants.

Avoiding alcohol and not eating too quickly can help reduce the chance of hiccups.

Causes

Hiccups
Hiccups can occur after eating spicy food, drinking alcohol, and a range of other situations.

The National Organization for Rare Diseases (NORD) describes hiccups as “an involuntary spasmodic contraction of the muscle at the base of the lungs (diaphragm) followed by the rapid closure of the vocal cords.”

A wide range of underlying conditions can trigger chronic or persistent hiccups.

Exactly how or why short bouts of hiccups happen remains unclear, but some factors have been associated with a higher risk of having them.

Lifestyle factors

The following may trigger hiccups:

hot or spicy food that irritates the phrenic nerve, which is near the esophagus

gas in the stomach that presses against the diaphragm

eating too much or Causing stomach distension

drinking sodas, hot liquids, or alcoholic drinks, especially carbonated drinks

experiencing stress or strong emotions

Some medications, such as opiates, benzodiazepines, anesthesia, corticosteroids, barbiturates, and methyldopa are known to cause hiccups.

Medical conditions

Often, hiccups occur unexpectedly and neither the patient nor the doctor can identify their likely cause.

However, a number of medical conditions have been linked to chronic hiccups.

These include:

gastrointestinal conditions, including inflammatory bowel disease (IBD), a small bowel obstruction, or gastroesophageal reflux disease (GERD)

respiratory conditions, such as pleurisy of the diaphragm, pneumonia, or asthma

excessive and habitual consumption of alcohol

conditions that affect the central nervous system (CNS), including a traumatic brain injury (TNI), encephalitis, a brain tumor, or stroke

conditions that irritate the vagus nerve, such as meningitis, pharyngitis, or goitre

psychological reactions, including grief, excitement, anxiety, stress, hysterical behavior, or shock

conditions that affect metabolism, including hyperglycemia, hypoglycemia, or diabetes

liver and kidney problems

cancer, either as a result of damage caused by the condition or as a side effect of treatment, such as chemotherapy.

conditions of the autonomic nervous system, which also affects breathing, sweating, heartbeat, hiccups, and coughing

Other conditions include bladder irritation, liver cancer, pancreatitis, pregnancy, and hepatitis. Surgery, tumors, and lesions may also be risk factors.

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Treatment

Most cases of hiccups will go away after a few minutes or hours with no medical treatment. If they persist, see your doctor.

Some tips may help, but their effectiveness is uncertain.

Tips for getting rid of hiccups

The following steps may help get rid of hiccups:

Sip ice-cold water slowly or gargle with very cold water.

Hold your breath for a short time, breath out, then do it again three or four times, and do this every 20 minutes.

While you swallow, place gentle pressure on your nose.

Place gentle pressure on your diaphragm.

Bite on a lemon.

Swallow some granulated sugar.

Take a tiny amount of vinegar, just enough to taste.

Breathe in and out of a paper bag, but never a plastic bag and never covering your head with the bag.

Sit down and hug your knees as close to your chest as possible for a short time.

Lean forward so that you gently compress your chest.

Alternative therapies may include acupuncture and hypnosis.

Gently pull on the tongue.

Rub the eyeballs.

Put your finger in your throat to trigger a gag reflex.

Many of these tips have been passed down through generations. They may be effective, but there is little research to support their use.

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