Hiccups occur when a person’s airway becomes temporarily closed. It can happen at any time and for no apparent cause. Hiccups are normally a minor annoyance, but persistent hiccups can signal a significant medical issue.
A hiccup occurs when the diaphragm contracts involuntarily at the same time that the voice box, or larynx, contracts and the glottis, which houses the vocal cords, closes completely. As a result, the lungs receive a burst of air, accompanied by the characteristic “hic” sound.
Synced diaphragmatic flutter or singultus is the medical term for hiccups. They can occur alone or in clusters. They are frequently rhythmic, which means that the time between hiccups is rather consistent.
Most people get hiccups now and then, and they normally go away on their own within a few minutes.
Prolonged or chronic hiccups, which can last a month or longer, are uncommon. Intractable hiccups are hiccups that continue longer than two months.
An attack of hiccups that lasts more than 48 hours is considered chronic, and the person should seek medical attention. This is more common in males than in women, and it could indicate a more serious medical condition.
Causes
“An involuntary spasmodic contraction of the muscle at the base of the lungs (diaphragm) followed by the fast closure of the vocal cords,” according to the National Organization for Rare Disorders.
Chronic or persistent hiccups can be caused by a variety of underlying conditions.
Although it is unclear how or why short bouts of hiccups occur, researchers have connected some conditions to a higher risk of experiencing them. Some of these issues are discussed in greater depth in the sections following.
Lifestyle factors
Hiccups can be caused by the following factors:
- eating hot or spicy food that irritates the phrenic nerve, which is located near the esophagus
- having 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
Opiates, benzodiazepines, anesthetic, corticosteroids, barbiturates, and methyldopa are among the drugs that might produce hiccups.
Medical problems
Hiccups frequently strike without warning, and neither the person nor the doctor is able to pinpoint the cause.
Chronic hiccups, on the other hand, have been related to a number of medical disorders. These are some of them:
- Gastronomic conditions such as inflammatory bowel disease, 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, such as traumatic brain injuries, encephalitis, a brain tumor, or a stroke,
- Conditions that irritate the vagus nerve, such as meningitis, pharyngitis, or goiter,
- Psychological reactions include grief, excitement, anxiety, stress, and shock.
- Conditions that affect metabolism, including hyperglycemia, hypoglycemia, and diabetes,
- Liver and kidney problems
- Cancer, either as a result of damage caused by the condition or as a side effect of the treatment, such as chemotherapy,
- conditions of the autonomic nervous system, which also affect breathing, sweating, the heartbeat, hiccups, and coughing.
Bladder irritation, liver cancer, pancreatitis, pregnancy, and hepatitis are among the illnesses that can cause hiccups. Surgical procedures and lesions could also pose a threat.
In newborns
Hiccups are more common in infants during and after feeding because they may swallow food too quickly or overfeed. Hiccups might also indicate that a newborn is full. As a result, physicians usually advise brief feedings with burping pauses.
Hiccups can also be caused by an infant’s breathing and swallowing being out of sync. As a result, an infant may take a deep inhale and swallow, resulting in a hiccup.
Changes in stomach temperature can also cause hiccups in newborns. This could be the situation if they drink something cold first and then eat something warm.
In general, hiccups are a sign of normal development and growth. Hiccups can also be caused by GERD, which is a common and easily curable condition in children.
Hiccups alone are not a sign of reflux. Other symptoms to look out for in newborns with suspected GERD include:
- crying more frequently
- arching the back excessively during or after feeds
- spitting up more often than usual
What is the best way to get rid of hiccups?
Hiccups usually go away on their own after a few minutes or hours, and no medical treatment is required. However, if they persist, a person should see a doctor. The following suggestions may be useful, but their usefulness is unknown.
Tips for getting rid of hiccups
The following suggestions may aid in the elimination of hiccups:
- Sip ice-cold water slowly or gargle with very cold water.
- Hold the breath for a short time, then breathe out. Do this three or four times every 20 minutes.
- While swallowing, place gentle pressure on the nose.
- Place gentle pressure on the diaphragm.
- Bite into a lemon.
- Swallow some granulated sugar.
- Take a tiny amount of vinegar, just enough to taste.
- Breathe in and out of a paper bag. Never use a plastic bag for this, and never cover your head with the bag.
- Sit down and hug the knees as close to the chest as possible for a short time.
- Lean forward to compress the chest gently.
- Try an alternative remedy, such as acupuncture or hypnosis.
- Gently pull on the tongue.
- Rub the eyes.
- Try touching one finger to the throat to try to trigger a gag reflex.
Many of these hints have been handed down from generation to generation. They may work for some people, but there isn’t much evidence to back up their use.
Medications
If an underlying condition is treated, the hiccups will most likely disappear.
A doctor may recommend medicine if a person’s quality of life is being harmed by chronic hiccups.
The first-line treatment is chlorpromazine, which is the only medicine approved by the Food and Drug Administration (FDA) to treat hiccups.
If there appears to be no underlying cause for the hiccups, a doctor may prescribe the following medications:
- metoclopramide (Reglan), which is an antinausea medication that may help some people with hiccups
- baclofen (Lioresal), which is a muscle relaxant (off-label use)
- gabapentin, which is an antiseizure medication that doctors commonly prescribe for neuropathic pain and that can help alleviate the symptoms of hiccups (off-label use)
Hiccups caused by anesthesia or surgery can be treated with ephedrine or ketamine.
Doctors commonly recommend a low-dose, 2-week course of medicine for hiccups. They may progressively increase the dosage until the hiccups are no longer present. The severity of the hiccups, as well as the person’s general health and age, will determine the course and dosage.
Surgery
A surgeon may inject medicine into the phrenic nerve to temporarily block the nerve’s function or sever the phrenic nerve in the neck in severe cases that do not respond to previous therapies.
Complications
Hiccups that last for a long time might cause problems like:
- Weight loss and dehydration: If the hiccups are long-term and occur at short intervals, it can become difficult to eat.
- Insomnia: If prolonged hiccups persist during the sleeping hours, it can be hard to fall asleep or stay asleep.
- Fatigue: Prolonged hiccups can be exhausting, especially if they make it hard to sleep or eat.
- Communication problems: It can be difficult for a person to speak if they have hiccups. a
- Depression: Long-term hiccups can increase the risk of developing clinical depression.
- Delayed wound healing: persistent hiccups can make it harder for post-surgical wounds to heal, thereby increasing the risk of infection or bleeding after surgery. persistent
An irregular heartbeat and GERD are two other potential concerns.
Diagnosis
Hiccups that last less than 48 hours normally don’t require medical care because they usually go away on their own. If they last longer than this, the person should seek medical advice.
The doctor may inquire:
- when the hiccups began
- how often they occur
- if they are happening all the time
- what the person was doing before the hiccups started
They will most likely conduct a general physical examination as well as a neurological test to determine the following:
- reflexes
- balance
- coordination
- eyesight
- sense of touch
- muscle strength
- muscle tone
If the doctor suspects an underlying condition, he or she may request the following tests:
- blood tests to check for infections, kidney disease, or diabetes.
- Imaging tests — such as an X-ray, CT scan, or MRI scan — to assess for any anatomical irregularities that may be affecting the phrenic or vagus nerves or the diaphragm
- An endoscopic test, in which a healthcare professional passes an endoscope—which is a flexible tube with a small camera at the end—down the person’s throat to check the windpipe or esophagus,
- an electrocardiogram to check for heart-related conditions by measuring electrical activity in the heart.
Prevention
Some causes of hiccups can be avoided. There are a few things you can do to lessen your chances of getting hiccups:
- avoiding sudden changes in temperature
- not drinking alcohol or sodas
- eating moderately and not too quickly
The majority of hiccups are brief and go away completely after a short period of time. However, if they persist or cause troubling symptoms, the individual should seek medical advice.
Sources:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3325297/
- https://rarediseases.info.nih.gov/diseases/6657/chronic-hiccups
- https://www.ncbi.nlm.nih.gov/books/NBK538225/
- https://www.nhs.uk/conditions/hiccups/
- https://www.medicalnewstoday.com/articles/181573
- https://rarediseases.org/rare-diseases/hiccups-chronic/
- https://pubmed.ncbi.nlm.nih.gov/29934880/
