Hiccups: Causes and Remedies

MNT Knowledge Center

Hiccups are sudden, involuntary contractions in the diaphragm which occur concurrently just like a contraction in the voice box (larynx) and total closure in the glottis, effectively obstructing air intake. The glottis could be the middle part of the larynx, where the vocal cords sit.

Hiccups may also be typed “hiccoughs” and so are medically known to as SDF (synchronous diaphragmatic flutter) or singultus.

Hiccups could occur without pointless. It’s quite common to acquire a bout of hiccups every so often and there isn’t any requirement of alarm should purchasing one. In almost all cases, hiccups resolve neglected inside a few momemts.

Hiccups can occur individually or possibly in bouts and usually happen rhythmically, and then the interval among each hiccup is pretty constant. Lots of people see them to become minor nuisance. However, prolonged hiccups can increased to become significant condition and want treatment. Prolonged hiccups affect men more than women. When attacks traverses monthly, the hiccups are known as intractable.

Fast particulars on hiccups

Listed here are a couple of recommendations on hiccups. More detail and supporting information is within the primary article.

  • Experts are still divided on why hiccups occur.
  • Some medical conditions such as stroke and asthma are associated with a higher incidence of hiccups.
  • Prolonged cases of hiccups can lead to complications such as insomnia and depression.
  • Cases of hiccups that last for longer than 48 hours should be referred to a doctor.
  • There are many tips that are known to help patients with hiccups.
  • For prolonged cases of hiccups, drugs such as muscle relaxants can be prescribed.
  • Some causes of hiccups can be avoided, such as alcohol and eating too quickly.
  • Most cases of hiccups resolve without treatment.

Causes of hiccups

Experts haven’t yet achieve a definitive conclusion on which the systems are that create hiccups, or why they occur. Based on studies, the next conditions, conditions and illnesses happen to be connected having a greater chance of developing hiccups:

Diagram of how hiccups occur

  • Hot food has irritated the phrenic nerve. The phrenic nerve is near the esophagus.
  • When there is gas in the stomach, which presses against the diaphragm.
  • Too much food is eaten.
  • Food is eaten too rapidly.
  • There is a sudden change in temperature.
  • Fizzy drinks are consumed.
  • Some people get hiccups after eating spicy foods.
  • After eating dry breads.
  • Many people anecdotally report hiccups after consuming alcoholic beverages.
  • Some medications, such as opiates, benzodiazepines, anesthesia, corticosteroids, barbiturates, and mythyldopa are known to cause hiccups.

Some medical conditions are linked to a higher incidence of hiccups, such as:

  • Gastrointestinal conditions, including IBD (inflammatory bowel disease), a small bowel obstruction, or GERD (gastro-esophageal reflux disease).
  • Respiratory conditions, such as pleurisy, pneumonia or asthma.
  • Conditions which affect the CNS (central nervous system), including a traumatic brain injury, encephalitis, a brain tumor, or stroke.
  • Conditions which irritate the vagus nerve, such as meningitis, pharyngitis or goitre.
  • Psychological reactions, including grief, excitement, anxiety, stress, hysterical behavior, or shock.
  • Conditions which affect metabolism, including hyperglycemia, hypoglycemia, or diabetes.

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

Possible complications of hiccups

If a patient has prolonged hiccups, complications may develop, including:

  • Weight loss – in some cases the hiccups are not only long-term, but occur at short intervals, making it hard for the patient to eat properly.
  • Insomnia – if the prolonged hiccups persist during the sleeping hours, the patient will find it hard to get to sleep, and/or stay asleep.
  • Fatigue – people with prolonged hiccups may become exhausted, especially if they cannot sleep or eat properly.
  • Communication problems – persistent hiccups may make it harder for the patient to communicate orally.
  • Depression – patients with long-term hiccups have a considerably higher risk of developing clinical depression.
  • Post-surgical wound healing – if the patient is hiccupping all day long, post-surgical wounds will probably take much longer to heal. Some patients may have a higher risk of developing infections, or start bleeding after surgery.

On the next page we look at tests for patients with prolonged hiccups and we examine the treatment options for hiccups.

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Tests for patients with prolonged hiccups

Hiccups that last less than 48 hours do not usually need any medical attention, because they resolve on their own. If your hiccups persists for longer, you should check with your doctor.

After talking to the patient about their hiccups, when they began, how often they occur, etc., the doctor will probably perform a general physical exam and then a neurological exam to check the person’s:

  • Reflexes
  • Balance
  • Coordination
  • Eyesight
  • Sense of touch
  • Muscle strength
  • Muscle tone.

If the doctor, usually a GP (general practitioner, primary care physician) at this point, believes an underlying condition may be the cause, the following diagnostic tests may be ordered:

  • Blood tests – to check for infection, kidney disease or diabetes
  • Imaging tests – to determine whether there are any anatomical abnormalities which may be affecting the phrenic or vagus nerves or the diaphragm. This may involve taking a chest X-ray, a CT scan or an MRI scan.
  • Endoscopic test – the doctor inserts an endoscope, a flexible tube with a small camera at the end, down the patient’s throat to check the windpipe or esophagus.
  • An electrocardiogram (ECG) – this test checks for heart-related conditions by measuring electrical activity in the heart.

Treatments for hiccups

In the vast majority of cases, hiccups require no medical treatment and will go away after a few hours or a couple of days at the most.

Tips for getting rid of hiccups

According to the National Health Service (NHS), UK, the following steps have been known to help some patients with hiccups:

Lady with hiccups
Hiccups are common and often occur unexpectedly.

  • Sip ice-cold water slowly.
  • Hold your breath for a short time, breath out, then do it again three or four times – do this every 20 minutes.
  • While you swallow, place gentle pressure on your nose.
  • Place gentle pressure on your diaphragm.
  • Gargle with very cold water.
  • Bite on a lemon.
  • Take some granulated sugar and swallow it.
  • Have a tiny bit of vinegar (enough to taste).
  • Breathe into a paper bag (note: you should never cover your head with the bag).
  • Sit down and hug your knees as close to your chest as you can for a short period of time.
  • Lean forward so that you gently compress your chest.

More tips are featured in our article how to get rid of hiccups.

If you have an underlying condition which may be causing the hiccups

If the underlying condition or illness is treated and/or controlled, the hiccups will likely resolve. In some cases, the patient may be referred to a specialist.

Medications to treat hiccups

For prolonged hiccups which may be interfering with the patient’s quality of life, the doctor may prescribe a drug. The following medications may be prescribed if no underlying health condition is diagnosed:

  • baclofen (Lioresal) – a muscle relaxant
  • chlorpromazine – an antipsychotic medication which can alleviate hiccups
  • gabapentin – originally used for the treatment of epilepsy, now commonly prescribed for neuropathic pain. It can help alleviate the symptoms of hiccups.
  • haloperidol – an antipsychotic drug which can also alleviate hiccups symptoms
  • metoclopramide (Reglan) – an anti nausea medication, known to help some patients with hiccups.

The doctor will usually prescribe a low-dose two-week course of medication. The dosage may gradually be increased until the hiccups are gone. Medication course length depends on the severity of hiccups, the patients’ general health, and their age.

Preventing hiccups

Some of the causes of hiccups are preventable.

  • Avoid abrupt changes in temperature
  • Avoid drinking alcohol
  • Avoid fizzy drinks
  • Avoid having large meals
  • Do not eat too rapidly.

Further reading:
How to get rid of hiccups