What are hiccups?
are repetitive, uncontrollable contractions of the diaphragm muscle. Your
diaphragm is the muscle just below your lungs. It marks the boundary between
your chest and abdomen. The diaphragm regulates breathing. When your diaphragm
contracts, your lungs take in oxygen. When your diaphragm relaxes, your lungs
release carbon dioxide.
diaphragm contracting out of rhythm causes hiccups. Each spasm of the diaphragm
makes the larynx and vocal cords close suddenly. This results in a sudden rush
of air into the lungs. Your body reacts with a gasp or chirp, creating the
sound characteristic of hiccups.
is the medical term for hiccups.
Onset of hiccups
no way to anticipate hiccups. With each spasm, there usually is a slight
tightening of the chest or throat prior to your making the distinctive hiccup
cases of hiccups start and end abruptly, for no discernable reason. Episodes
generally last only a few minutes. Hiccups that last longer than 48 hours are
considered persistent. Hiccups that last longer than two months are considered
intractable, or difficult to manage.
Causes of hiccups
causes of hiccups have been identified. However, there is no definitive list of
triggers. Hiccups often come and go for no apparent reason.
common causes of short-term hiccups include:
- eating spicy food
- consuming alcohol
- drinking carbonated beverages,
such as sodas
- consuming very hot or very cold
- a sudden change in air temperature
- swallowing air while chewing gum
- excitement or emotional stress
- aerophagia (swallowing too much
that last longer than 48 hours are categorized by the type of irritant that
caused the episode.
majority of persistent hiccups are caused by injury or irritation to either the
vagus or phrenic nerve. The vagus and phrenic nerves control the movement of
your diaphragm. These nerves may be affected by:
- irritation of your eardrum, which
may be caused by a foreign object
- throat irritation or soreness
- goiter (enlargement of the thyroid
- gastroesophageal reflux (stomach
acid backing up into the esophagus, the tube that moves food from the mouth to
- an esophageal tumor or cyst
causes of hiccups may involve the central nervous system (CNS). The CNS
consists of the brain and spinal cord. If the CNS is damaged, your body may
lose the ability to control hiccups. CNS damage that may lead to persistent
- multiple sclerosis (a chronic,
degenerative nerve disease)
- meningitis and encephalitis
(infections that can cause swelling in the brain)
- head trauma or brain injury
- hydrocephalus (accumulation of
fluid on the brain)
- neurosyphilis and other brain
that last for longer periods also can be caused by:
- overuse of alcohol
- tobacco use
- an anesthesia reaction after
- certain classes of drugs,
including barbiturates, steroids, and tranquilizers
- an electrolyte imbalance
- kidney failure
- arteriovenous malformation (a
condition in which arteries and veins are tangled in the brain)
- cancer and chemotherapy treatments
- Parkinson’s disease (a
degenerative brain disease)
a medical procedure can accidentally cause you to develop long-term hiccups.
They can be caused by procedures used to treat or diagnose other conditions,
- use of catheters to access the
- placement of an esophageal stent
to prop open the esophagus
- bronchoscopy (when an instrument
is used to look inside your lungs)
- tracheostomy (creation of a
surgical opening in the neck to allow breathing around an airway obstruction)
Risk factors for hiccups
can occur at any age. They can even occur while a fetus is still in the
mother’s womb. However, there are several factors that can increase your
likelihood of developing hiccups.
be more susceptible if you:
- are male
- experience intense mental or
emotional responses, ranging from anxiety to excitement
- have received general anesthesia
(you were put to sleep during surgery)
- had surgery, especially abdominal
hiccups are not an emergency. However a prolonged episode can be uncomfortable
and disruptive to daily life. Contact your physician if you have hiccups that
last longer than two days. Your doctor can determine the severity of your
hiccups in relation to your overall health and other conditions.
numerous options for treating hiccups. Typically, a short-term case of hiccups
will take care of itself. However, the discomfort may make waiting out hiccups
unbearable if they last longer than a few minutes.
none of these have been proven to stop hiccups, the following potential
treatments for hiccups can be tried at home:
- Breathe into a paper bag.
- Eat a teaspoon of granulated
- Hold your breath.
- Drink a glass of cold water.
- Pull on your tongue.
- Lift your uvula with a spoon. Your
uvula is the fleshy piece of tissue that is suspended above the back of your
- Attempt to purposefully gasp or
- Bring your knees to your chest and
maintain this position.
- Try the Valsalva maneuver by shutting
your mouth and nose and exhaling forcibly.
- Relax and breathe in a slow,
still have hiccups after 48 hours, talk to your doctor. Your physician may
attempt gastric lavage (stomach pumping) or carotid sinus massage (rubbing the
main carotid artery in the neck).
cause of your hiccups is unclear, your physician may recommend tests. These can
help detect any underlying disease or condition. The following tests may be
useful in determining the cause of persistent or intractable hiccups:
- blood tests to identify signs of
infection, diabetes, or kidney disease
- liver function tests
- imaging of the diaphragm with a
chest X-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI)
- echocardiogram to assess heart
- endoscopy, which utilizes a thin,
lighted tube with a camera on the end to investigate your esophagus, windpipe,
stomach, and intestine
- bronchoscopy, which utilizes a
thin, lighted tube with a camera on the end to examine your lungs and airways
any underlying causes of your hiccups will usually make them go away. If
persistent hiccups have no obvious cause, there are several anti-hiccup
medications that may be prescribed. The more commonly used drugs include:
- chlorpromazine and haloperidol
- benzodiazepines (a class of
- Benadryl (an antihistamine)
- metoclopramide (a nausea drug)
- baclofen (a muscle relaxant)
- nifedipine (a blood pressure
- seizure medications, such as
also more invasive options, which can be used to end extreme cases of hiccups.
- nasogastric intubation (insertion
of a tube through your nose into your stomach)
- an anesthetic injection to block
your phrenic nerve
- surgical implantation of a
diaphragmatic pacemaker, a battery-powered device that stimulates your
diaphragm and regulates breathing
of Untreated Hiccups
long-term episode of hiccups can be uncomfortable and even harmful to your
health. If left untreated, prolonged hiccups can disturb your sleeping and
eating patterns, leading to:
- weight loss
How to prevent hiccups
no proven method for preventing hiccups. However, if you experience hiccups
frequently, you can try to reduce your exposure to known triggers.
following may help reduce your susceptibility to hiccups:
- Don’t overeat.
- Avoid carbonated beverages.
- Protect yourself from sudden
- Don’t drink alcohol.
- Remain calm, and try to avoid
intense emotional or physical reactions.