Hiccups

Hiccups are muscle spasms in your diaphragm that push air past your vocal cords faster than normal, causing them to tighten in response. The result is often a distinct sound, or a “hiccup.”

The diaphragm is a muscle at the base of your chest that helps you inhale. Muscle spasms in the diaphragm can occur for a number of reasons, including recent surgery, an irritation of the phrenic nerve (the nerve that controls the diaphragm), eating or drinking unusual foods or fluids, inhaling smoke or fumes, or having some types of disease or brain injury. Chronic hiccups commonly afflict people with advanced cancer.

Hiccups are a universal phenomenon – most everyone has experienced hiccups. Though hiccups usually go away on their own, a variety of home remedies have been suggested to shorten their duration. You can try relaxing, swallowing a teaspoon of sugar, sipping ice water, and breathing deeply and purposefully.

Hiccups can be annoying, and if they continue for an extended period, they can become quite uncomfortable. In the majority of cases, hiccups are not of great concern. However, if your hiccups continue for hours or days, or if they occur more and more frequently, then you should contact your health care provider to see if a less common or more serious cause is possible.

Seek prompt medical care if you have hiccups that do not resolve after a few hours, are very painful, make it difficult to breathe, or if you notice that you are having hiccups very often for a reason that is not known.

Symptoms of hiccups include a sudden contraction of your belly and chest and a “hiccup” sound. A hiccup can feel like a cross between a burp and a sneeze. It is possible to have hiccups that do not make any sound or hiccups that you can hear but do not feel.

You may experience hiccup symptoms daily or only occasionally. Symptoms include:

• A “hiccup” sound
• Quick and uncontrolled tightening of the diaphragm, which will feel like a spasm that is coming from your abdomen and chest area

In some cases, hiccups can occur with a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:

• Difficulty breathing
• Loss of consciousness

Hiccups are caused by a spasm in the diaphragm. The diaphragm is a muscle between your lower ribs and back that helps you breathe. At times, it can contract quickly, forcing a quick exhalation of air from the lungs. As the air rushes past your vocal cords, they contract, causing a distinct “hiccup” sound.

There are a variety of reasons why hiccups may occur. In some cases, the cause is not known. In other cases, hiccups occur because the phrenic nerve (nerve that controls the diaphragm), the diaphragm, or the lungs become irritated. An illness, such as pneumonia, can irritate the phrenic nerve. Hot, spicy, or very cold food or beverages may irritate the diaphragm. Toxic chemicals from smoke or fumes can irritate the lungs. Each of these irritating factors could trigger hiccups.

Some surgeries can cause hiccups, though the exact reason for this is not known. In rare cases, hiccups can result from injury to a specific part of the brain, particularly due to stroke, trauma or a tumor.

A number of factors increase the risk of developing hiccups. Not all people with risk factors will get hiccups. Risk factors include:

• Male gender (males are more likely than females to develop hiccups)
• Genitourinary disorders
• Irritation or trauma to the vagus nerve
• Recent surgery (general anesthesia or conscious sedation)
• Spicy, hot or cold food or drinks
• Stress, either physical or emotional

There is no cure for hiccups, though there are many anecdotal treatments and cures. In nearly all cases, hiccups disappear and require no treatment. In the case of hiccups caused by another condition, such as a lung infection irritating the phrenic nerve (the nerve that controls the diaphragm), treatment of the underlying condition may prevent the hiccups from continuing.

When hiccups persist for a long time or are severe, a variety of treatments are available, including muscle relaxants and surgical options.

If hiccups last longer than a few days or come back frequently, certain medications may help control the symptoms or decrease the occurrence of the condition including:

• Antinausea drugs such as metoclopramide (Reglan), which can help reduce the duration of hiccups
• Antipsychotic drugs such as chlorpromazine (Thorazine), which can help decrease chronic hiccups
• Antiseizure medications such as phenytoin (Dilantin), which can be used to treat hiccups
• Muscle relaxants such as baclofen (Lioresal), which can calm the diaphragm and reduce spasm

A variety of surgical options are available for chronic hiccups. These can be used to decrease the frequency or severity of hiccups. They include:

• Implanting a small device into the vagus nerve, a treatment usually used in patients with epilepsy, which has been shown to improve chronic hiccups

• Injecting a nerve block into the phrenic nerve, which can to relieve hiccups

• Inserting a nasogastric tube, which may help to relieve chronic hiccups for reasons that are not known

Some complementary treatments may help some people to better deal with chronic hiccups. The current medical literature suggests that acupuncture works as well, or better than, conventional medical therapy. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments.

Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

• Acupuncture

• Massage therapy

• Nutritional dietary supplements, herbal remedies, tea beverages, and similar products

• Yoga

Though many remedies claim to cure hiccups, there is no effective method of self-care that has been proven or is guaranteed to work. There are some common things you can do to limit hiccups in some circumstances including:

• Breathing into and out of a paper bag

• Breathing purposefully and deeply

• Drinking cold water

• Relaxing

Hiccups by themselves usually present only mild complications, such as embarrassment, difficulty communicating, and discomfort.

Complications of hiccups include:

• Difficulty sleeping

• Difficulty speaking

• Discomfort

• Embarrassment