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On and off hiccups. Understanding Hiccups: Causes, Remedies, and When to Seek Medical Attention

by alexxlab

What causes hiccups and how can they be alleviated. When do hiccups indicate a more serious medical condition. How long should hiccups last before seeking medical help. What are effective home remedies for stopping hiccups. Can hiccups be a symptom of underlying health issues.

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The Science Behind Hiccups: What Causes These Involuntary Contractions?

Hiccups are a common physiological phenomenon that most people experience occasionally. But what exactly causes these involuntary contractions? Hiccups originate from the diaphragm or the nerves controlling it, despite seeming to come from the chest. When a spasm occurs, it causes a quick influx of air that hits the vocal cords, producing the characteristic “hic” sound.

Several factors can trigger hiccups:

  • Eating too quickly or excessively
  • Emotional states like excitement, nervousness, or fear
  • Consuming carbonated beverages or alcohol
  • Experiencing stress
  • Sudden temperature changes
  • Swallowing air while chewing gum or eating candy
  • Irritation of the esophagus

Esophageal reflux is a common culprit behind hiccups. In some cases, hiccups may persist due to more serious underlying conditions, such as post-surgical irritation of the phrenic or vagus nerves, cancers affecting the chest or neck, brain disorders, or cardiovascular disease. Certain medications can also trigger long-term hiccups.

Home Remedies: Effective Ways to Stop Hiccups

Are you looking for ways to get rid of those pesky hiccups? There are numerous home remedies that people swear by, some backed by science and others by anecdotal evidence. Here are some popular methods to try:

  1. Holding your breath: This simple technique can disrupt your breathing pattern and potentially stop hiccups.
  2. Valsalva maneuver: Attempt to exhale while closing your mouth and pinching your nose shut. This stimulates the vagus nerve and may interrupt the hiccup reflex.
  3. Ingesting ice or applying mild pressure to closed eyes: These actions might “reboot” your nervous system.
  4. Consuming a spoonful of sugar: This can stimulate the back of your throat, potentially causing a vagal nerve response.
  5. Eating peanut butter from a spoon: The thick consistency may help relax the back of your throat.
  6. Biting into a lemon wedge: Some individuals have reported success with this method.

It’s important to note that while these remedies are generally safe, one traditional method should be approached with caution: scaring someone to rid them of hiccups. While the startle response might induce a vagal nerve reaction, it also carries risks such as potential falls or adverse effects on underlying heart conditions.

The Vagus Nerve: How It Affects Hiccups and Overall Health

The vagus nerve plays a crucial role in hiccups and various bodily functions. As part of the autonomic nervous system, it helps control heart rate and breathing. Understanding its impact can shed light on why certain remedies for hiccups are effective.

How does the vagus nerve influence hiccups? The vagus nerve, along with the phrenic nerve, affects the diaphragm. When these nerves are stimulated or irritated, it can lead to hiccups. Conversely, maneuvers that affect the nerve reflex may help stop hiccups.

The Valsalva maneuver, for instance, stimulates the vagus nerve, causing what’s known as a vagal nerve response. This response can interrupt the hiccup reflex, effectively “rebooting” your nervous system. Other methods like ingesting ice or applying pressure to closed eyes might work similarly by triggering this response.

Beyond hiccups, the vagus nerve has far-reaching effects on overall health. It plays a role in digestion, heart rate regulation, immune response, and even mood. Some researchers are exploring vagus nerve stimulation as a potential treatment for various conditions, including depression and epilepsy.

When Hiccups Become a Concern: Signs You Should Seek Medical Attention

While most cases of hiccups are harmless and resolve on their own, there are instances when they may indicate a more serious underlying condition. When should you be concerned about hiccups?

Duration is one factor to consider. If hiccups persist for more than a couple of days, it’s advisable to consult your primary care provider. This is particularly important if the hiccups are interfering with your sleep or daily activities. Your healthcare provider can rule out other medical causes and may prescribe medications if traditional methods aren’t effective.

However, more critical than duration is the onset of additional symptoms alongside hiccups. Seek immediate medical attention if your hiccups are accompanied by:

  • Sudden onset of numbness or coordination issues
  • Difficulty speaking or swallowing
  • Facial droop
  • Speech changes
  • Vision changes (such as partial vision loss)
  • Weakness on one side of the body

These symptoms could indicate a stroke, which requires immediate treatment. Additionally, if you experience any cardiovascular symptoms alongside hiccups, it’s crucial to seek emergency care promptly.

Persistent Hiccups: Potential Underlying Medical Conditions

While most cases of hiccups are benign and short-lived, persistent hiccups can sometimes be a symptom of an underlying medical condition. What are some potential causes of prolonged hiccups?

Gastrointestinal Issues

Conditions affecting the digestive system can lead to persistent hiccups. These may include:

  • Gastroesophageal reflux disease (GERD)
  • Peptic ulcers
  • Inflammatory bowel disease

Neurological Disorders

Various neurological conditions can trigger long-lasting hiccups:

  • Brain tumors
  • Stroke
  • Multiple sclerosis
  • Parkinson’s disease

Metabolic Disorders

Certain metabolic imbalances may contribute to persistent hiccups:

  • Diabetes
  • Electrolyte imbalances
  • Kidney disease

Other Potential Causes

Additional factors that might lead to prolonged hiccups include:

  • Tumors or infections affecting the diaphragm or nearby structures
  • Certain medications, such as steroids or benzodiazepines
  • Psychological factors, including stress or anxiety

If you’re experiencing persistent hiccups, it’s essential to consult a healthcare professional for proper evaluation and diagnosis. They can help determine if there’s an underlying condition requiring treatment.

Hiccups in Different Age Groups: From Infants to the Elderly

Hiccups can affect individuals of all ages, but their significance and management may vary across different life stages. How do hiccups manifest in different age groups, and what considerations should be taken into account?

Hiccups in Infants

Hiccups are common in newborns and infants, often occurring during or after feeding. They’re generally harmless and don’t cause discomfort to the baby. However, frequent hiccups might indicate:

  • Overfeeding
  • Swallowing too much air during feeding
  • Gastroesophageal reflux

Parents can try changing feeding positions or burping the baby more frequently to help reduce hiccups. If hiccups persist or seem to cause distress, consulting a pediatrician is advisable.

Hiccups in Adults

In adults, occasional hiccups are usually benign and often resolve on their own. However, persistent or recurrent hiccups might warrant medical attention, especially if accompanied by other symptoms or if they interfere with daily activities.

Hiccups in the Elderly

Older adults may be more susceptible to prolonged hiccups due to:

  • Increased likelihood of underlying medical conditions
  • Medication side effects
  • Age-related changes in the digestive system

In the elderly, persistent hiccups should be evaluated promptly to rule out serious underlying causes.

Medical Treatments for Persistent Hiccups: When Home Remedies Aren’t Enough

While most cases of hiccups resolve on their own or with simple home remedies, persistent hiccups may require medical intervention. What treatments are available when traditional methods fail to provide relief?

Pharmacological Interventions

Several medications can be prescribed to treat persistent hiccups:

  • Baclofen: A muscle relaxant that can help reduce diaphragm contractions
  • Chlorpromazine: An antipsychotic medication that can be effective in treating hiccups
  • Metoclopramide: A medication that improves stomach emptying and may help with hiccups
  • Gabapentin: An anticonvulsant that has shown efficacy in some cases of intractable hiccups

Non-Pharmacological Treatments

In some cases, other medical interventions may be considered:

  • Nerve blocks: Injecting anesthetic around certain nerves to interrupt the hiccup reflex
  • Acupuncture: Some studies suggest acupuncture may be beneficial for persistent hiccups
  • Hypnosis: This technique has shown promise in treating psychogenic hiccups

Surgical Interventions

In rare, extreme cases where other treatments have failed, surgical options might be considered:

  • Phrenic nerve ablation: A procedure to disable the phrenic nerve, which controls the diaphragm
  • Vagus nerve stimulation: Implanting a device to stimulate the vagus nerve

It’s important to note that these treatments are typically reserved for cases of intractable hiccups that significantly impact quality of life. The choice of treatment depends on the underlying cause of hiccups, the patient’s overall health, and the severity of symptoms.

If you’re experiencing persistent hiccups that don’t respond to home remedies, consult your healthcare provider. They can assess your condition, identify any underlying causes, and recommend appropriate treatment options tailored to your specific situation.

When are hiccups serious? | Ohio State Medical Center


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Hiccups. They can be annoying or embarrassing, but we typically don’t think of them as concerning. They’re usually short-lived, although in rare cases, they can persist. When they last more than a of couple days, or if other symptoms occur at their onset, they can be a sign of a more serious medical condition.

What causes hiccups?

Hiccups seem to come from the chest–a quick influx of air that hits your vocal cords and causes a little sound. The spasm that causes a hiccup is really coming from your diaphragm or the nerves that control it. Some common causes include:

  • Eating too much or too fast
  • Feeling excited, nervous or scared
  • Drinking carbonated beverages or too much alcohol (sometimes in excess)
  • Stress
  • A sudden change in temperature
  • Swallowing air while chewing gum or sucking on candy
  • Irritation of the esophagus

Esophageal reflux is a common cause of hiccups. Prolonged hiccups, though, could be caused by direct post-surgical irritation of the phrenic or vagus nerves. Irritation can also be caused by cancers of the chest or neck. Rarely, hiccups can be associated with disorders of the brain–including tumors and strokes, among others—or cardiovascular disease. Some medications can trigger long-term hiccups, too.

Finally, hiccups can also persist without an apparent cause.

What really gets rid of hiccups?

Before we worry too much about serious conditions, let’s consider some of the many recommendations to get rid of your hiccups. One of the most common is temporarily holding your breath to disrupt your breathing pattern. It can be helpful, and it doesn’t carry much risk to try.

As mentioned, the vagus and phrenic nerves affect your diaphragm. They’re part of your autonomic nervous system, which controls your heart rate and breathing.

Maneuvers that affect the nerve reflex may knock out your hiccups. The Valsalva maneuver is performed by attempting to exhale while closing your mouth and pinching your nose shut at the same time. You’ll bear down a bit as well, trying to (unsuccessfully) expel air, as if blowing up a balloon.

This motion stimulates the vagus nerve, called a vagal nerve response, and it can interrupt the hiccups. I like to think of it as rebooting your nervous system; sort of a reset for the irritated nerves.

Ingesting ice or applying mild pressure to your closed eye might also reboot this nervous system response.

You also may get rid of hiccups with a spoonful of sugar to stimulate the back of your throat (which also might cause a vagal nerve response). Eating peanut butter from a spoon might relax the back of your throat and could help. Interestingly, some patients have had success getting rid of hiccups by eating a lemon wedge.

The one common recommendation to be cautioned against is the tradition of scaring someone to rid them of hiccups. While the gasp of fright may induce a vagal nerve response that interrupts the spasm, it also risks dangerous side effects: If you scare someone, they could lose their balance and fall, and being startled may also negatively impact an underlying heart condition.

When should you seek medical attention?

There are two scenarios that should send you for medical care. First, if hiccups persist more than a couple of days, you should seek care with your primary care provider. This is important especially if the hiccups are preventing you from sleeping. Your provider can rule out other medical causes and may prescribe medications if more traditional methods of stopping your hiccups aren’t working.

More important than the duration, though, is the onset of additional symptoms with the hiccups. You may need to seek emergency care if your hiccups are accompanied by symptoms such as the sudden onset of numbness or coordination issues. These could indicate a stroke, which is serious and needs immediate treatment. Other symptoms of stroke include the sudden onset of difficulty speaking or swallowing, facial droop, speech change, vision changes (losing part of your vision) or weakness on one side of your body.

Pay attention to your body. If the onset of hiccups includes any cardiovascular symptoms, go to an emergency department and get evaluated right away.

But if you’re not experiencing anything else, give it a couple of days. Transient hiccups are usually part of the normal spectrum of life.

 

J. Chad Hoyle is a neurologist specializing in neuromuscular disorders and electromyography at The Ohio State University Wexner Medical Center.

Visit Ohio State Health & Discovery for more stories on health, wellness, innovation, research and science news from the experts at Ohio State.

Check out health.osu.edu


How to Make Them Stop and More

Hiccups are caused by the diaphragm involuntarily contracting. Some common causes for this contraction include drinking carbonated beverages, eating a large meal, swallowing too much air, or stress.

Hiccups are repetitive, uncontrollable contractions of the diaphragm, the muscle structure just below your lungs.

The diaphragm marks the boundary between your chest and abdomen, and it also regulates breathing. When your diaphragm contracts, your lungs take in oxygen. When your diaphragm relaxes, your lungs release carbon dioxide.

The diaphragm contracting out of rhythm is what causes hiccups. Each spasm of the diaphragm makes the larynx (voice box) 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.

There’s no way to anticipate hiccups. With each spasm, there’s usually a slight tightening of the chest or throat prior to you making the distinctive hiccup sound.

Most cases of hiccups start and end abruptly, for no noticeable reason. Episodes generally last only a few minutes.

Did you know?

The medical term for hiccups is singultus.

Numerous causes of hiccups have been identified. However, there’s no definitive list of triggers. Hiccups often come and go for no apparent reason.

Common causes of short-term hiccups may include:

  • overeating
  • eating spicy food
  • consuming alcohol
  • drinking carbonated beverages, like sodas
  • consuming very hot or very cold foods
  • a sudden change in air temperature
  • aerophagia, which is swallowing too much air
  • swallowing air while chewing gum
  • excitement or emotional stress

There are several factors that can increase your likelihood of developing hiccups. You may be more susceptible if you:

  • are male
  • experience intense mental or emotional responses, ranging from anxiety to excitement
  • have had surgery, especially abdominal surgery
  • have received general anesthesia

Hiccups and your baby

Hiccups can occur at any age. They can even occur while a fetus is still in the womb.

Hiccups are also normal in newborns, are rarely bothersome for them, and don’t typically require home remedies or treatment.

Was this helpful?

Most hiccups aren’t an emergency or anything to worry about. However, a prolonged episode can be uncomfortable and disruptive to your daily life.

Contact a doctor if you have hiccups that last longer than 2 days. The doctor can determine the severity of your hiccups in relation to your overall health and other conditions.

There are 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.

Home remedies

Not all of these have been proven to stop hiccups, but you can try the following potential treatments for hiccups at home:

  • Breathe into a paper bag.
  • Eat a teaspoon of granulated sugar.
  • Hold your breath.
  • Drink a glass of cold water.
  • Pull on your tongue.
  • Lift your uvula, which is the fleshy piece of tissue that’s suspended above the back of your throat, with a spoon.
  • Attempt to purposefully gasp or belch.
  • 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, controlled manner.

Medications

Treating any underlying causes of your hiccups will usually make them go away.

If your hiccups last for a while and have no obvious cause, a doctor may recommend several anti-hiccup medications. The more commonly used medications include:

  • antipsychotic medications chlorpromazine and haloperidol
  • benzodiazepines, a class of tranquilizers
  • seizure medications, such as gabapentin (Neurontin)
  • diphenhydramine (Benadryl), an antihistamine
  • metoclopramide (Reglan), an anti-nausea drug
  • baclofen, a muscle relaxant
  • nifedipine (Procardia, Procardia XL), a blood pressure medication

The Food and Drug Administration (FDA) hasn’t approved any prescription medications for the treatment of hiccups. If a doctor recommends any of the prescription medications above, it’ll be an example of off-label drug use.

Off-label drug use

Off-label drug use means a drug that’s approved by the Food and Drug Administration (FDA) for one purpose is used for a different purpose that hasn’t yet been approved.

However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use them to treat their patients. So your doctor can prescribe a medication however they think is best for your care.

Massage

A doctor may perform a carotid sinus massage to help stop long lasting hiccups. This involves rubbing the main carotid artery in the neck.

Invasive procedures

There are also more invasive options, which can be used to end extreme cases of hiccups. They include:

  • nasogastric intubation, which is the insertion of a tube through your nose into your stomach
  • gastric lavage (stomach pumping)
  • an anesthetic injection to block the phrenic nerve, which is located in the diaphragm
  • surgical implantation of a diaphragmatic pacemaker, a battery-powered device that stimulates your diaphragm and regulates breathing

Hiccups that last longer than 48 hours are considered persistent. Hiccups that last longer than 2 months are considered intractable, or difficult to manage.

These types of long-term hiccups are categorized by the type of irritant that caused the episode.

Nerve injury or irritation

The 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
  • gastroesophageal reflux disease (GERD)
  • an esophageal cyst or tumor

Central nervous system (CNS) damage

Other 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 hiccups includes:

  • stroke
  • multiple sclerosis (MS)
  • tumors
  • head trauma or brain injury
  • meningitis and encephalitis, which are infections that can cause swelling in the brain
  • hydrocephalus, or the accumulation of fluid on the brain
  • neurosyphilis and other brain infections

Other causes

Hiccups that last for longer periods can also be caused by:

  • misuse of alcohol
  • tobacco use
  • a reaction to anesthesia after surgery
  • certain classes of medications, including barbiturates, steroids, and tranquilizers
  • electrolyte imbalance
  • diabetes
  • kidney failure
  • arteriovenous malformation, a condition in which arteries and veins are tangled in the brain
  • Parkinson’s disease
  • cancer and chemotherapy treatments

Medical procedures

Sometimes, a medical procedure can accidentally cause you to develop long-term hiccups. These procedures are used to treat or diagnose other conditions and include:

  • use of catheters to access the heart muscle
  • placement of an esophageal stent to prop open the esophagus
  • bronchoscopy, in which a doctor uses a thin, lighted tube with a camera on the end to examine your lungs and airways
  • tracheostomy, or the creation of a surgical opening in the neck to allow breathing around an airway obstruction

Diagnosis

If the cause of your hiccups is unclear, a doctor 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, CT scan, or MRI
  • echocardiogram to assess heart function
  • endoscopy, in which a doctor uses a thin, lighted tube with a camera on the end to investigate your esophagus, windpipe, stomach, and intestine
  • bronchoscopy

A 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:

  • sleeplessness
  • exhaustion
  • malnutrition
  • weight loss
  • dehydration

There’s no proven method for preventing hiccups. However, if you experience hiccups frequently, you can try to reduce your exposure to known triggers.

Following this advice may also help reduce your susceptibility to hiccups:

  • Try not to overeat.
  • Avoid carbonated beverages.
  • Protect yourself from sudden temperature changes.
  • Don’t drink alcohol.
  • Remain calm, and try to avoid intense emotional or physical reactions.

Hiccups have a wide range of possible triggers, from drinking soda and eating certain foods to medication use and underlying conditions. A number of possible treatments are also available.

In rare instances, hiccups can last longer than 48 hours. If your hiccups last longer than 48 hours, don’t respond to treatment, or you aren’t sure what’s causing them, see a doctor for a diagnosis.

Also, see a doctor or seek emergency help if you’re having numbness and coordination issues alongside your persistent hiccups. These may be symptoms of a stroke.

Causes and Quick Remedies

Hiccups: Causes and Quick Remedies

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  • Hiccups: Causes and Quick Remedies

Hiccuping is an uncontrolled physiological reaction, in the development of which the phrenic nerve, vagus nerve, and centers of the brain are involved. During hiccups, the intercostal and diaphragmatic muscles tighten, as when inhaling, but the airways overlap, so there is a short breath hold. People hiccup with a characteristic sound, which is caused by the sharp closing of the vocal folds.

Why hiccups occur

Hiccups help to remove excess air from the stomach, so its periodic appearance is not considered a problem. It can occur with a hasty meal, talking while eating. Also, the symptom occurs during laughter, accompanied by a series of quick breaths and overflow of the stomach with air.

The second physiological reason for the appearance of hiccups is irritation of the fibers of the phrenic and vagus nerves, which triggers a specific reflex. The situation most often occurs when the stomach is overdistended with a large amount of food, when swallowing large pieces that hardly pass through the esophagus, after taking spicy, too hot or cold food. In some people, hiccups are provoked by hypothermia, stress, and drinking alcohol.

Long-term hiccups that occur frequently and without association with typical precipitating factors usually indicate a health problem. Possible causes of an unpleasant symptom:

● gastroesophageal reflux disease (GERD), diaphragmatic hernia and other diseases of the esophagus;

● diseases of the liver, pancreas, stomach and intestines;

● diseases of the chest organs – pleurisy, pneumonia, pericarditis, myocardial infarction;

● pathology of the nervous system: encephalitis, intracranial hypertension, traumatic brain injury, tumors of the posterior cranial fossa.

How to deal with hiccups

There are quite a few ways to quickly eliminate hiccups:

● breath holding for 20-30 s;

● a series of deep and slow breaths;

● drinking several sips of water;

● torso tilt forward;

● sucking on an ice cube;

● eating a piece of lemon or other product with a sharp taste;

● inhalation of ammonia;

● pulling the tongue forward for a few seconds.

These simple actions have one of two goals: to stimulate the vagus nerve to stop pathological impulses, or to increase the concentration of carbon dioxide in the blood, as a result of which the nervous regulation of the respiratory system normalizes. Usually a person needs to try several methods and choose the most suitable for himself.

Short-term hiccups pass without a trace and do not have a negative effect on the body, so it is not at all necessary to use the above methods. The person may simply wait a few minutes for the symptom to subside and then return to daily activities.

When to see a doctor

Hiccups that last for several hours and do not disappear after all the methods described in the previous section may be one of the first signs of an organic disease. In such a situation, patients are advised to visit a doctor in order to exclude or confirm the presence of a pathology, to start treatment on time.

The initial consultation is conducted by an ID-Clinic therapist who receives patients at the clinic and provides online consultations via video link. The doctor will analyze the symptoms, ask clarifying questions, refer you for an extended examination and consultation of highly specialized specialists, if necessary.

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