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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 stopped. When do hiccups require medical attention. What are effective home remedies for hiccups. How long can hiccups last before becoming a concern. What medical conditions can cause persistent hiccups.

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The Science Behind Hiccups: Understanding the Mechanism

Hiccups are a common physiological occurrence that most people experience from time to time. But what exactly happens in our body when we hiccup? Hiccups originate from the diaphragm or the nerves controlling it, despite appearing to come from the chest. A sudden influx of air hits the vocal cords, producing the characteristic “hic” sound. This involuntary spasm of the diaphragm is what we recognize as a hiccup.

The nerves primarily responsible for hiccups are the vagus and phrenic nerves. These are part of the autonomic nervous system, which regulates involuntary bodily functions like heart rate and breathing. Understanding this neurological basis is crucial in comprehending why certain remedies may be effective in stopping hiccups.

Common Triggers: What Causes Hiccups?

Hiccups can be triggered by various factors, many of which are harmless and part of our daily lives. Some common causes include:

  • Eating too quickly or consuming large portions
  • Swallowing air while chewing gum or eating candy
  • Drinking carbonated beverages or excessive alcohol
  • Sudden temperature changes
  • Emotional states like excitement, nervousness, or fear
  • Stress
  • Esophageal irritation or reflux

In most cases, hiccups caused by these factors are transient and resolve on their own within a short period. However, understanding these triggers can help in preventing frequent occurrences of hiccups.

Effective Home Remedies: How to Stop Hiccups

While hiccups often resolve spontaneously, several home remedies can help alleviate them more quickly. These methods typically aim to disrupt the breathing pattern or stimulate the vagus nerve:

  1. Holding your breath: This simple technique can help reset your breathing pattern.
  2. Valsalva maneuver: Attempt to exhale while closing your mouth and pinching your nose shut. This stimulates the vagus nerve.
  3. Consuming a spoonful of sugar: The granules may stimulate the back of the throat, potentially triggering a vagal nerve response.
  4. Eating peanut butter: The thick consistency may help relax the back of the throat.
  5. Sucking on a lemon wedge: The sour taste might help interrupt the hiccup reflex.
  6. Applying mild pressure to closed eyes: This can potentially “reboot” the nervous system response.
  7. Ingesting ice: The cold sensation may stimulate the vagus nerve.

It’s important to note that while these remedies are generally safe, individuals should avoid potentially dangerous methods like scaring someone to stop their hiccups. The sudden fright could lead to accidents or exacerbate underlying health conditions.

Persistent Hiccups: When Should You Be Concerned?

While most cases of hiccups are benign and short-lived, persistent hiccups can sometimes indicate an underlying medical condition. How long do hiccups need to last before they become a cause for concern? Generally, if hiccups persist for more than 48 hours, it’s advisable to seek medical attention.

Prolonged hiccups can be distressing and may interfere with daily activities, including sleep. They might be caused by various factors, including:

  • Post-surgical irritation of the phrenic or vagus nerves
  • Certain medications
  • Tumors or cancers in the chest or neck region
  • Neurological disorders, including brain tumors or strokes
  • Cardiovascular diseases

In some cases, persistent hiccups may occur without an apparent cause. Regardless, if hiccups last for an extended period, it’s crucial to consult a healthcare provider to rule out any serious underlying conditions.

Red Flags: When Hiccups Require Immediate Medical Attention

While persistent hiccups warrant medical evaluation, certain scenarios require immediate medical attention. When should you seek emergency care for hiccups? If hiccups are accompanied by any of the following symptoms, it’s crucial to seek immediate medical help:

  • Sudden onset of numbness
  • Coordination issues
  • Difficulty speaking or swallowing
  • Facial drooping
  • Changes in speech
  • Vision changes, particularly loss of part of the visual field
  • Weakness on one side of the body

These symptoms, when occurring alongside hiccups, could indicate a stroke or other serious neurological conditions that require prompt medical intervention. Additionally, if hiccups are accompanied by any cardiovascular symptoms, immediate evaluation at an emergency department is necessary.

Medical Interventions: Treating Persistent Hiccups

When hiccups persist beyond a couple of days or significantly impact daily life, medical intervention may be necessary. How do healthcare providers approach the treatment of persistent hiccups? The first step typically involves a thorough evaluation to identify any underlying causes.

If no specific cause is identified, or if the hiccups persist despite addressing the underlying condition, various treatment options may be considered:

  1. Medications: Certain drugs can help suppress the hiccup reflex. These may include:
    • Baclofen: A muscle relaxant that can help reduce diaphragm spasms
    • Chlorpromazine: An antipsychotic medication that can also help with hiccups
    • Metoclopramide: A medication typically used for nausea that may also alleviate hiccups
  2. Nerve blocks: In some cases, blocking the phrenic nerve may be considered to stop persistent hiccups
  3. Surgical interventions: In rare, severe cases where other treatments have failed, surgical procedures might be considered

It’s important to note that these interventions are typically reserved for cases where hiccups significantly impact quality of life or when they’re associated with an underlying medical condition.

Preventing Hiccups: Lifestyle Modifications and Precautions

While it’s not always possible to prevent hiccups, certain lifestyle modifications may help reduce their frequency. How can you minimize the occurrence of hiccups? Consider the following strategies:

  • Eat slowly and in smaller portions to avoid overloading your stomach
  • Avoid carbonated beverages or drink them slowly
  • Limit alcohol consumption, particularly carbonated alcoholic drinks
  • Practice stress-reduction techniques like meditation or deep breathing exercises
  • If you have acid reflux, manage it effectively through diet, lifestyle changes, or medication as advised by your healthcare provider
  • Be mindful of sudden temperature changes, especially when eating or drinking

By being aware of common hiccup triggers and making conscious efforts to avoid them, you may be able to reduce the frequency of hiccup episodes. However, remember that occasional hiccups are a normal part of life and usually nothing to be concerned about.

The Role of Hydration in Hiccup Prevention

Proper hydration plays a crucial role in overall health and may also help prevent hiccups. How does staying hydrated contribute to hiccup prevention? Adequate hydration helps maintain the proper function of the digestive system and may reduce the likelihood of esophageal irritation, a common cause of hiccups.

To ensure proper hydration:

  • Drink water regularly throughout the day
  • Consume water-rich foods like fruits and vegetables
  • Limit intake of dehydrating substances like caffeine and alcohol
  • Pay extra attention to hydration during hot weather or physical activity

While staying hydrated isn’t a guaranteed method to prevent hiccups, it contributes to overall digestive health and may help reduce the frequency of hiccup episodes.

Hiccups in Special Populations: Children and Pregnant Women

Hiccups can affect people of all ages, but they may present unique considerations in certain populations. How do hiccups affect children and pregnant women?

In children, hiccups are generally harmless and often more frequent than in adults. They’re especially common in infants and may even occur in the womb. For most children, hiccups resolve on their own and rarely require medical attention. However, if a child experiences persistent hiccups that interfere with eating or sleeping, it’s advisable to consult a pediatrician.

Pregnant women may experience an increase in hiccups due to changes in the digestive system and the growing uterus putting pressure on the diaphragm. While usually harmless, persistent hiccups during pregnancy can be uncomfortable. Pregnant women should consult their healthcare provider if hiccups become frequent or bothersome, as they may be related to acid reflux or other pregnancy-related conditions.

The Psychological Impact of Chronic Hiccups

While occasional hiccups are a minor inconvenience, chronic hiccups can have a significant impact on an individual’s quality of life. How do persistent hiccups affect mental health and daily functioning?

Chronic hiccups can lead to various psychological and social issues:

  • Sleep disturbances: Persistent hiccups can make it difficult to fall asleep or stay asleep, leading to fatigue and irritability
  • Anxiety and stress: The unpredictability and discomfort of chronic hiccups can cause increased anxiety
  • Social embarrassment: Frequent hiccupping in social situations may lead to embarrassment and social withdrawal
  • Depression: In severe cases, the ongoing discomfort and life disruption can contribute to depressive symptoms
  • Difficulty concentrating: Constant hiccups can make it challenging to focus on work or other tasks

Given these potential impacts, it’s crucial for individuals experiencing chronic hiccups to seek medical attention. Healthcare providers can not only address the physical aspects of hiccups but also consider the psychological impact and provide appropriate support or referrals if needed.

Hiccups in Medical Research: Current Understanding and Future Directions

While hiccups are a common phenomenon, there’s still much to learn about their exact mechanisms and potential treatments. What is the current state of hiccup research, and what future developments might we expect?

Current research on hiccups focuses on several areas:

  1. Neurological mechanisms: Scientists are working to better understand the complex neurological pathways involved in hiccups
  2. Genetic factors: Some studies are exploring whether certain genetic variations might predispose individuals to frequent or persistent hiccups
  3. Novel treatments: Researchers are investigating new medications and interventions for chronic hiccups, including nerve stimulation techniques
  4. Connections to other conditions: Studies are examining the relationship between hiccups and various medical conditions, potentially leading to new diagnostic approaches

Future research may lead to more effective treatments for chronic hiccups and a deeper understanding of their role in overall health. As our knowledge expands, we may see the development of targeted therapies and improved management strategies for those affected by persistent hiccups.

In conclusion, while hiccups are often a benign and temporary inconvenience, understanding their causes, remedies, and potential implications can help individuals manage them more effectively. By recognizing when hiccups might signal a more serious condition and knowing how to address them, we can minimize their impact on our daily lives and overall well-being.

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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