What are the common causes of cough-induced hiccups. How can persistent hiccups be a sign of underlying health issues. What are effective treatment options for managing cough-related hiccups. How do coughs and hiccups relate to pulmonary embolism. When should you seek medical attention for persistent coughing and hiccuping.

Understanding the Connection Between Coughing and Hiccups

The relationship between coughing and hiccups is a complex one that often perplexes both patients and healthcare providers. While these two reflexes are typically separate physiological responses, in some cases, they can become intertwined, leading to a phenomenon where coughing triggers hiccups. This unusual connection warrants closer examination to understand its underlying mechanisms and potential implications for health.

Coughing is a protective reflex that helps clear the airways of irritants, while hiccups are involuntary contractions of the diaphragm. When coughing induces hiccups, it may indicate an underlying issue that affects both the respiratory and nervous systems. Understanding this connection is crucial for proper diagnosis and treatment.

Why does coughing sometimes trigger hiccups?

Cough-induced hiccups can occur due to several reasons:

• Irritation of the phrenic nerve, which controls the diaphragm
• Inflammation in the chest or abdomen affecting both reflexes
• Disruption of normal breathing patterns during intense coughing fits
• Underlying medical conditions that impact both respiratory and neurological functions

Identifying the specific cause in each case is essential for effective management and treatment.

Common Causes of Persistent Hiccups

While occasional hiccups are normal and usually harmless, persistent hiccups can be a sign of underlying health issues. Understanding the potential causes of chronic hiccups, especially when associated with coughing, is crucial for proper diagnosis and treatment.

What medical conditions can lead to persistent hiccups?

Several medical conditions can cause prolonged bouts of hiccups:

1. Gastroesophageal reflux disease (GERD)
2. Tumors or infections affecting the central nervous system
3. Certain medications, particularly steroids and chemotherapy drugs
4. Metabolic disorders, such as diabetes or kidney failure
5. Pulmonary embolism (rarely)

It’s important to note that persistent hiccups lasting more than 48 hours should be evaluated by a healthcare professional to rule out serious underlying conditions.

The Link Between Pulmonary Embolism and Hiccups

One of the more surprising and potentially serious causes of persistent hiccups is pulmonary embolism (PE). While rare, this connection highlights the importance of thorough evaluation in cases of unexplained, prolonged hiccups.

How can pulmonary embolism cause hiccups?

Pulmonary embolism can lead to hiccups through several mechanisms:

• Irritation of the phrenic nerve due to lung inflammation
• Disruption of normal diaphragm function
• Altered blood flow affecting the brainstem’s hiccup control center
• Hypoxia (low oxygen levels) affecting nerve function

While hiccups alone are not a definitive sign of PE, they should be considered alongside other symptoms such as shortness of breath, chest pain, and cough when evaluating for this condition.

Diagnostic Approaches for Cough-Induced Hiccups

When faced with persistent cough-induced hiccups, healthcare providers employ a range of diagnostic tools to identify the underlying cause. This comprehensive approach ensures that both common and rare conditions are considered.

What diagnostic tests are used to evaluate persistent hiccups?

Diagnostic procedures may include:

• Thorough medical history and physical examination
• Blood tests to check for metabolic abnormalities
• Chest X-ray or CT scan to examine the lungs and diaphragm
• Endoscopy to evaluate the esophagus and stomach for GERD
• Neurological exams and imaging studies if central nervous system issues are suspected
• In cases where PE is suspected, additional tests such as D-dimer blood test or CT pulmonary angiography may be ordered

The choice of diagnostic tests depends on the patient’s symptoms, medical history, and physical examination findings.

Treatment Options for Cough-Induced Hiccups

Managing cough-induced hiccups often requires a multifaceted approach that addresses both the underlying cause and the symptoms themselves. Treatment strategies can range from simple home remedies to medical interventions, depending on the severity and duration of the hiccups.

What are effective treatments for persistent hiccups?

Treatment options may include:

1. Addressing the underlying cause (e.g., treating GERD or adjusting medications)
2. Physical maneuvers to interrupt the hiccup reflex (e.g., holding breath, drinking water rapidly)
3. Medications such as baclofen, gabapentin, or chlorpromazine for persistent cases
4. Breathing exercises and relaxation techniques
5. In severe cases, nerve blocks or surgical interventions may be considered

The most appropriate treatment depends on the underlying cause and the individual patient’s response to various interventions.

Preventing Cough-Induced Hiccups

While not all cases of cough-induced hiccups can be prevented, there are steps individuals can take to reduce their frequency and severity. Prevention strategies often focus on managing underlying conditions and avoiding known triggers.

How can one reduce the likelihood of developing cough-induced hiccups?

Preventive measures may include:

• Proper management of chronic conditions like GERD or asthma
• Avoiding rapid eating or drinking, which can lead to air swallowing
• Limiting consumption of carbonated beverages and spicy foods
• Practicing good posture to reduce pressure on the diaphragm
• Managing stress through relaxation techniques
• Staying hydrated to prevent irritation of the throat and diaphragm

By addressing these factors, individuals may be able to reduce the frequency of cough-induced hiccups and improve their overall respiratory health.

When to Seek Medical Attention

While occasional hiccups are usually harmless, there are situations where medical attention is necessary. Recognizing the signs that warrant professional evaluation is crucial for timely diagnosis and treatment of potentially serious underlying conditions.

What signs indicate that hiccups require medical evaluation?

Seek medical attention if:

• Hiccups persist for more than 48 hours
• They interfere with eating, sleeping, or daily activities
• They are accompanied by severe chest pain, shortness of breath, or fever
• You experience unexplained weight loss or difficulty swallowing
• Hiccups occur frequently and disrupt your quality of life

Early evaluation can lead to prompt diagnosis and treatment, potentially preventing complications from underlying conditions.

The Impact of Chronic Hiccups on Quality of Life

Persistent or recurrent hiccups can have a significant impact on an individual’s quality of life. Beyond the physical discomfort, chronic hiccups can affect various aspects of daily living and overall well-being.

How do chronic hiccups affect daily life and mental health?

The effects of chronic hiccups may include:

1. Sleep disturbances leading to fatigue and decreased cognitive function
2. Difficulty eating and drinking, potentially leading to nutritional deficiencies
3. Social embarrassment and isolation
4. Anxiety and depression related to the persistent nature of the condition
5. Reduced work productivity and career impacts

Addressing the psychological and social impacts of chronic hiccups is an important aspect of comprehensive patient care.

Understanding the complex relationship between coughing and hiccups is crucial for effective management and treatment. While the connection between these two reflexes can sometimes be benign, it may also indicate underlying health issues that require medical attention. By recognizing the potential causes, seeking appropriate diagnosis, and exploring various treatment options, individuals can better manage cough-induced hiccups and improve their overall quality of life. Healthcare providers play a vital role in this process, offering comprehensive evaluations and tailored treatment plans to address both the symptoms and any underlying conditions. As research in this area continues, we may gain further insights into the mechanisms behind cough-induced hiccups and develop more targeted therapeutic approaches.

Persistent Hiccups as a Rare Presenting Symptom of Pulmonary Embolism

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Hiccups: Causes, treatments, and complications

Hiccups happen when a person’s intake of air becomes momentarily blocked. Possible causes include having gas in the stomach, eating spicy food, and having an underlying health condition.

When a hiccup forms, it is because of a sudden, involuntary contraction of the diaphragm at the same time as a contraction of the voice box, or larynx, and the total closure of the glottis, which is where the vocal cords are located. As a result, there is a sudden rush of air into the lungs, accompanied by the familiar “hic” sound.

Hiccups are medically known as synchronous diaphragmatic flutter or singultus. They can occur individually or in bouts. They are often rhythmic, meaning that the interval between each hiccup is relatively constant.

Most people have hiccups from time to time, and they usually resolve without treatment within a few minutes.

Rarely, there may be prolonged or chronic hiccups, which can last for a month or longer. Hiccups that last for longer than 2 months are known as intractable hiccups.

If a bout of hiccups lasts for longer than 48 hours, this is considered persistent, and the person should contact a doctor. This tends to be more common in men than women and could signify a more serious medical condition.

Fast facts on hiccups

• The exact cause of hiccups remains unclear, but experts have linked chronic hiccups to a wide range of conditions, including stroke and gastrointestinal problems.
• Most cases resolve without treatment, but prolonged hiccups can lead to complications such as insomnia and depression.
• If hiccups last for longer than 48 hours, the person should contact a doctor, who may prescribe muscle relaxants.
• Avoiding alcohol and not eating too quickly can reduce the chance of experiencing hiccups.

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The National Organization for Rare Disorders describes hiccups as “an involuntary spasmodic contraction of the muscle at the base of the lungs (diaphragm) followed by the rapid closure of the vocal cords. ”

A wide range of underlying conditions can trigger chronic or persistent hiccups.

Exactly how or why short bouts of hiccups happen remains unclear, but experts have linked some factors to a higher chance of experiencing them. The sections below look at some of these factors in more detail.

Lifestyle factors

The following may trigger hiccups:

• eating hot or spicy food that irritates the phrenic nerve, which is located near the esophagus
• having gas in the stomach that presses against the diaphragm
• eating too much or causing stomach distension
• drinking sodas, hot liquids, or alcoholic drinks, especially carbonated drinks
• experiencing stress or strong emotions

Some medications — such as opiates, benzodiazepines, anesthesia, corticosteroids, barbiturates, and methyldopa — can also cause hiccups.

Medical conditions

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

However, doctors have linked chronic hiccups to several conditions. These include:

• gastrointestinal conditions, such as inflammatory bowel disease, a small bowel obstruction, or gastroesophageal reflux disease (GERD)
• respiratory conditions, such as pleurisy of the diaphragm, pneumonia, or asthma
• excessive and habitual consumption of alcohol
• conditions that affect the central nervous system, such as a traumatic brain injury, encephalitis, a brain tumor, or a stroke
• conditions that irritate the vagus nerve, such as meningitis, pharyngitis, or goiter
• psychological reactions, including grief, excitement, anxiety, stress, and shock
• conditions that affect metabolism, including hyperglycemia, hypoglycemia, and diabetes
• liver and kidney problems
• cancer, either as a result of damage caused by the condition or as a side effect of the treatment, such as chemotherapy
• conditions of the autonomic nervous system, which also affects breathing, sweating, the heartbeat, hiccups, and coughing

Other conditions that may be related to hiccups include bladder irritation, liver cancer, pancreatitis, pregnancy, and hepatitis. Surgical procedures and lesions may also be risk factors.

Infants may experience hiccups more frequently during or after feeding, as they may swallow food too quickly or overfeed. Hiccups could also be a sign of an infant being full. Therefore, pediatricians typically recommend short feeds with burping breaks.

Hiccups may also occur due to an infant’s breathing and swallowing not yet being in sync. In turn, this can cause an infant to draw breath and swallow, which can produce a hiccup.

Hiccups in infants may also result from changes in stomach temperature. For example, this may be the case if they consume a cold drink then have something warm to eat.

Generally, hiccups tend to be a sign of healthy growth and development. However, frequent hiccups may also result from GERD, which is a common and easily treatable condition in infants.

Hiccups alone are not a sign of reflux. Some other possible symptoms in infants with suspected GERD include:

• crying more frequently
• arching the back excessively during or after feeds
• spitting up more often than usual

Parents and caregivers should consult a pediatrician if they notice that their infant is experiencing several symptoms and suspect that reflux may be causing them.

Most cases of hiccups go away after a few minutes or hours with no medical treatment. If they persist, however, a person should contact a doctor. The following tips may help, but their effectiveness remains unclear.

Tips for getting rid of hiccups

The following tips may help get rid of hiccups:

• Sip ice-cold water slowly or gargle with very cold water.
• Hold the breath for a short time, then breathe out. Do this three or four times every 20 minutes.
• While swallowing, place gentle pressure on the nose.
• Place gentle pressure on the diaphragm.
• Bite on a lemon.
• Swallow some granulated sugar.
• Take a tiny amount of vinegar, just enough to taste.
• Breathe in and out of a paper bag. Never use a plastic bag for this, and never cover the head with the bag.
• Sit down and hug the knees as close to the chest as possible for a short time.
• Lean forward to compress the chest gently.
• Try an alternative remedy, such as acupuncture or hypnosis.
• Gently pull on the tongue.
• Rub the eyes.
• Gently touch one finger to the throat to try to trigger a gag reflex.

Many of these tips have been passed down through generations. They may be effective for some people, but there has been little research to support their use.

Medications

If a person has an underlying condition, managing it will probably resolve the hiccups.

If prolonged hiccups are interfering with a person’s quality of life, a doctor may prescribe a medication.

Chlorpromazine is the first-line treatment, as it is the only medication with Food and Drug Administration (FDA) approval to treat hiccups.

A doctor may recommend the following medications for hiccups if there appears to be no underlying condition:

• metoclopramide (Reglan), which is an antinausea medication that may help some people with hiccups
• baclofen (Lioresal), which is a muscle relaxant (off-label use)
• gabapentin, which is an antiseizure medication that doctors commonly prescribe for neuropathic pain and that can help alleviate the symptoms of hiccups (off-label use)

Ephedrine or ketamine can treat hiccups related to anesthesia or surgery.

For hiccups, doctors usually prescribe a low-dose, 2-week course of medication. They may gradually increase the amount until the hiccups are gone. The course and dosage will depend on the severity of the hiccups, the person’s general health, and age.

Surgery

In severe cases that do not respond to other treatments, a surgeon may inject medication into the phrenic nerve to temporarily block the nerve’s action or sever the phrenic nerve in the neck.

Prolonged hiccups can lead to complications such as:

• Weight loss and dehydration: If the hiccups are long term and occur at short intervals, it can become difficult to eat.
• Insomnia: If prolonged hiccups persist during the sleeping hours, it can be hard to fall asleep or stay asleep.
• Fatigue: Prolonged hiccups can be exhausting, especially if they make it hard to sleep or eat.
• Communication problems: It can be difficult for the person to speak if they have hiccups.
• Depression: Long-term hiccups can increase the risk of developing clinical depression.
• Delayed wound healing: Persistent hiccups can make it harder for post-surgical wounds to heal, thereby increasing the risk of infections or bleeding after surgery.

Other potential complications include an irregular heartbeat and GERD.

Hiccups that last for under 48 hours do not usually need any medical attention because they typically resolve on their own. If they persist for longer than this, the person should consult a doctor.

The doctor may ask:

• when the hiccups began
• how often they occur
• if they are happening all the time
• what the person was doing before the hiccups started

They will likely perform a general physical examination and a neurological exam to check the person’s:

• reflexes
• balance
• coordination
• eyesight
• sense of touch
• muscle strength
• muscle tone

If an underlying condition may be the cause, the doctor may order the following tests:

• blood tests to check for infections, kidney disease, or diabetes
• imaging tests — such as an X-ray, CT scan, or MRI scan — to assess for any anatomical irregularities that may be affecting the phrenic or vagus nerves or the diaphragm
• an endoscopic test, in which a healthcare professional passes an endoscope — which is a flexible tube with a small camera at the end — down the person’s throat to check the windpipe or esophagus
• en electrocardiogram to check for heart-related conditions by measuring electrical activity in the heart

Some causes of hiccups are preventable. A few ways to reduce the chance of experiencing hiccups include:

• avoiding sudden changes in temperature
• not drinking alcohol or sodas
• eating moderately and not too quickly

Most hiccups are brief and go away after a short while. However, if they persist or cause worrying symptoms, the person should contact a doctor.

Causes of hiccups, frequent yawning, sneezing: body language

The causes of hiccups, sneezing and yawning are quite serious. Therefore, if you are used to drinking water in small sips during hiccups, without thinking about what hiccups mean, it’s time to pay attention to the signals that the body gives.

Hiccups: Causes

The causes of hiccups in adults are the consumption of alcohol or a large portion of food eaten, especially if it was absorbed very quickly. The causes of hiccups in newborns are overeating, and hiccups in children have other causes, namely, the baby’s desire to drink or if he is cold.

Frequent hiccups: causes

Hiccups, the causes of which are overeating, have the following mechanism of occurrence. So, chewing large pieces of food poorly while quickly absorbing food, a person provokes irritation of the vagus nerve – one of the cranial nerves that runs along the pharynx and esophagus from the brain to the diaphragm and stomach. When large pieces of food travel down the esophagus, they irritate the vagus nerve, and it sends signals to the muscle fibers of the stomach and esophagus, causing spasms – hiccups.

These spasms are trying to get rid of the swelling of the esophageal mucosa.

Hiccups: how to get rid of?

If you have hiccups after drinking alcohol, drinking cold water in small sips will help get rid of it. Holding your breath helps with hiccups caused by overeating. In addition, you can try other methods: eat a teaspoon of sugar without drinking water, or hold a slice of lemon in your mouth for several minutes.

Sneezing: causes

Frequent sneezing, which is caused by the accumulation of dust in the nasal cavity, helps to get rid of all the excess from the nose, so that the “garbage” does not enter the nasopharynx. The norm is 2-3 sneezes in a row.

Frequent sneezing, the causes of which are clarified above, if it happens more than 10 times in a row, most likely signals the presence of edema on the nasal mucosa. For the body, edema is an irritant that it tries to “sneeze out”, but the edema does not go away from this. In this case, you can try to drip vasoconstrictor drops into the nose, with the help of which the swelling will be eliminated.

Yawning: causes

Frequent yawning has causes – hypoxia, when the brain lacks oxygen. Therefore, a person needs a deep and strong breath, because when yawning, much more air is inhaled than with a normal breath. This is due to the fact that the airways open and a large amount of oxygen quickly enters the blood.

In addition, yawning occurs with severe fatigue and lack of sleep. From fatigue, excess carbon dioxide accumulates in the tissues, which is the same hypoxia.

Also, people often yawn when they feel bored when they have to do something they don’t want to do, which is explained by the fact that working through “I don’t want to” causes much more fatigue.

Cough

Cough is a frequent companion of a cold, but quite often it occurs without this disease. What are its causes and what does the body want to say with a cough? Cough may indicate gastroesophageal reflux disease (gastric acids in the esophagus). Cough in this case usually manifests itself during sleep, it is often accompanied by a sour taste in the mouth, heartburn. Allergies, smoking, dust exposure, bronchospasm can also cause coughing.

If you have a cough without a cold, it is best to stop smoking and make sure to humidify the air in the room.

Gargling with salt water (half a teaspoon of salt in a glass of warm water) is also not superfluous.

Is it possible to die from hiccups

May 30, 2023
16:30

Photo: freepik.com

Hiccups are usually harmless, but a very unpleasant and annoying symptom. Everyone is used to the fact that it passes somehow by itself and does not attach due importance to it. Can the well-known “ik” be deadly?

Just a reflex

Hiccups are the result of contraction of the diaphragm and chest muscles. So there is a sharp closure of the glottis, accompanied by a characteristic sound and a shudder of the body.

In simple words, hiccups are a kind of unconditioned reflex, whether it’s sneezing or coughing. With the help of such a mechanism, the body can get rid of excess air that has ended up inside the stomach. The attack will stop as soon as all the air is out.

Why does it occur

Physiological hiccups in a healthy adult can be associated with a long stay in an uncomfortable position, as well as irritation of the esophagus and stomach. In addition, the cause of hiccups may be the habit of quickly eating food or a tendency to overeat. This causes excess air to enter the stomach. It can also be associated with stress and laughter.

Also, occasional hiccups can be caused by drinking alcohol, which causes intoxication of the body, negatively affects the nervous system and irritates the mucous membrane of the gastrointestinal tract.

How dangerous is hiccups

Hiccups are not serious or life threatening in and of themselves. However, in some cases, it can indicate serious violations in the body. You need to understand in what cases you need to see a doctor, and not self-medicate.

First, if the hiccups persist for more than an hour. Secondly, if the attacks bother you several times a day or several times a week. And, thirdly, if, in addition to hiccups, you feel chest pain, suffer from heartburn, or feel swallowing problems.

There are two forms of hiccups: physiological (normal), we talked about it above. And there is also pathological, it can be the cause of any disease and can last for a long time – sometimes it does not end for several days. She happens:

1. Central origin – occurs in diseases of the brain and spinal cord, central nervous system and mental disorders.

2. Peripheral origin – when it affects the phrenic nerve, coming from the cervical spinal cord. In such hiccups, there is one that is explained by irritation of the vagus nerve due to diseases of the stomach, esophagus and heart.

3. Reflected – refers to a type of peripheral hiccups. It occurs in diseases of organs that are far from the service area of ​​the phrenic nerve. It includes hiccups due to bowel disease.

4. Toxic – it is associated with poisoning of the body with harmful substances. Hiccups can occur as a result of alcohol and drug intoxication, infectious diseases, diabetes mellitus, and severe renal failure.

Do not immediately panic if you are haunted by prolonged hiccups. Usually, all serious diseases have much more pronounced signs that you will notice earlier than pathological diaphragmatic contraction.

How to help yourself

Physiological hiccups that are not associated with serious illness usually resolve on their own within 10-20 minutes. And although it does not threaten life, it delivers a lot of unpleasant sensations. Making a loud “hic” sound is sometimes completely out of place, so people come up with various ways to get rid of an attack as soon as possible.

Here are some life hacks. First, you can press down on the base of the tongue with your finger, as if you were inducing vomiting. Contraction of the esophagus after irritation will block diaphragmatic spasms.