What are hiccups?

A hiccup is a repetitive, involuntary contraction of the diaphragm – a muscle that separates the chest from the abdomen. When the diaphragm contracts, a person rapidly intakes air that is interrupted by a closure of the elongated space between their vocal cords, or the glottis. This sudden closure of the vocal cords is what produces the characteristic ‘hic’ sound.

Types of hiccups

The three most common types of hiccups are classified by the length of each attack. An acute episode lasts less than 48 hours, a persistent episode continues for more than 2 days and intractable hiccups persist for longer than 1 month.

Causes

There appears to be no clear answer as to why hiccups occur. Though hiccups have been reported to serve no physiological purpose in adults, observations of hiccups during prenatal ultrasound suggest hiccups may have a role in training respiratory muscles in preparation for life outside the womb.

Consuming a large meal, eating too fast, drinking large amounts of alcohol or a sudden bout of excitement may lead to acute hiccups.

According to the Mayo Clinic, other common causes of acute episodes of hiccups include:

• Bloated stomach;

• Drinking carbonated beverages;

• Sudden temperature changes;

• and swallowing air while chewing gum or sucking on candy.

Persistent hiccups have several causes, the most common of which is damage to or irritation of the vagus or phrenic nerves, which control the diaphragm. According to the Mayo Clinic, factors that may result in the damage or irritation of those nerves include:

• Tumor, cyst or goiter in the neck;

• Gastroesophageal reflux;

• and a sore throat or laryngitis.

Tumors, infections or damage to an individual’s central nervous system can also disrupt a body’s normal control of the reflex that causes hiccups. According to the Mayo Clinic, examples include:

• Encephalitis;

• Drugs;

• Meningitis;

• Metabolic disorders;

• Multiple sclerosis;

• Stroke;

• and traumatic brain injury.

There are several causes of intractable hiccups, according to the Mayo Clinic. Individuals who suffer from alcoholism, receive anesthesia, have diabetes or kidney failure, or frequently use steroids or tranquilizers are prone to frequent bouts of hiccups.

How to stop hiccups

Hiccups tend to go away on their own without the need for medical attention. However, there are occurrences where a doctor visit is warranted. Individuals who experience hiccups for consecutive days and are suffering from interrupted sleep, headaches, weakness or chest pain should consult a physician. Whenever possible, treatment should be directed at the underlying cause of the hiccups. The most commonly prescribed drugs to treat hiccups include:

• Chlorpromazine;

• Metoclopramide;

• and Baclofen.

A physician may recommend an injection of an anesthetic to block the phrenic nerve to stop hiccups if less invasive treatments are ineffective. Alternatively, a battery-operated device that delivers mild electrical stimulation to the vagus nerve may be surgically implanted to stop hiccups.

Home remedies

Brief bouts of hiccups are often treated using various home remedies. Though most generally do not work and are not proven alternatives, they are safe to try. Many methods involve attempting to increase the levels of carbon dioxide in the blood, which is why some home remedies involve holding one’s breath or breathing deeply into a paper bag. Other methods are used to stimulate the vagus nerve, including:

• Drinking water quickly;

• Gently pulling the tongue;

• Stimulating gag reflexes;

• and swallowing dry bread or granulated sugar.

Additional information can be found on these websites:

http://www.mayoclinic.org/diseases-conditions/hiccups/basics/definition/con-20031471

http://www.merckmanuals.com/home/digestive-disorders/symptoms-of-digestive-disorders/hiccups

http://www.merckmanuals.com/professional/gastrointestinal-disorders/symptoms-of-gi-disorders/hiccups

http://onlinelibrary.wiley.com/doi/10.1111/apt.13374/full