What Are Hiccups?

Most of us are familiar with hiccups. But what are they, and where do they come from? And can they ever be serious?

In this post, we’ll go over the basics of hiccups and their causes. We’ll also cover what you can do to prevent them and when and how to treat them.

Hiccups describe a sudden spasm (contraction) of your diaphragm. This is the muscle that splits your chest and abdomen and helps you breathe.

Brief hiccups

The quick and sudden intake of air causes your glottis to close. This is a valve in your throat that sits between your vocal cords. When your glottis snaps shut, you let out that distinct “hic” sound.

Hiccups tend to last for short periods. Most resolve on their own within 48 hours. These are called acute or brief hiccups.

Prolonged hiccups

Hiccups that last for more than 2 days are known as persistent or prolonged hiccups. Intractable hiccups describe those that last for more than a month.

People with certain health issues are at greater risk of long-lasting hiccups. These include people with health issues such as:

What can cause hiccups?

Lifestyle triggers

Hiccups often come and go for no obvious reason. Aerophagia or quickly swallowing too much air can trigger them.

Other common causes of brief hiccups include:

Alcohol and carbonated drinks
Spicy or very hot or cold foods and drinks
Strong emotions such as excitement and stress
Tobacco smoke and other things that irritate your lungs or gastrointestinal tract

Medical triggers

Prolonged or intractable hiccups may be caused by certain medications, such as:

Opiates (natural opioids) to ease pain
Benzodiazepines to help you sleep or ease stress
Anesthesia to prevent and treat pain during a medical procedure
Chemotherapies to treat cancer
Corticosteroids to reduce swelling
Barbiturates to treat insomnia, seizures, and anxiety

Hiccups may also be a symptom of an underlying illness. Examples include:

Asthma
COVID-19
Diabetes
HIV/AIDS
Lung cancer
Meningitis
Migraines
Multiple sclerosis
Pneumonia
Pulmonary embolism
Shingles

Trauma to the chest or skull can also prompt hiccups. And so can issues that affect your mental health. These include grief, schizophrenia, and anorexia.

How can you make hiccups go away?

The methods for stopping hiccups have anecdotal support. This means they’re based on tips shared by others instead of evidence from strong research.

Here are a few that you can try and repeat if needed.

Raise carbon dioxide

Hiccups tend to decrease as your carbon dioxide (CO2) level goes up.

To raise your CO2 level just enough to help stop hiccups:

Hold a small paper bag over your mouth and nose, and inflate and deflate it as you inhale and exhale.
Exhale fully, and then take a deep inhale and hold for 10 seconds. Without breathing the air out, take two more deep breaths and hold for 5 seconds each before you exhale.

Stimulate vagus nerve

Stimulate the vagus nerve that runs through your ear, nose, and throat. The nerve sends signals from your brainstem to parts of your body such as your throat, lungs, and abdomen. It aids in functions such as breathing and swallowing.

You may be able to do this by:

Drinking ice water slowly
Gargling ice water for 30 seconds
Gently applying pressure to either your ears or closed eyelids
Gently pulling your tongue forward a few times
Letting sugar sit on your tongue for a few seconds before swallowing it
Sipping or sniffing vinegar

Other reports suggest that rectal massage and having sex might also help.

What treatments are there for serious cases of hiccups?

Hiccups sometimes don’t stop despite your best efforts. In these cases, it’s best to see your healthcare provider for further care. They can assess your symptoms, order tests to help diagnose their cause, and work with you on an appropriate treatment plan.

Medications such as chlorpromazine are often the first-choice treatment. But when these treatments fail to help, alternate therapies may be an option. These include:

Acupuncture
Hypnosis
Local anesthetic to block the part of the phrenic nerve that controls your diaphragm
Surgery to sever this part of the phrenic nerve

Can you prevent hiccups?

Hiccups can happen no matter what you do. But you can lower your risk for those caused by certain lifestyle triggers. If these are your triggers, try to:

Avoid or limit spicy foods or those that are too hot or cold.
Limit alcohol and carbonated drinks.
Eat and drink slowly.
Find ways to ease stress and calm strong emotions.
Stay away from tobacco smoke and other things that irritate your lungs or throat.

When should you see your healthcare provider?

Seek care from your healthcare provider for hiccups that last more than 2 days. They can assess your symptoms and run tests to help pinpoint the cause. They can then work with you on the proper care plan to treat them.

Get medical care right away if your hiccups are accompanied by other sudden and serious symptoms like:

Chest or calf pain
Severe headache
Numbness or weakness on one side of your face or body

The bottom line

Hiccups describe sudden spasms in your diaphragm. They may occur for many reasons but tend to go away quickly on their own. Simple remedies may help. But some may call for treatments such as medicine or surgery. These include bouts that last more than 2 days or are accompanied by serious symptoms.

References

Hodgens, A., et al. (2021). Corticosteroids. StatPearls.

Kohse, E. K., et al. (2017). Chronic hiccups: An underestimated problem. Anesthesia & Analgesia.

Lee, C., et al. (2017). Termination of persistent hiccups by digital rectal massage. The Journal of Emergency Medicine.

National Cancer Institute. (2015). Chemotherapy to treat cancer.

Petroianu, G. A. (2015). Treatment of hiccup by vagal maneuvers. Journal of the History of the Neurosciences.

Petroianu, G. A. (2016). Treatment of singultus by sexual stimulation: Who was George T Dexter, MD. Journal of Medical Biography.

Petroianu, G. A. (2020). Singultus, paper-bag ventilation, and hypercapnia. Journal of the History of the Neurosciences.

Skibiski, J., et al. (2021). Barbiturates. StatPearls.

Steger, M., et al. (2015). Systemic review: The pathogenesis and pharmacological treatment of hiccups. Alimentary Pharmacology & Therapeutics.

View article originally written for and posted on GoodRx.com.