All About Hiccups: Causes, Symptoms, And Management

We all know what hiccups are! Those frustrating “hic” sounds that often occur after having a heavy meal. But sometimes, you get them for no apparent reason at all. Despite being slightly discomforting and embarrassing, hiccups are quite common and tend to resolve on their own.

Over the years, people have been connecting hiccups with all sorts of myths. Some say they are a sign that someone is remembering you while others presume that they can “scare away” these hiccups by frightening the heck out of you all of a sudden.

With all sorts of mysteries and myths associated with this perfectly natural phenomenon, have you ever wondered what these hiccups really are and why do you get them at all? Can they be a sign of something serious? When should you worry about these hiccups?

This article will review hiccups in detail including their mechanism, why they occur, and when you should see a doctor for them.

What Hiccups Really Are

So you have just finished your favorite steak dinner but suddenly hiccups won’t leave you alone. Wonder where these funny noises come from and why you get them anyway?

Your diaphragm is to be blamed. The diaphragm is a muscle shaped like a dome at the very bottom of your chest. This is where the hiccups begin. (1,2)

Under normal circumstances, the diaphragm is working perfectly. It pulls down as you inhale to accommodate the air you breathe in and get it to the lungs. On the other hand, it relaxes on exhalation so that the air in the lungs can easily flow out through the mouth and nose.

Sometimes, this perfectly working diaphragm gets irritated and when this happens, it adopts a jerky motion every time you try to inhale. As a result, the air gets sucked into the throat instead of the lungs. This air, when rushing towards the throat, hits the vocal cords and causes them to close suddenly, producing a hiccup.

So anything that can irritate your diaphragm can cause hiccups. It can be anything; from food to emotions. Irrespective of what the cause is, hiccups are generally harmless and seem to go away on their own. In extremely rare cases, they may persist for days or even months and can indicate an underlying medical problem.

Symptoms Of Hiccups

Symptoms of Hiccups

The symptoms of a hiccup include:

  • A noticeable sharp spasm or contraction in the diaphragm that can be felt just below the breastbone
  • Involuntary sucking of air into the throat
  • A ‘hic’ sound produced as the epiglottis is closed

Why Do You Get Hiccups?

Hiccups that stick around for a few minutes and resolve on their own might be due to:

  • A sudden change in temperature
  • Having an overindulgent meal
  • A feeling of stress or excitement
  • Chewing gum
  • Drinking alcohol or any other carbonated drink

However, in some rare cases, hiccups don’t seem to go away or keep coming back too often. This might be a sign that your body is suffering from underlying problems. These problems can be related to different systems of the body and are mentioned below. (3)

Disorders of the central nervous system 

The most common CNS disorders that may force you to experience frequent or persistent hiccups include:

  • Meningitis
  • Multiple sclerosis
  • Head trauma
  • Tumor
  • Stroke
  • Irritation of the phrenic and vagus nerve

The following issues may irritate the vagus and phrenic nerves leading to chronic hiccups:

  • Irritation of the eardrum
  • Goiter
  • Gastrointestinal reflux
  • Laryngitis

Disorders of the gastrointestinal tract

Persistent hiccups might be due to:

  • Gastritis
  • Issues of the gallbladder
  • Pancreatitis
  • Peptic ulcer disease
  • Inflammatory bowel disease

Issues within the thorax

The following thoracic issues might be behind your hiccup attacks that don’t seem to go away for days:

  • Asthma
  • Bronchitis
  • Pulmonary embolism
  • Emphysema
  • Pneumonia

Cardiovascular issues

The following cardiovascular issues can also sometimes lead to persistent hiccups:

  • Pericarditis
  • Heart attack

Other factors that must be considered for managing certain cases of chronic hiccups include:

  • Excessive use of alcohol
  • Electrolyte imbalance
  • Diabetes
  • Kidney disease
  • Certain medicines, such as barbiturates, tranquilizers, steroids, and anesthesia

Preventing Hiccups

Some people are more prone to acquiring hiccups every other day. While there is no proven method to help such individuals to prevent them, they can try reducing their exposure to the known triggers.

The following tips can help decrease the possibility of acquiring hiccups so frequently.

  • Avoid consuming too much alcohol and carbonated drinks
  • Do not overeat
  • Protect yourself from sudden, drastic changes in the temperature
  • Keep your calm and avoid getting into any intense emotional reactions

Natural And Medical Ways To Manage Hiccups

If you are tired of having hiccups every other day, the following natural, as well as medical ways, can help.

#1 - Pressure points

  • Gently press on your diaphragm.
  • Pull on your tongue. Tug the tongue after holding its end in your fingers. Doing this leads to the stimulation of the vagus nerve and easing of the diaphragmatic contractions. This can stop hiccups; however, this trick may not always work.

#2 - Posture and breathing

  • Breathe into a paper bag while ensuring that the bag does not cover your head.
  • Bring your knees close to the chest and use your arms to hug them for two minutes.
  • Breathe in and hold your breath for about 10 seconds. Then, breathe out. Perform 2-4 rounds of this. Repeat breathing exercise again 20 minutes later.
  • Lean forward to compress your chest gently.

#3 - Eating and drinking

  • Use ice water for gargling.
  • Drop a few drops of vinegar in the mouth.
  • Put some granulated sugar on your tongue and wait for it to melt. Swallow it as soon as it does.
  • Keep sipping on cold water. (4)
  • Slowly consume a glass of water without breathing.
  • Slice lemon very thinly and place a slice on your tongue. Suck it like candy.
  • In some cases, burping after consuming a fizzy drink can also make the hiccups go away. However, some experts are against this tip due to the argument that consuming sodas can actually trigger hiccups.

In most cases, hiccups are short-lived and tend to go away on their own even if you don’t do anything about it. However, if there is an underlying medical condition causing them, it is better to get it treated first.

#4 - Medications

If you have tried all the natural remedies yet your hiccups don’t seem to go away, a doctor may suggest getting help from medicine. This usually occurs when hiccups are so persistent or frequent that they start disturbing your everyday life in the following ways:

  • You are unable to eat properly to an extent that you start losing weight
  • You are unable to sleep properly
  • You are displaying signs of clinical depression

In such circumstances, one or more of the following drugs are commonly prescribed: (5)

  • Gabapentin: initially used for managing epilepsy, it is now being prescribed to get rid of hiccups and neuropathic pain.
  • Baclofen: It is a muscle relaxant that helps get rid of the contractions within the diaphragm.
  • Haloperidol: It is an antipsychotic medication.
  • Chlorpromazine: It is also an antipsychotic medication.
  • Metoclopramide: It is commonly used for the management of nausea.

Medical treatment is usually saved for serious cases when nothing else seems to work. Moreover, these medicines are also best used in the case of chronic hiccups which tend to linger for too long.

In very extreme cases, anesthesia blocks are used for blocking the phrenic nerve followed by surgically implanting an electronic stimulator on the vagus nerve. Disabling the phrenic nerve surgically is the very last resort.

When To Seek Medical Attention For Hiccups?

There are two scenarios in which you must seek medical attention for your hiccups.

First, if your hiccups tend to persist for a couple of days and don’t go away no matter what you try, get in touch with your primary healthcare doctor. It is urgent to get it addressed and evaluated by a professional, especially if the intensity of the hiccups is not letting you sleep. Your doctor will work closely with you to rule out any medical causes that might be behind these hiccup attacks and prescribe medicine and other natural ways of stopping them.

Secondly, if your hiccups are accompanied by additional symptoms, it is best to seek medical help on an urgent basis. Symptoms like coordination issues and numbness may occur with hiccups and warrant an immediate visit to a healthcare provider as they might be a sign of stroke. Some other symptoms that must be watched out for include changes in vision, altered speech, difficulty in swallowing and speaking, drooping of the face, or feeling weakness on one side of the body.

Pay close attention to your body as soon as the hiccups begin. If you find any cardiovascular symptoms accompanying them, visit the emergency department and get yourself checked right away. However, if you are not experiencing anything, give your hiccups some time to go away on their own.

Last Words 

Hiccups are a very common phenomenon and a lot of people seem to encounter them randomly or after every few days. While it is completely normal to have them for a few minutes after eating a heavy meal or consuming alcohol, persistent attacks of hiccups that last for days can be concerning. Such cases of chronic hiccups warrant urgent medical evaluation to rule out any underlying medical issue and start necessary treatment.

To Your Health and Happiness, Doctor Danielle

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