Internal Medicine
The exact cause of hiccups has not been identified yet. However, it seems to be associated with several factors that can trigger this response. Some examples of these factors include inhaling a large amount of air, eating too quickly without pauses, drinking carbonated beverages or alcohol, eating dry foods or spicy food, laughing vigorously, coughing, sobbing with long inhalational breaks, smoking, belching, hiatal hernia, or gastroesophageal reflux disease. Since most of these causes are physiological, hiccups caused by these causes resolve themselves within a short time. Long-term hiccups that last for days or weeks are called chronic hiccups. They can be signs of an underlying disease such as myocardial infarction, kidney failure, stroke, meningitis, etc. Damage to the vagus nerve, which supplies our digestive tract during a surgical procedure, can be considered as a cause of chronic hiccups in some cases.
There are no known risk factors for hiccups. They can occur at any age. Babies experience hiccups within the uterus as well. Certain theories have been identified as to why hiccups arise, and some conclude that it is an evolutionary response. There is no age limit for hiccups, although they are more frequently observed among infants and younger children. Males have a higher tendency to develop hiccups, occasionally for an extended period, compared to females.
Hiccups present as an involuntary spasm of the diaphragm that is repetitive. The interval between two hiccups is usually 0.5 to 1 second. In the majority of the cases, this time interval remains the same until hiccups are over. Hiccups with a brief time interval can limit your ability to have a fluent conversation, eat food, or drink beverages until they are resolved. Minor tremors may accompany them in the chest, shoulders, or abdominal cavity. Long-term or chronic hiccups can be a symptom of other underlying diseases for which other suspected body systems will have to be examined. Severe bouts of hiccups may also lead to difficulty breathing and pain in the chest or abdominal cavity.
In the majority of the cases, diagnosis of hiccups is made by its characteristic presentation. It does not require any specific test or imaging. However, if hiccups have persisted for a few days or weeks, your doctor might follow up with a thorough clinical examination to rule out any systemic disease that might be the cause. Depending upon the suspected condition, your doctor may suggest suitable diagnostic tests like ECG, CT scan, endoscopy, etc.
Other conditions that might present with prolonged standing hiccups include pregnancy, acute cholecystitis, biliary colic, pleurisy of the diaphragm, acute angle-closure glaucoma, pneumonia, bowel diseases, abnormalities in esophagus or stomach, hepatitis, liver cancer, uremia, or bladder irritation.
Hiccups do not require any particular treatment in the majority of its cases. There are multiple home remedies available that have been noticed to stop frequent hiccups. These remedies include drinking a few sips of water, deep breathing, holding in your breath while squeezing your abdominal muscles, placing sugar or salt on your tongue, breathing into a paper bag, induced gagging by inserting a finger in your throat or gargling water. Much of these remedies stem from older cultures or generations that have moved on without any scientific evidence. They may be effective in some cases and ineffective in others. Another known method to stop persisting hiccups is immediately distracting people’s attention by startling them or asking them a confusing question. This has been noticed to be adequate to pause recurrent bouts of hiccups.
If hiccups are caused by physiological causes like eating quickly or drinking carbonated beverages. In that case, it does not require any medication and will resolve on its own within a few minutes to hours. Chronic hiccups that have persisted for over a few days or weeks will need a checkup by your doctor. In severe cases, antipsychotic or sedative drugs such as haloperidol, chlorpromazine, etc., are prescribed. A gastrointestinal stimulant such as metoclopramide or antispasmodic medications such as baclofen may also be recommended in rare cases of persistent hiccups.
The overall prognosis of hiccups is good. Maximum cases will resolve within a few minutes if caused by any physiological factor. The use of the above-mentioned home remedies can also help limit the duration of hiccups. Long-term hiccups can be treated well with medications but will require an examination of other organs or systems that may be suspected as an underlying cause. Only very rare cases of chronic hiccups have been reported, leading to other serious complications of the chest or abdominal cavity.
Prevention of hiccups is linked to the management of its causative factors. Eating food slowly while giving short intervals in between two bites has been effective in preventing hiccups. Carbonated beverages should be avoided if you have a history of developing hiccups easily. Drinking water, alcohol, or beverages while eating food is another stimulating factor, so it should be limited as well. Bouts of hysterical laughter or uncontrollable sobbing can both lead to hiccups. Therefore it is necessary to perform breathing exercises to calm down and prevent hiccups. Inhalation of smoke or toxic fumes should be limited as well. Very few cases require prophylactic medication to reduce the chance of hiccups, such as administering metoclopramide before anesthesia for a surgical procedure.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 07, 2023.
https://link.springer.com/article/10.1007/s11938-020-00273-3
Hiccups are a common condition that can occur at any age and usually lasts for a short period. They are caused by repetitive, involuntary diaphragm spasms (a muscle that separates your chest and abdominal cavity. The understood mechanism for hiccups is that if the air is inhaled too quickly at once, the diaphragm moves down, and the vocal cords close up, resulting in the characteristic ‘hic’ sound that gives this condition its name. Most of the time, it resolves by itself within a few minutes to a few hours without any medication or treatment.