Most simple cases of hiccups come after eating or drinking too much or too quickly. The stomach, which is situated right below the diaphragm, becomes distended and irritates it. This will cause the diaphragm to contract, as it does when we breathe in.
Sometimes hiccups will occur because of a disturbance to the nerve pathways from the brain to the muscles involved. This explains why hiccups may occur with temperature changes or emotional situations. It is also the reason that a sudden shock can sometimes abolish an attack.
Persistent hiccups may signify problems in the brain, spinal cord or any of the structures around the diaphragm or chest wall.
What are Hiccups?
A hiccup, medically known as SDF (synchronous diaphragmatic flutter) or singultus, is a sudden, involuntary contraction of the diaphragm which occurs at the same time as a contraction of the voice box (larynx) and total closure of the glottis, effectively blocking air intake. The glottis is the middle part of the larynx, where the vocal cords are located.
Hiccups may also be spelled "hiccoughs". Health Articles - Why Do We Hiccup?
Experts are not sure what causes hiccups and why we do them. Most agree that they are often triggered by minor stomach upsets. Sometimes, hiccups are said to have a psychological, rather than a physical cause - however, nobody really knows.
In the majority of cases, hiccups resolve without any treatment within a few minutes.
Hiccups, which can occur individually or in bouts, commonly happen rhythmically - the interval between each hiccup is relatively constant. Most people find them to be a minor nuisance. However, prolonged hiccups can became a serious medical problem and require treatment. Prolonged hiccups affect men much more than women. When attacks last longer than a month, the hiccups are termed intractable.
What are the causes of hiccups?
Hot food has irritated the phrenic nerve. The phrenic nerve is near the esophagus. Health Articles - Why Do We Hiccup?
When there is gas in the stomach, which presses against the diaphragm.
- After eating dry breads.
- Fizzy drinks are consumed.
- Food is eaten too rapidly
- Many people anecdotally report hiccups after consuming alcoholic beverages.
- Some medications, such as opiates, benzodiazepines, anesthesia, corticosteroids, barbiturates, and mythyldopa are known to cause hiccups.
- Some people get hiccups after eating spicy foods.
- There is a sudden change in temperature.
- Too much food is eaten.
- Conditions which affect metabolism, including hyperglycemia, hypoglycemia, or diabetes
- Conditions which affect the CNS (central nervous system), including a traumatic brain injury, encephalitis, a brain tumor, or stroke
- Conditions which irritate the vagus nerve, such as meningitis, pharyngitis or goitre
- Gastrointestinal conditions, including IBD (inflammatory bowel disease), a small bowel obstruction, or GERD (gastro-esophageal reflux disease)
- Respiratory conditions, such as pleurisy, pneumonia or asthma
- Psychological reactions, including grief, excitement, anxiety, stress, hysterical behavior, or shock
- Communication problems - persistent hiccups may make it harder for the patient to communicate orally.
- Depression - patients with long-term hiccups have a considerably higher risk of developing clinical depression.
- Fatigue - people with prolonged hiccups may become exhausted, especially if they cannot sleep or eat properly.
- Insomnia - if the prolonged hiccups persist during the sleeping hours, the patient will find it hard to get to sleep, and/or stay asleep.
- Post-surgical wound healing - if the patient is hiccupping all day long, post-surgical wounds will probably take much longer to heal. Some patients may have a higher risk of developing infections, or start bleeding after surgery.
- Weight loss - in some cases the hiccups are not only long-term, but occur at short intervals, making it hard for the patient to eat properly.
Hiccups that last less than 48 hours do not usually need any medical attention, because they resolve on their own. If your hiccups persists for longer, you should check with your doctor. Health Articles - Why Do We Hiccup?
After talking to the patient about their hiccups, when they began, how often they occur, etc., the doctor will probably perform a general physical exam and then a neurological exam to check the person's:
- Muscle strength
- Muscle tone
- Sense of touch
Blood tests - to check for infection, kidney disease or diabetes
Imaging tests - to determine whether there are any anatomical abnormalities which may be affecting the phrenic or vagus nerves or the diaphragm. This may involve taking a chest X-ray, a CT scan or an MRI scan.
Endoscopic test - the doctor inserts an endoscope, a flexible tube with a small camera at the end, down the patient's throat to check the windpipe or esophagus.
An electrocardiogram (ECG) - this test checks for heart-related conditions by measuring electrical activity in the heart.
What are the treatment options for hiccups?
Health Articles - Why Do We Hiccup?
Self-care tips for hiccups
According to the National Health Service (NHS), UK, the following steps have been known to help some patients with hiccups. These are featured in full in our article how to get rid of hiccups:
- Bite on a lemon
- Breathe into a paper bag (you should never cover your head with the bag)
- Gargle with very cold water
- Have a tiny bit of vinegar (enough to taste)
- Hold your breath for a short time, breath out, then do it again three or four times - do this every 20 minutes
- Lean forward so that you gently compress your chest
- Place gentle pressure on your diaphragm
- Sip ice-cold water slowly
- Sit down and hug your knees as close to your chest as you can for short periods
- Take some granulated sugar and swallow it
- While you swallow, place gentle pressure on your nose
If the underlying condition or illness is treated and/or controlled, the hiccups will likely resolve. In some cases, the patient may be referred to a specialist.
For prolonged hiccups which may be interfering with the patient's quality of life, the doctor may prescribe a drug.
The following medications may be prescribed if no underlying health condition is diagnosed:
- Baclofen (Lioresal) - a muscle relaxant
- Chlorpromazine - an antipsychotic medication which can alleviate hiccups
- Gabapentin - originally used for the treatment of epilepsy, now commonly prescribed for neuropathic pain. It can help alleviate the symptoms of hiccups.
- Haloperidol - an antipsychotic drug which can also alleviate hiccups symptoms
- Metoclopramide (Reglan) - an anti nausea medication, known to help some patients with hiccups
Some of the causes of hiccups are preventable.
- Avoid abrupt changes in temperature
- Avoid drinking alcohol
- Avoid fizzy drinks
- Avoid having large meals
- Do not eat too rapidly
Please read our previous post Health Tips for Today - Healthy Living Facts