Hiccups are sudden, involuntary contractions of the diaphragm muscle. As the muscle contracts repeatedly, the opening between the vocal cords snaps shut to check the inflow of air and makes the hiccup sound. Irritation of the nerves that extend from the neck to the chest can cause hiccups.
Although associated with a variety of ailments (some can be serious such as pneumonia or when harmful substances build up in the blood for example from kidney failure), hiccups are not serious and have no clear reason for occurring. Rarely, their presence causes health problems such as speech changes or interference with eating and sleeping.
Because most cases of hiccups resolve themselves either spontaneously or with self-administered treatment, complications are extremely rare.
In severe and persistent cases, where hiccups disturb eating and sleeping patterns, weight loss or sleep disturbances may occur.
More uncommonly, cardiac ar rhythmias and gastroesophageal reflux have been noted in severe cases of hiccups.
Hiccups cannot always be prevented. Avoiding overeating, eating too quickly, or drinking too much can help prevent hiccups.
Hiccups can be described as brief, irritable spasms of the diaphragm that can occur for a few seconds or minutes. They infrequently last longer in normal individuals without any underlying medical problem.
Common symptoms of hiccups
You may experience hiccup symptoms daily or only occasionally.
- A “hiccup” sound.
- Quick and uncontrolled tightening of the diaphragm, which will feel like a spasm that is coming from your abdomen and chest area.
Symptoms that might indicate a serious condition
In some cases, hiccups can occur with a serious condition that should be immediately evaluated in an emergency setting.
Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:
• Difficulty breathing.
• Loss of consciousness.
Many conditions are associated with hiccups, but none has been shown to be the cause of hiccups.
- If a person eats too fast, he or she can swallow air along with food and end up with the hiccups.
- Any other practices that might irritate the diaphragm such as eating too much (especially fatty foods) or drinking too much (alcohol or carbonated drinks) can make a person prone to having hiccups.
- In these instances, the stomach, which sits underneath and adjacent to the diaphragm, is distended or stretched. Because they occur in relation to eating and drinking, hiccups are sometimes thought to be a reflex to protect a person from choking.
- Strokes or brain tumors involving the brain stem, and some chronic medical disorders (such as renal failure) are reported to cause hiccups; trauma to the brain, meningitis and encephalitis may also cause them.
- Damage to the vagus or phrenic nerve may cause hiccups to last a long time.
- Some medications that can cause acid reflux may also have hiccups as a side effect. Most benzodiazepines, including diazepam (Valium), alprazolam (Xanax) and lorazepam (Ativan) can cause hiccups. In addition, medications such levodopa, nicotine and ondansetron (Zofran).
- Noxious fumes can also trigger hiccup symptoms.
- A baby may hiccup after crying or coughing. This is common in babies in the first year. In some instances, babies with gastroesophageal reflux (GERD) could be more prone to hiccups.
- Anxiety and stress can induce both short and long-term hiccups.
Treatment for getting rid of the hiccups depends on how severe they are.
- For the common hiccups that will usually stop on their own, home remedies are generally recommended to cure the symptoms.
- For more severe, persistent hiccups (usually lasting over to 2 days), the doctor may try medications to manage the patient's hiccups. Chlorpromazine(Thorazine) is usually the first prescription medication tried for hiccups, although drugs such as baclofen (Lioresal) and medications for convulsions such asphenytoin (Dilantin) have also been successful.
- Anesthesia to block the phrenic nerve and surgical implantation of an electronic stimulator to the vagus nerve has been effective. Surgery to disable the phrenic nerve (the nerve that controls the diaphragm) is often the treatment of last resort.