We all got hiccups, especially when we gulped food in a haste to reach the workplace on time, or when we partied all night and forgot to keep a track of how much alcohol we guzzled. Hiccups are common.
A sudden, involuntary contraction of the diaphragm, a dome-shaped muscle that separates the chest from abdomen results in hiccups. Hiccups, also called hiccoughs, are medically termed as synchronous diaphragmatic flutter or singultus. The diaphragm plays a crucial role in the breathing process, i.e., inhalation and exhalation. When a person’s intake air is blocked momentarily, causing sudden closure of vocal cords, ‘hic’ sound is produced. It is a minor and temporary condition which lasts only a few minutes. But prolonged hiccups and frequent hiccups indicate a serious problem for which doctor consultation is a must.
Based on the duration, hiccups are classified into three types.
1) Transient hiccups – Last for seconds to a few minutes
2) Persistent or chronic hiccups – Last longer than 48 hours
3) Recurrent hiccups – Frequent repetition of hiccups lasting for more than that of transient hiccups.
What Causes Hiccups?
Hiccups may be triggered by a number of factors. The most common causes of hiccups include:
- A heavy meal – Since the stomach is situated right below the diaphragm, excessive eating interferes with the diaphragm and induces contraction
- Excessive alcohol consumption
- Drinking carbonated beverages
- Sudden Shock
- Sudden temperature changes
- Swallowing air while chewing gum
- Gas in the stomach that presses the diaphragm
- Opiate drug use
- Laughing continuously
- Abdominal surgery
Hiccups are common in newborn babies. Babies hiccup after crying, coughing or swallowing milk from the feeding bottle. This is because during these processes their stomach is filled with air and it may push diaphragm causing hiccups. Taking a break while feeding and making them burp can help get rid of hiccups.
Best Ways to Get Rid of Hiccups
There are numerous ways which may help you get rid of hiccups. Some of the best ways to get rid of hiccups are listed below.
- Sip ice-cold water
- Gargle cold water
- Drink a glass of warm water in one go
- Hold your breath for a short time and breath out slowly. Repeat it for every 20 minutes
- Breathe into a paper bag
- Pull your knees up to your chest and lean forward
- Swallow sugar granules
- Bite a lemon
- Taste tiny amount of vinegar
- A common home remedy – having someone frighten you or surprise you. This forces them to take a deep breath.
Persistent or Chronic Hiccups
Persistent or chronic hiccups continue for more than 48 hours and up to one month. Persistent hiccups are a sign of a serious condition. Persistent hiccups indicate a serious medical condition and doctor consultation is recommended. Factors that can cause prolonged hiccups to include:
- Nerve damage or irritation due to hair or other particles touching the eardrum
- Tumour or cyst in goiter
- Sore throat or laryngitis
- Gastrointestinal conditions such as inflammatory bowel disease (IBD) or gastroesophageal reflux disease
- Respiratory conditions such as pneumonia or asthma
- Central nervous system disorders such as encephalitis, meningitis, multiple sclerosis, stroke, traumatic brain injury and brain tumour.
- Metabolic disorders
- Drugs and steroids
Health disorders such as diabetes, lung disease, brain disorders, and kidney disease cause hiccups because these disease conditions interfere with the functioning of the diaphragm.
If hiccups last for more than 3 hours and are accompanied by severe abdominal pain, vomiting, spitting of blood, fever, or shortness of breath, the person should consult a doctor immediately.
Prolonged hiccups lead to weight loss as it becomes difficult for a person to eat, insomnia as hiccups interfere with sleep, and fatigue as prolonged hiccups are exhaustive. Other complications with persistent hiccups include dehydration, depression, and communication problem.
Prolonged hiccups interfere with eating, sleeping, speaking, and other regular activities.
Doctors perform a physical examination and neurological examination to check the underlying reason behind persistent hiccups. Based on the results, further tests are recommended. The tests include:
Blood tests to check for infection, kidney disease and diabetes.
- Imaging tests such as an X-ray computed tomography scan (CT scan), and magnetic resonance imaging scans (MRI scan) to identify abnormalities in phrenic nerve, vagus nerve and the diaphragm.
- Endoscopy in which a flexible tube with a small camera is sent into the esophagus
- Electrocardiogram (ECG) to measure the heart’s electrical activity and check for any heart conditions
- Based on the health condition, doctors may prescribe medication. Chlorpromazine (Thorazine) is usually prescribed as the first-line of medication to treat hiccups. Other medications include haloperidol (Haldol) and metoclopramide (Reglan). Doctors might also prescribe medications such as muscle relaxants (baclofen), sedatives, and anti-seizure drugs (gabapentin). Initially, a low dose drug is prescribed, based on the severity the dosage will be increased.
- In severe cases, phrenic nerve surgery may be performed. A surgeon injects medication into the phrenic nerve to temporarily block the nerve’s action or implants an electronic stimulator to the vagus nerve.
More Ways to Get Rid of Hiccups
- Try covering your nose and mouth with one hand (cupping) and breath normally
- Press the palm of your hand with the thumb of your other hand
- Press diaphragm gently
- Try to exhale squeezing your nose tight and closing your mouth
- Stick your tongue out
- Plug your ears for 20 to 30 seconds
- Rub your eyeballs
- Have a spoonful of peanut butter
- Sip hot sauce
- Have honey water (a teaspoon of honey stirred in lukewarm water)
- Chew some dill seeds
- Massage carotid arteries on two sides of your neck
- Rub the back of your neck
Prevention of hiccups
- Avoid eating or drinking quickly – eat smaller amounts and slowly!
- Avoid eating spicy food
- Avoid carbonated beverages
- Drink less alcohol
- Avoid smoking
- Do not change the temperature suddenly
- Do not stress yourself more
- Practice meditation