Hiccups: Why They Start, What May Help and When to Be Seen

What it involves

MedlinePlus describes a hiccup as an unintentional spasm of the diaphragm, the muscle at the base of the lungs, followed by a quick closing of the vocal cords. The closing of the vocal cords is what makes the familiar sound. The encyclopedia calls hiccups common and normal in newborns and infants.

Who this is for

• Patients whose hiccups have gone on for more than a few days
• Patients whose hiccups keep coming back and disturb sleep, eating or talking
• Patients who notice hiccups along with other new symptoms such as chest, stomach or breathing problems
• Patients who want to know whether a medicine they take could be behind the hiccups

What to expect

• Questions about how long this bout has lasted, what you ate or drank beforehand and whether it stopped and restarted
• A physical exam, because MedlinePlus says that is the starting point for hiccups that need a visit
• A review of your medicines and other symptoms, with tests only if a disease or disorder is suspected as the cause
• A plan that may include treating the underlying cause or a referral if the hiccups continue

What is happening when you hiccup

A hiccup has two parts, according to the MedlinePlus health topic. First the diaphragm, the main muscle used for breathing, moves involuntarily. Then the vocal cords snap shut quickly, and that second step makes the sound. Because the whole thing is a reflex, you cannot decide to stop it the way you can decide to stop coughing, which is why the folk remedies people pass around are really attempts to interrupt the reflex rather than treatments for a disease.

Common triggers

MedlinePlus says hiccups can start and stop for no obvious reason, but they often follow something that irritates the diaphragm. Its list includes eating too quickly or too much, hot or spicy foods, alcohol, carbonated drinks, feeling nervous or excited and a bloated stomach. Abdominal surgery and certain medicines are also listed. The heartburn and acid reflux guide covers a stomach complaint that often shows up after the same big or spicy meals, and the alcohol use screening guide explains how a provider asks about drinking without judgment.

Home tips that people try

The health topic is honest that there is no proof the usual suggestions work, but it says they are not harmful, so you could try them. They include breathing into a paper bag, sipping a glass of cold water, holding your breath and gargling with ice water. The medical encyclopedia adds eating a teaspoon of sugar and says there is no sure way to stop hiccups. Most episodes disappear within a few minutes on their own, so the practical advice is to try one or two of these and then wait.

When hiccups point to something else

MedlinePlus lists diseases or disorders that irritate the nerves that control the diaphragm, including pleurisy, pneumonia and upper abdominal diseases, along with harmful fumes. It also lists metabolic disorders and central nervous system disorders. In rare cases a stroke or tumor affecting the brain is a cause. These are uncommon explanations for a short bout, which is why a provider usually asks about other symptoms first. If hiccups arrive with a cough or fever, the pneumonia symptoms guide explains the signs that call for an exam.

When to be seen

Hiccups that last more than a few days, or that keep coming back, are what MedlinePlus calls chronic hiccups, and it advises contacting your provider. It says chronic hiccups can interfere with sleep, eating, drinking and talking. If a condition is causing them, treating that condition may help. Otherwise the listed options are medicines, surgery and other procedures. The encyclopedia says a provider may in rare cases try gastric lavage or massage of the carotid sinus in the neck, and it warns never to try carotid massage yourself. Medicines, a stomach tube and, very rarely, a nerve block are other steps it lists, and any of them would be a referral rather than something this practice is shown to perform.

What a visit covers

The encyclopedia says you will have a physical exam and be asked questions such as how long this episode has lasted, whether you get hiccups easily, whether you recently ate something hot or spicy or drank carbonated beverages, whether you have been exposed to fumes and what you have already tried. Extra tests are done only when a disease or disorder is suspected. If swallowing is also hard or food sticks, the difficulty swallowing guide explains what a provider asks about that symptom.

Sources

• MedlinePlus — Hiccups (health topic)
• MedlinePlus — Hiccups (medical encyclopedia)