Why We Get Occasional or Constant Hiccups
With Suggestions to Help Stop Hiccups
Medically reviewed by Michael Menna, DO
Hiccups are a reflex involving the phrenic nerve, vagus nerve, or thoracic sympathetic fibers. The causes of hiccups range from acute factors like eating a large meal or drinking carbonated drinks to more persistent factors like central nervous system or gastrointestinal disorders.
This article explains the causes of occasional and constant hiccups and treatment. It also covers what happens when you have hiccups and how long you can expect them to last.
Common Causes of Occasional Hiccups
Common causes of hiccups include how you eat and emotional factors.
Eating and Drinking Habits
Hiccups occur when your stomach distends after eating a large meal or drinking carbonated drinks. If you have a habit of eating quickly or until you are full or drinking sparkling water or soda, you may be more likely to experience occasional hiccups.
In addition, the following foods may trigger the hiccup reflex:
Alcohol
Fried foods
Meat
Salty foods
Sour foods
Spicy foods
Sweets
Emotional Factors
Emotions, such as overexcitement, stress, or anxiety, can lead to hiccups in some people. For example, you may swallow excess air in your enthusiasm when overexcited.
Causes of Constant Hiccups
When hiccups are more often than occasional, they are called persistent or intractable. These painful hiccups typically last longer than a couple of days. Some health conditions can cause persistent hiccups.
Central Nervous System Disorders
Vascular conditions, infections, and structural central nervous system problems, including the following disorders, could lead to chronic hiccups:
Arteriovenous malformation: Group of abnormally interconnected blood vessels
Brain abscess: Pus-filled brain infection
Brain stem neoplasms: Tumors in the brain stem
Encephalitis: Brain inflammation
Head trauma: Injury to the brain or skull
Hemorrhagic stroke: When blood supply to a region of the brain is diminished due to bleeding
Hydrocephalus: Fluid on the brain
Intracranial neoplasms: Brain tumors
Ischemic stroke: When an artery supplying blood to the brain becomes blocked
Meningitis: Inflammation of the meninges, the lining of the brain and spinal cord
Multiple sclerosis: Progressive neurological disease
Neurosyphilis: Central nervous system infection
Subphrenic abscess: Infected fluid above the diaphragm
Syringomyelia: Spinal cord cyst
Temporal arteritis: Inflamed arteries by the temples
Vagus and Phrenic Nerve Irritation
Since these nerves are involved in the hiccup reflex, any irritation of these nerves could lead to hiccups. Conditions associated with these nerves include:
Goiter: Enlarged thyroid
Hair or foreign-body irritation of the tympanic membrane (eardrum)
Laryngitis: Larynx inflammation resulting in lost voice
Pharyngitis: Sore throat
Gastrointestinal Disorders
Gastrointestinal disorders that may lead to chronic hiccups include:
Abdominal abscesses
Aerophagia: Swallowing too much air
Esophageal distention
Esophagitis: Esophagus irritation or swelling
Gallbladder disease
Gastric carcinoma: Stomach cancer
Gastric distention: Enlarged stomach
Gastritis: Inflamed stomach lining
Pancreatitis: Pancreas inflammation
Peptic ulcer disease: Open sores in the stomach and small intestine
Thoracic Disorders
Thoracic disorders involve the lungs, heart, esophagus, chest wall, diaphragm, and great vessels. These types of conditions can cause chronic hiccups and include:
Aortic aneurysm: Dilated aorta, the body's main artery
Chest trauma
Empyema: Pus between membranes lining the lungs
Mediastinal tumors: Growths between the lungs
Mediastinitis: Swelling and irritation in the chest between the lungs
Pleuritis: Inflammation of the membrane covering the lungs and chest
Pulmonary embolism: Blood clot in the lungs
Cardiovascular Disorders
Heart conditions, including myocardial infarction (heart attack) and pericarditis (inflammation of the pericardium, the protective sac around the heart), can also cause hiccups.
Infections and Toxicity
Some infections and toxins can also lead to persistent hiccups. These include:
Alcohol
Herpes zoster (shingles)
Hypocalcemia (low calcium)
Hypocapnia (reduced carbon dioxide in blood)
Hyponatremia (low sodium)
Uremia (reduced kidney function)
Postoperative
Many factors related to surgery can cause postoperative hiccups. This includes anesthesia, intubation (inserting a tube through a patient's nose or mouth and down into the airway), neck stretching, and abdominal distention.
Drugs
Some drugs can also cause persistent hiccups, including:
Alpha methyldopa (blood pressure medication)
Chemotherapy (for example, carboplatin)
Dexamethasone (corticosteroid)
Short-acting barbiturates
Psychological
Psychological disorders that may lead to chronic hiccups include:
Excitement
Malingering (exaggeration of illness)
Stress
Things to Try to Stop Hiccups
The good news is there are many tactics for getting rid of hiccups.
At-Home Treatment
At-home treatments include:
Pressing on your eyeballs
Using the Valsalva maneuver (breathe out forcefully while holding your mouth and nose closed)
Plugging your ears
Swallowing ice
Breathing into a paper bag
Sucking on a lemon
Pulling on your tongue
Pulling your knees to your chest
Medical Treatment
Persistent hiccups may require treating the underlying medical condition causing them. In addition, some medications may help. These include:
Anticonvulsants (for epilepsy and seizure disorders)
Baclofen (medicine for pain and muscle spasms)
Chlorpromazine (antipsychotic)
Defoaming agents (for stomach distention)
Dexamethasone (corticosteroid)
Gabapentin (medication for seizures and nerve pain)
Haldol (haloperidol (antipsychotic)
Lidocaine (local anesthesia)
Methylphenidate (attention deficit hyperactivity disorder, or ADHD, medication)
Midazolam (used for procedural sedation)
Nifedipine (high blood pressure medicine)
Prokinetic agents (gastroesophageal reflux disease, or GERD, medication)
Zoloft (sertraline, an antidepressant)
While the list is long, it's worth noting that chlorpromazine is the only drug approved by the Food and Drug Administration (FDA) for hiccups.
What’s Happening During Hiccups?
When you hiccup, your body makes an involuntary movement (called a reflex). The first movement happens with your diaphragm (the muscle at the bottom of your lungs). Next, your vocal cords quickly close, making the notable "hic" sound. This reflex occurs when certain nerves are stimulated.
How Long Do Hiccups Last?
Occasional hiccups are short-lived, usually lasting no longer than 48 hours. Intractable hiccups can last longer than a month.
Summary
There are many causes of hiccups, from food to emotions to medical conditions. Fortunately, there are many remedies for getting rid of hiccups, and they will eventually go away. A cause may need to be determined for persistent hiccups in order to treat the underlying condition and relieve the hiccups.
Read the original article on Verywell Health.