What are hiccups? Hiccups are repetitive, uncontrollable contractions of the diaphragm muscle. Your diaphragm is the muscle just below your lungs. It marks the boundary between your chest and abdomen. The diaphragm regulates breathing. When your diaphragm contracts, your lungs take in oxygen. When your diaphragm relaxes, your lungs release carbon dioxide. The diaphragm contracting out of rhythm causes hiccups. Each spasm of the diaphragm makes the larynx and vocal cords close suddenly. This results in a sudden rush of air into the lungs. Your body reacts with a gasp or chirp, creating the sound characteristic of hiccups. Singultus is the medical term for hiccups.

Onset of hiccups There’s no way to anticipate hiccups. With each spasm, there’s usually a slight tightening of the chest or throat prior to making the distinctive hiccup sound. Most cases of hiccups start and end abruptly, for no discernable reason. Episodes generally last only a few minutes. Hiccups that last longer than 48 hours are considered persistent. Hiccups that last longer than two months are considered intractable, or difficult to manage.

Risk factors for hiccups Hiccups can occur at any age. They can even occur while a fetus is still in the mother’s womb. However, there are several factors that can increase your likelihood of developing hiccups. You may be more susceptible if you: are male

experience intense mental or emotional responses, ranging from anxiety to excitement

have received general anesthesia (you were put to sleep during surgery)

had surgery, especially abdominal surgery

Treating hiccups Most hiccups aren’t an emergency, or anything to worry about. However, a prolonged episode can be uncomfortable and disruptive to daily life. Contact a doctor if you have hiccups that last longer than two days. They can determine the severity of your hiccups in relation to your overall health and other conditions. There are numerous options for treating hiccups. Typically, a short-term case of hiccups will take care of itself. However, the discomfort may make waiting out hiccups unbearable if they last longer than a few minutes. Although none of these have been proven to stop hiccups, the following potential treatments for hiccups can be tried at home: Breathe into a paper bag.

Eat a teaspoon of granulated sugar.

Hold your breath.

Drink a glass of cold water.

Pull on your tongue.

Lift your uvula with a spoon. Your uvula is the fleshy piece of tissue that’s suspended above the back of your throat.

Attempt to purposefully gasp or belch.

Bring your knees to your chest and maintain this position.

Try the Valsalva maneuver by shutting your mouth and nose and exhaling forcibly.

Relax and breathe in a slow, controlled manner. If you still have hiccups after 48 hours, talk to your doctor. Your doctor may attempt gastric lavage (stomach pumping) or carotid sinus massage (rubbing the main carotid artery in the neck). If the cause of your hiccups is unclear, your doctor may recommend tests. These can help detect any underlying disease or condition. The following tests may be useful in determining the cause of persistent or intractable hiccups: blood tests to identify signs of infection, diabetes, or kidney disease

liver function tests

imaging of the diaphragm with a chest X-ray, CT scan, or MRI

an echocardiogram to assess heart function

an endoscopy, which utilizes a thin, lighted tube with a camera on the end to investigate your esophagus, windpipe, stomach, and intestine

a bronchoscopy, which utilizes a thin, lighted tube with a camera on the end to examine your lungs and airways Treating any underlying causes of your hiccups will usually make them go away. If persistent hiccups have no obvious cause, there are several anti-hiccup medications that may be prescribed. The more commonly used drugs include: chlorpromazine and haloperidol (antipsychotic medications)

benzodiazepines (a class of tranquilizers)

Benadryl (an antihistamine)

metoclopramide (a nausea drug)

baclofen (a muscle relaxant)

nifedipine (a blood pressure medication)

seizure medications, such as gabapentin There are also more invasive options, which can be used to end extreme cases of hiccups. They include: nasogastric intubation (insertion of a tube through your nose into your stomach)

an anesthetic injection to block your phrenic nerve

surgical implantation of a diaphragmatic pacemaker, a battery-powered device that stimulates your diaphragm and regulates breathing

Possible complications of untreated hiccups A long-term episode of hiccups can be uncomfortable and even harmful to your health. If left untreated, prolonged hiccups can disturb your sleeping and eating patterns, leading to: sleeplessness

exhaustion

malnutrition

weight loss

dehydration