Hiccups

Hiccups, or hiccoughs, are involuntary sounds made by spasms of the diaphragm. The diaphragm is a large sheet of muscle slung beneath the lungs that, together with the intercostal muscles, causes us to breathe. The muscular spasm of these muscles sucks air into the lungs, and the quick inhalation makes a structure inside the throat (called the epiglottis) slam shut. (The epiglottis is a flap of tissue that closes over the windpipe during swallowing to prevent the inhalation of food, fluids or saliva.) This sharp closure of the epiglottis causes the characteristic ‘hic’ sound of hiccups.

Generally, hiccups resolve by themselves after a few minutes, but prolonged hiccups that last for days or weeks may be symptomatic of underlying disorders. Certain drugs, including epilepsy medications, can make a person more prone to hiccups.

Symptoms of hiccups

The symptoms of hiccups include:

• A sharp contraction or spasm of the diaphragm that is felt just below the breastbone.
• Air is involuntarily sucked into the throat.
• The closing epiglottis makes a ‘hic’ sound.
• Hiccups usually stop after a few minutes.

Cause of hiccups

The muscular activity of the diaphragm is controlled by nerves. Hiccups occur when particular stimuli trigger the nerves to send the diaphragm into spasms. It is not known why this occurs.

Triggers of hiccups

The cause of hiccups is often unknown and there may be no apparent trigger. Various triggers, particularly those that cause pressure on the diaphragm, are known to prompt an attack of hiccups in some people from time to time. Some of these triggers include:

• Eating food too quickly
• Hot or spicy foods
• Indigestion
• Overconsumption of alcohol
• Fizzy drinks
• Cigarette smoking
• Stress
• Bad odours
• Pregnancy.

Self-help strategies

Hiccups are harmless and usually resolve by themselves in a few minutes. Some hiccup ‘cures’ include:

• Hold your breath
• Take deep breaths
• Breathe into a paper bag
• Eat a bit of fresh ginger
• Suck on a lemon
• Have a hot water and honey drink
• Eat a spoonful of sugar
• Drink a glass of water slowly
• Eat ice
• Gargle
• Sit down and lean forward over your knees
• Ask someone to give you a fright.

Hiccups may be symptomatic of disease

Hiccups that last for days, weeks or even years may be symptomatic of underlying disease. Certain lung or brain disorders can sometimes interfere with the functioning of the diaphragm and make the person prone to hiccups. Hiccups may also be a side effect of surgery or particular medications.

Some of the diseases, conditions and drugs that may prompt frequent or prolonged attacks of hiccups include:

• Oesophagitis (inflammation of the oesophagus)
• An overactive thyroid gland
• Pleurisy (inflammation of the membrane surrounding the lungs)
• Pneumonia (inflammation of the lungs)
• Kidney disease
• Brain damage, such as stroke or tumour, that affects the area of the brain which controls the diaphragm
• Abdominal surgery
• Chest surgery
• Certain epilepsy medications
• Nicotine gum

Medical treatment

Prolonged hiccups should be medically investigated. Treatment options may include:

• Treatment for the underlying disorder
• Changes to current drug dosages
• Switching to another form of nicotine therapy
• Anti-spasmodic drugs to calm the diaphragm
• A tube inserted into the nose (nasogastric intubation)
• A nerve block
• Surgery, to sever some of the nerves servicing the diaphragm.

Where to get help

• Your doctor

Things to remember

• Hiccups, or hiccoughs, are involuntary sounds made by spasms of the diaphragm.
• Hiccups are usually harmless and resolve by themselves after a few minutes.
• In some cases, prolonged hiccups that last for days or weeks may be symptomatic of underlying disorders.