Hiccups are sudden, involuntary contractions of the diaphragm which occur at the same time as a contraction of the voice box (larynx) and total closure of the glottis, effectively blocking air intake. The glottis is the middle part of the larynx, where the vocal cords are located.
Hiccups may also be spelled "hiccoughs" and are medically known as SDF (synchronous diaphragmatic flutter) or singultus.
Hiccups can often occur for no apparent reason. It's common to get a bout of hiccups every now and again and there is no need for alarm should you get one. In the majority of cases, hiccups resolve without any treatment within a few minutes.
Hiccups can occur individually or in bouts and commonly happen rhythmically, meaning that the interval between each hiccup is relatively constant. Most people find them to be a minor nuisance. However, prolonged hiccups can became a serious medical problem and require treatment. Prolonged hiccups affect men much more than women. When attacks last longer than a month, the hiccups are termed intractable.
Here are some key points about hiccups. More detail and supporting information is in the main article.
- Experts are still divided on why hiccups occur.
- Some medical conditions such as stroke and asthma are associated with a higher incidence of hiccups.
- Prolonged cases of hiccups can lead to complications such as insomnia and depression.
- Cases of hiccups that last for longer than 48 hours should be referred to a doctor.
- There are many tips that are known to help patients with hiccups.
- For prolonged cases of hiccups, drugs such as muscle relaxants can be prescribed.
- Some causes of hiccups can be avoided, such as alcohol and eating too quickly.
- Most cases of hiccups resolve without treatment.
Causes of hiccups
Experts have yet to reach a definitive conclusion on what the mechanisms are that cause hiccups, or why they occur. According to studies, the following circumstances, conditions and illnesses have been associated with a higher risk of developing hiccups:
- Hot food has irritated the phrenic nerve. The phrenic nerve is near the esophagus.
- When there is gas in the stomach, which presses against the diaphragm.
- Too much food is eaten.
- Food is eaten too rapidly.
- There is a sudden change in temperature.
- Fizzy drinks are consumed.
- Some people get hiccups after eating spicy foods.
- After eating dry breads.
- Many people anecdotally report hiccups after consuming alcoholic beverages.
- Some medications, such as opiates, benzodiazepines, anesthesia, corticosteroids, barbiturates, and mythyldopa are known to cause hiccups.
Some medical conditions are linked to a higher incidence of hiccups, such as:
- Gastrointestinal conditions, including IBD (inflammatory bowel disease), a small bowel obstruction, or GERD (gastro-esophageal reflux disease).
- Respiratory conditions, such as pleurisy, pneumonia or asthma.
- Conditions which affect the CNS (central nervous system), including a traumatic brain injury, encephalitis, a brain tumor, or stroke.
- Conditions which irritate the vagus nerve, such as meningitis, pharyngitis or goitre.
- Psychological reactions, including grief, excitement, anxiety, stress, hysterical behavior, or shock.
- Conditions which affect metabolism, including hyperglycemia, hypoglycemia, or diabetes.
Often, hiccups occur unexpectedly and neither the patient nor the doctor can identify their likely cause.
Possible complications of hiccups
If a patient has prolonged hiccups, complications may develop, including:
- Weight loss - in some cases the hiccups are not only long-term, but occur at short intervals, making it hard for the patient to eat properly.
- Insomnia - if the prolonged hiccups persist during the sleeping hours, the patient will find it hard to get to sleep, and/or stay asleep.
- Fatigue - people with prolonged hiccups may become exhausted, especially if they cannot sleep or eat properly.
- Communication problems - persistent hiccups may make it harder for the patient to communicate orally.
- Depression - patients with long-term hiccups have a considerably higher risk of developing clinical depression.
- Post-surgical wound healing - if the patient is hiccupping all day long, post-surgical wounds will probably take much longer to heal. Some patients may have a higher risk of developing infections, or start bleeding after surgery.
On the next page we look at tests for patients with prolonged hiccups and we examine the treatment options for hiccups.