Hiccups happen when a person’s intake of air becomes momentarily blocked. It can happen for no apparent reason. It is usually a minor nuisance, but prolonged hiccups can indicate a serious medical problem.

When a hiccup forms, it is because of a sudden, involuntary contraction of the diaphragm at the same time as a contraction of the voice box, or larynx, and the total closure of the glottis, which is where the vocal cords are located. As a result, there is a sudden rush of air into the lungs, accompanied by the familiar “hic” sound.

Hiccups are medically known as synchronous diaphragmatic flutter or singultus. They can occur individually or in bouts. They are often rhythmic, meaning that the interval between each hiccup is relatively constant.

Most people have hiccups from time to time, and they usually resolve without treatment within a few minutes.

Rarely, there may be prolonged or chronic hiccups, which can last for a month or longer. Hiccups that last for longer than 2 months are known as intractable hiccups.

If a bout of hiccups lasts for longer than 48 hours, this is considered persistent, and the person should contact a doctor. This tends to be more common in men than women and could signify a more serious medical condition.

Fast facts on hiccups

  • The exact cause of hiccups remains unclear, but experts have linked chronic hiccups to a wide range of conditions, including stroke and gastrointestinal problems.
  • Most cases resolve without treatment, but prolonged hiccups can lead to complications such as insomnia and depression.
  • If hiccups last for longer than 48 hours, the person should contact a doctor, who may prescribe muscle relaxants.
  • Avoiding alcohol and not eating too quickly can reduce the chance of experiencing hiccups.

Share on Pinterest
CasarsaGuru/Getty Images

The National Organization for Rare Disorders describes hiccups as “an involuntary spasmodic contraction of the muscle at the base of the lungs (diaphragm) followed by the rapid closure of the vocal cords.”

A wide range of underlying conditions can trigger chronic or persistent hiccups.

Exactly how or why short bouts of hiccups happen remains unclear, but experts have linked some factors to a higher chance of experiencing them. The sections below look at some of these factors in more detail.

Lifestyle factors

The following may trigger hiccups:

  • eating hot or spicy food that irritates the phrenic nerve, which is located near the esophagus
  • having gas in the stomach that presses against the diaphragm
  • eating too much or causing stomach distension
  • drinking sodas, hot liquids, or alcoholic drinks, especially carbonated drinks
  • experiencing stress or strong emotions

Some medications — such as opiates, benzodiazepines, anesthesia, corticosteroids, barbiturates, and methyldopa — can also cause hiccups.

Medical conditions

Often, hiccups occur unexpectedly, and neither the person nor the doctor can identify their likely cause.

However, doctors have linked chronic hiccups to several conditions. These include:

Other conditions that may be related to hiccups include bladder irritation, liver cancer, pancreatitis, pregnancy, and hepatitis. Surgical procedures and lesions may also be risk factors.

Infants may experience hiccups more frequently during or after feeding, as they may swallow food too quickly or overfeed. Hiccups could also be a sign of an infant being full. Therefore, pediatricians typically recommend short feeds with burping breaks.

Hiccups may also occur due to an infant’s breathing and swallowing not yet being in sync. In turn, this can cause an infant to draw breath and swallow, which can produce a hiccup.

Hiccups in infants may also result from changes in stomach temperature. For example, this may be the case if they consume a cold drink then have something warm to eat.

Generally, hiccups tend to be a sign of healthy growth and development. However, frequent hiccups may also result from GERD, which is a common and easily treatable condition in infants.

Hiccups alone are not a sign of reflux. Some other possible symptoms in infants with suspected GERD include:

  • crying more frequently
  • arching the back excessively during or after feeds
  • spitting up more often than usual

Parents and caregivers should consult a pediatrician if they notice that their infant is experiencing several symptoms and suspect that reflux may be causing them.

Most cases of hiccups go away after a few minutes or hours with no medical treatment. If they persist, however, a person should contact a doctor. The following tips may help, but their effectiveness remains unclear.

Tips for getting rid of hiccups

The following tips may help get rid of hiccups:

  • Sip ice-cold water slowly or gargle with very cold water.
  • Hold the breath for a short time, then breathe out. Do this three or four times every 20 minutes.
  • While swallowing, place gentle pressure on the nose.
  • Place gentle pressure on the diaphragm.
  • Bite on a lemon.
  • Swallow some granulated sugar.
  • Take a tiny amount of vinegar, just enough to taste.
  • Breathe in and out of a paper bag. Never use a plastic bag for this, and never cover the head with the bag.
  • Sit down and hug the knees as close to the chest as possible for a short time.
  • Lean forward to compress the chest gently.
  • Try an alternative remedy, such as acupuncture or hypnosis.
  • Gently pull on the tongue.
  • Rub the eyes.
  • Gently touch one finger to the throat to try to trigger a gag reflex.

Many of these tips have been passed down through generations. They may be effective for some people, but there has been little research to support their use.

Medications

If a person has an underlying condition, managing it will probably resolve the hiccups.

If prolonged hiccups are interfering with a person’s quality of life, a doctor may prescribe a medication.

Chlorpromazine is the first-line treatment, as it is the only medication with Food and Drug Administration (FDA) approval to treat hiccups.

A doctor may recommend the following medications for hiccups if there appears to be no underlying condition:

  • metoclopramide (Reglan), which is an antinausea medication that may help some people with hiccups
  • baclofen (Lioresal), which is a muscle relaxant (off-label use)
  • gabapentin, which is an antiseizure medication that doctors commonly prescribe for neuropathic pain and that can help alleviate the symptoms of hiccups (off-label use)

Ephedrine or ketamine can treat hiccups related to anesthesia or surgery.

For hiccups, doctors usually prescribe a low-dose, 2-week course of medication. They may gradually increase the amount until the hiccups are gone. The course and dosage will depend on the severity of the hiccups, the person’s general health, and age.

Surgery

In severe cases that do not respond to other treatments, a surgeon may inject medication into the phrenic nerve to temporarily block the nerve’s action or sever the phrenic nerve in the neck.

Prolonged hiccups can lead to complications such as:

  • Weight loss and dehydration: If the hiccups are long term and occur at short intervals, it can become difficult to eat.
  • Insomnia: If prolonged hiccups persist during the sleeping hours, it can be hard to fall asleep or stay asleep.
  • Fatigue: Prolonged hiccups can be exhausting, especially if they make it hard to sleep or eat.
  • Communication problems: It can be difficult for the person to speak if they have hiccups.
  • Depression: Long-term hiccups can increase the risk of developing clinical depression.
  • Delayed wound healing: Persistent hiccups can make it harder for post-surgical wounds to heal, thereby increasing the risk of infections or bleeding after surgery.

Other potential complications include an irregular heartbeat and GERD.

Hiccups that last for under 48 hours do not usually need any medical attention because they typically resolve on their own. If they persist for longer than this, the person should consult a doctor.

The doctor may ask:

  • when the hiccups began
  • how often they occur
  • if they are happening all the time
  • what the person was doing before the hiccups started

They will likely perform a general physical examination and a neurological exam to check the person’s:

  • reflexes
  • balance
  • coordination
  • eyesight
  • sense of touch
  • muscle strength
  • muscle tone

If an underlying condition may be the cause, the doctor may order the following tests:

  • blood tests to check for infections, kidney disease, or diabetes
  • imaging tests — such as an X-ray, CT scan, or MRI scan — to assess for any anatomical irregularities that may be affecting the phrenic or vagus nerves or the diaphragm
  • an endoscopic test, in which a healthcare professional passes an endoscope — which is a flexible tube with a small camera at the end — down the person’s throat to check the windpipe or esophagus
  • en electrocardiogram to check for heart-related conditions by measuring electrical activity in the heart

Some causes of hiccups are preventable. A few ways to reduce the chance of experiencing hiccups include:

  • avoiding sudden changes in temperature
  • not drinking alcohol or sodas
  • eating moderately and not too quickly

Most hiccups are brief and go away after a short while. However, if they persist or cause worrying symptoms, the person should contact a doctor.