Hiccups
What are hiccups?
Hiccups (also known as hiccoughs or singultus) are involuntary contractions or spasms of your diaphragm muscle. Your diaphragm is a dome-shaped muscle that sits beneath your lungs which helps you breathe. Three things happen simultaneously when you have the hiccups:1
1. your diaphragm muscle contracts suddenly
2. your larynx (or voice box) contracts at the same time
3. the flap at the top of your windpipe (epiglottis) quickly shuts
When these three things happen together, you get the typical ‘hic’ sound of hiccups.
Almost everyone will experience hiccups at some time in their life. Hiccups are usually harmless and often go away within a few minutes.
What causes hiccups?
The exact cause of hiccups is unknown. However, they seem to occur when your diaphragm is irritated in some way.2 Factors that increase the likelihood of hiccups include:3 4
- eating too quickly or overeating
- eating hot and spicy foods
- drinking too much alcohol
- carbonated drinks
- hot drinks
- indigestion
- stress, fear or excitement
- irritated stomach
- smoking
- swallowing air, particularly when chewing gum or sucking on candy
- pregnancy
What about persistent hiccups?
Fortunately, most hiccups go away within a few minutes. However, in rare cases hiccups may last for 48 hours or more. These are defined as persistent or chronic hiccups and may be caused by an underlying injury, condition, or medication.5
Medical conditions that may cause persistent hiccups include6 7 8:
- heartburn or gastro-oesophageal reflux disease (GORD)
- oesophagitis (inflammation of the oesophagus)
- pneumonia
- pleurisy
- asthma
- kidney disease
- chest or abdominal surgery
- overactive thyroid
- brain injury caused by stroke, tumour, or trauma
- disorders of the central nervous system, including multiple sclerosis and stroke
- diabetes
- damage or irritation to the nerve serving the diaphragm muscle, caused by:
o sore throat or laryngitis
o tumour, cyst or goitre
o reflux
o a hair or other foreign matter touching your ear drum
Medications that can contribute to persistent hiccups include9:
- anaesthetics
- corticosteroids
- chemotherapy
- medications used for anxiety, blood pressure, pain relief, and seizures
What are complications of hiccups?
Hiccups are usually just a nuisance and go away within in a few minutes with no long-term complications. However, persistent or chronic hiccups may lead to10:
- fatigue
- weight loss
- malnutrition
- insomnia
- psychological distress such as anxiety or depression
- gastrointestinal problems, including vomiting
When to see a doctor?
If your hiccups continue for 48 hours or more, you should visit your doctor, as there may be an underlying condition causing your hiccups. You should also visit your doctor if your hiccups are causing you distress, or making it hard for you to eat or breathe. To determine the cause, your doctor may order a number of tests. These include:11
Persistent or chronic hiccups, may be treated with:12 13
- treating the underlying disorder causing the hiccups
- changes to current medications and dosages
- medications such as tranquilisers, muscle relaxants, anti-seizure medications, pain medications or stimulants
- acupuncture
- physical manoeuvres or therapy
- nasogastric intubation (inserting a tube into the nose)
- nerve block
- surgery to sever the nerves servicing the diaphragm
Depending upon the underlying cause of your persistent hiccups, you might also be referred to a specialist, such as a gastroenterologist or neurologist for further treatment.
Most of the time, hiccups will go away by themselves with no need for any treatment or intervention. There are many strategies promoted as ‘cures’ for hiccups, although evidence for these is more anecdotal than scientific. Strategies you could try include:
- slowly sip cold water
- hold your breath, and then release it slowly when you are unable to hold it any longer
- breathe deeply into a paper bag
- drink hot water and honey
- gargle with water
- sit down with your head over your knees
- get someone to scare you
How TerryWhite Chemmart can help
Hiccups can be caused by numerous factors, including medication. At TerryWhite Chemmart we can help you manage your health with a Medication Review, where one of our pharmacists will review your medication and discuss which ones may be contributing to your hiccups, and how we can best help you manage them. Our friendly pharmacists can also provide advice on products that may assist with other digestive symptoms, or may refer you to your doctor for further treatment.
