Causes of Hiccups overview
Everything You Need to Know About Causes of Hiccups. A hiccup is a sudden, involuntary contraction (spasm) of the diaphragm muscle. When the muscle spasms, the vocal cords snap shut, producing the hiccup sound.
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.
Causes of hiccups
Numerous causes of hiccups have been identified. However, there’s no definitive list of triggers. Hiccups often come and go for no apparent reason.
Possible common causes of short-term hiccups include:
- eating spicy food
- consuming alcohol
- drinking carbonated beverages, such as sodas
- consuming very hot or very cold foods
- a sudden change in air temperature
- swallowing air while chewing gum
- excitement or emotional stress
- aerophagia (swallowing too much air)
Hiccups that last longer than 48 hours are categorized by the type of irritant that caused the episode.
The majority of persistent hiccups are caused by injury or irritation to either the vagus or phrenic nerve. The vagus and phrenic nerves control the movement of your diaphragm. These nerves may be affected by:
- irritation of your eardrum, which may be caused by a foreign object
- throat irritation or soreness
- a goiter (enlargement of the thyroid gland)
- gastroesophageal reflux (stomach acid backing up into the esophagus, the tube that moves food from the mouth to the stomach)
- an esophageal tumor or cyst
Other causes of hiccups may involve the central nervous system (CNS). The CNS consists of the brain and spinal cord. If the CNS is damaged, your body may lose the ability to control hiccups.
CNS damage that may lead to persistent hiccups includes:
- multiple sclerosis (a chronic, degenerative nerve disease)
- meningitis and encephalitis (infections that can cause swelling in the brain)
- head trauma or brain injury
- hydrocephalus (accumulation of fluid on the brain)
- neurosyphilis and other brain infections
- overuse of alcohol
- tobacco use
- an anesthesia reaction after surgery
- certain classes of drugs, including barbiturates, steroids, and tranquilizers
- an electrolyte imbalance
- kidney failure
- arteriovenous malformation (a condition in which arteries and veins are tangled in the brain)
- cancer and chemotherapy treatments
- Parkinson’s disease (a degenerative brain disease)
Sometimes, a medical procedure can accidentally cause you to develop long-term hiccups. These procedures are used to treat or diagnose other conditions and include:
- use of catheters to access the heart muscle
- placement of an esophageal stent to prop open the esophagus
- bronchoscopy (when an instrument is used to look inside your lungs)
- tracheostomy (creation of a surgical opening in the neck to allow breathing around an airway obstruction)
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
How can hiccups in infants and babies be stopped?
As in adults, hiccups in newborns, infants, and babies are common and generally of no concern. If hiccups occur during feeding, stop feeding until the hiccups go away. Usually the hiccups will “go away” in an infant or baby.
You may try changing the position of the infant or baby; try to get your baby to burp; or calming him/her down to cure the hiccups. Sometimes resuming feeding will stop the hiccups. If your baby frequently hiccups during feedings, feed your baby when he or she is already relaxed, and is not overly hungry yet.
If your child’s hiccups worsen or they seem to upset him, contact your pediatrician.
What are the signs and symptoms of 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:
- weight loss
How to prevent hiccups
There’s no proven method for preventing hiccups. However, if you experience hiccups frequently, you can try to reduce your exposure to known triggers.
The following may help reduce your susceptibility to hiccups:
- Don’t overeat.
- Avoid carbonated beverages.
- Protect yourself from sudden temperature changes.
- Don’t drink alcohol.
- Remain calm, and try to avoid intense emotional or physical reactions.