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.
Possible common causes of short-term hiccups include:
- 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)
- irritation of your eardrum, which may be caused by a foreign object
- throat irritation or soreness
- 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
- 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
Hiccups that last for longer periods also can be caused by:
- an anesthesia reaction after surgery
- certain classes of drugs, including barbiturates, steroids, and tranquilizers
- 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)
- 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
- 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
Treating Hiccups
- Breathe into a paper bag.
- Eat a teaspoon of granulated sugar.
- Drink a glass of cold water.
- Lift your uvula with a spoon. Your uvula is the fleshy piece of tissue that is 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.
- blood tests to identify signs of infection, diabetes, or kidney disease
- imaging of the diaphragm with a chest X-ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI) scan
- echocardiogram to assess heart function
- endoscopy, which utilizes a thin, lighted tube with a camera on the end to investigate your esophagus, windpipe, stomach, and intestine
- bronchoscopy, which utilizes a thin, lighted tube with a camera on the end to examine your lungs and airways
- 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 is no way to anticipate hiccups. With each spasm, there usually is a slight tightening of the chest or throat prior to your making the distinctive hiccup sound.
Most cases of hiccups start and end abruptly, for no discernable reason. Episodes generally last only a few minutes. Hiccups that last longer than 48 hours are considered persistent. Hiccups that last longer than two months are considered intractable, or difficult to manage.
Prolonged hiccups affect men much more than women. When attacks last longer than a month, the hiccups are termed intractable
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:
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:
Sometimes, a medical procedure can accidentally cause you to develop long-term hiccups. They can be caused by procedures used to treat or diagnose other conditions, including:
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:
Most hiccups are not an emergency. However a prolonged episode can be uncomfortable and disruptive to daily life. Contact your physician if you have hiccups that last longer than two days. Your doctor 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:
If you still have hiccups after 48 hours, talk to your doctor. Your physician 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 physician 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:
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:
To be continued next week.
Doctor Christian writes for Info 247 Plus
