Hiccups
Overview
What are hiccups?
Hiccups are repeated spasms of your diaphragm paired with a ‘hic’ sound from your vocal cords closing. Your diaphragm is a muscle under your ribcage, separating your chest and stomach area. This muscle is an important part of the breathing process. It moves downward when you breathe in and upward when you breathe out.
Two things happen when you hiccup:
- Your diaphragm pulls down between breaths, making you suck in air.
- The glottis (space between the vocal cords) closes to stop more air coming in.
These actions make the ‘hic’ sound of the hiccup. The process of the hiccup happens very quickly and you’ll usually return to normal within minutes to a couple of hours without treatment.
Can hiccups happen to anyone?
Yes. Hiccups can happen to adults, children and babies.
Who commonly gets hiccups?
Hiccups are more common in men. They can also have hiccups for a longer period.
Symptoms and Causes
What causes hiccups?
It’s not clear why people get hiccups. There are several reasons hiccups might happen, including low levels of carbon dioxide in the blood and irritated nerves. The phrenic nerve (which connects the neck to the diaphragm) and vagus nerve (which connects the brain to the stomach) are important parts of the breathing process.
Mild hiccups (those that go away in a short time) can happen when you:
- Eat and drink too quickly.
- Drink carbonated beverages or alcohol.
- Eat too much.
- Experience stress – including fear and excitement.
- Over-stretch your neck.
- Take drugs (particularly those for anxiety – benzodiazepines).
- Drink a very hot or very cold drink.
- Go through chemotherapy.
- Are anesthetized for a procedure.
- Inhale toxic fumes.
What does it mean if the hiccups last for more than two days?
If your hiccups don’t go away within a few days, they are called ‘persistent.’ If they last for a few months they are called ‘intractable’ (long-lasting hiccups). Long-lasting hiccups are rare. They can be stressful and exhausting. Intractable hiccups can be part of a larger, underlying medical problem and might not go away until that issue is corrected.
Some of these larger, underlying conditions include:
- Cancer and tumors.
- Stroke.
- Disorders of the stomach or esophagus, including GERD (a gastrointestinal and abdominal disorder).
- Pleurisy of the diaphragm.
- Uremia.
- Pneumonia.
- Bowel diseases.
- Pancreatitis and bladder irritation.
- Hepatitis and liver cancer.
- Tumors and lesions.
Hiccups can also happen after surgery and during the recovery process from a procedure. See a healthcare provider if your hiccups last for a long period of time.
Diagnosis and Tests
How are hiccups diagnosed?
Diagnosing hiccups is not complicated. Your healthcare provider needs only to listen to the ‘hic’ sound.
However, your healthcare provider may perform a physical examination to see if an underlying condition may be causing your hiccups. If the physical examination reveals anything of concern, he or she may order tests such as imaging tests, endoscopic tests and lab tests.
What questions might my healthcare provider ask?
- How long have you had hiccups?
- How often do you hiccup?
- Have you tried any home remedies to fix your hiccups?
- Are you interested in taking medication to fix your hiccups?
- Do you have GERD?
- Is there a history of cancer in your family? Strokes? Tumors?
- Are you experiencing any other symptoms?
Management and Treatment
How do I treat hiccups?
Because the exact cause of hiccups is uncertain, some remedies may or may not work. These home treatments will not hurt you, so there is typically no harm in trying them. Home treatments include:
- Drinking water quickly.
- Swallowing granulated sugar, dry pieces of bread, or crushed ice.
- Gently pulling on your tongue.
- Gagging (sticking a finger down your throat).
- Gently rubbing your eyeballs.
- Gargling water.
- Holding your breath.
- Breathing into a paper bag (do not use a plastic bag).
Are there any medications I can take for serious hiccups?
Hiccups that last for a long time can be treated by medication. Prescription drugs used for long-lasting hiccups include:
- Gabapentin.
- Baclofen.
- Chlorpromazine.
What are the side effects of long-term hiccups?
- Trouble eating.
- Trouble sleeping (including insomnia) and feeling tired.
- Some people feel embarrassed.
How do I stop my kid’s hiccups?
Babies get hiccups just like children, teenagers and adults. In fact, a developing fetus can get hiccups! Babies under 12 months often get hiccups and they’re unharmed by them. If you want, you can try to stop them by breastfeeding or giving them some water. However, if the hiccups don’t stop after a couple of hours, see your healthcare provider.
Kids can try the home treatments listed above.
Never hesitate to contact your pediatrician if you have a concern about your child.
Prevention
How are hiccups prevented?
Sometimes medications taken before a treatment can prevent hiccups from happening. For example, hiccups caused by anesthesia can be prevented by taking metoclopramide beforehand. Steroids with ramosetron might prevent chemotherapy-related hiccups.
Again, mild hiccups (those that go away in a short interval) can happen because of the following. Therefore, you may try to avoid the following to prevent hiccups from happening. Try not to:
- Eat and drink too quickly.
- Drink carbonated beverages or alcohol
- Eat too much.
- Experience stress – including fear and excitement.
- Over-stretch your neck.
- Take drugs (particularly those for anxiety – benzodiazepines).
- Drink a very hot or very cold drink.
- Inhale toxic fumes.
Outlook / Prognosis
How long will I have hiccups?
Hiccups can last minutes, hours, days or, if severe, weeks. The longest known and recorded bout of hiccups lasted 60 years!
Can hiccups go away on their own?
Yes. Often no treatment is needed, either home remedies or treatment provided by your healthcare provider.
Living With
Can I live a normal life with hiccups?
Hiccups shouldn’t prevent you from enjoying your daily activities.
When should I go see a healthcare provider?
If your hiccups last only minutes to a couple of hours, you probably don’t need to see your healthcare provider. However, if the hiccups last more than a few days (typically two), you should see him or her. When the hiccups happen at the same time as symptoms like a headache, trouble keeping your balance, or numbness, it can be a sign of something more serious. If you have those symptoms with hiccups, see your healthcare provider immediately or go to the nearest emergency room.
A note from Cleveland Clinic
Hiccups are usually harmless. Most stop without treatment, or with simple home remedies. They don’t reduce your quality of life. However, remember to keep an eye on how long they last. Hiccups may be a symptom of a serious illness, or they could just be annoying.
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