Hiccups are an involuntary and uncontrollable contraction of the diaphragm. They are an extremely common condition that everyone experiences from time to time, but that doesn't make them any less annoying! Hiccups only last a few minutes and don't usually require any treatment, but in some very rare cases hiccups can last for a long time.
If you have hiccups that last longer than 48-hours you might have an underlying medical condition that requires further investigation. GP Dr Roger Henderson looks at common causes, treatments and how to get rid of hiccups:
What are hiccups?
Hiccups are a reflex action – in other words, they cannot be voluntarily controlled – but unlike other reflexes, such as coughing and sneezing, hiccups cannot be controlled, which makes them very frustrating sometimes.
Why do we get hiccups?
Hiccups are caused by a sudden, involuntary contraction of the diaphragm muscle just below the lungs. This then triggers the top of the windpipe (the glottis) to close and this then causes the typical 'hic' sound everyone has heard.
We all get a short bout of hiccups occasionally, usually starting and stopping for no apparent reason.
Possible hiccup triggers include the following:
- Acute stress
- Drinking fizzy drinks too quickly
- Eating too fast
- Drinking alcohol
- Sudden changes in temperature
What if you have chronic hiccups?
Persistent hiccups – defined as hiccups that last more than 48 hours – are rare. There is often no cause found for these, but their problem is that they rapidly cause emotional and physical distress in sufferers.
Possible causes for chronic hiccups include acid reflux, where acid spills into the gullet from the stomach, sometimes due to a hiatus hernia, medication such as strong painkillers, steroids and tranquillisers, and diabetes. If you have persistent hiccups, you should see your doctor to help rule out any obvious underlying cause.
How to get rid of hiccups
The vast majority of cases of hiccups do not require any treatment because they usually stop within a few minutes. However if you keep getting them it can be frustrating, so try the following tips to get rid of hiccups:
There are a great many anecdotal and popular home remedies that are said to cure hiccups, but these have little basis in fact. If your hiccups don't go away give them a try.
Examples of hiccup home remedies include:
- Hold your breath for as long as you can
- Sip iced water
- Suck on a lemon
- Ask someone to shock you!
- Hold your breath when pushing out as if you are straining on the toilet
- Pull your knees up to your chest and bend forward
- Breathe into a paper bag in your hands
- Sip water from the outside of the glass and turn your head upside down
- French kissing can help - but ask first!
To prevent hiccups try the following:
- Avoid alcoholic, fizzy or hot drinks
- Don't chew gum
- Quit smoking
- Avoid spicy food
- Eat slowly and mindfully
When to see your doctor about hiccups
If your hiccups still do not settle after 48-hours make an appointment with your doctor. They will try to work out if your hiccups are caused by an underlying health condition or any medication you're currently taking.
Treating the condition or changing your medicine should help to stop your hiccups. Tests may be considered such as blood tests, an ECG (a heart tracing) and a chest X-ray. Other tests may then be advised depending on these results and if any other medical condition is suspected.
Medications for hiccups
Medication is sometimes needed to stop persistent hiccups, although this can occasionally seem to be a case of trial and error as every sufferer of persistent hiccups responds differently.
Examples of medication treatments for hiccups include:
- Chlorpromazine to help relax the diaphragm.
- Antacid medicines, such as omeprazole or ranitidine, metoclopramide to help the stomach empty faster.
- Baclofen to help relax muscles in general.
- Newer treatments include gabapentin to help relax the nerve supply to the diaphragm and intravenous ketamine, although this is given only by specialists in a hospital setting.
Medical devices for hiccups
If all else fails, pacemaker devices have been used to influence the vagus and phrenic nerves, and blocking the phrenic nerve can be considered too, but this is a high-risk procedure because of its possible impact on breathing.
Last updated: 15-04-2021