What Are Hiccups?
Once is funny, twice is hilarious, and anything more than that is usually just annoying. We’ve all had them, but do you actually know where they come from? They’re hiccups, and they’re the strange little sounds that can escape from your mouth without warning.
Hiccups start much lower in your body, in the diaphragm — the dome-shaped muscle between your lungs and stomach. Normally, the diaphragm pulls down when you inhale to let air into your lungs, and then relaxes when you exhale so air can flow back out of your lungs to exit your nose and mouth.
But if something irritates your diaphragm, it can cause an involuntary spasm, forcing you to suddenly suck air into your throat, where it hits your voice box. That makes your vocal cords suddenly close, creating the distinct “hic!” sound.
The medical term for hiccups is singultus, which comes from the Latin word "singult," meaning "to catch your breath while sobbing."
What Causes Hiccups?
Hiccups can happen for a lot of reasons -- some of them are physical and some emotional. That’s because the actual irritation happens in the nerve connecting the brain to the diaphragm. Some common causes include:
- Eating too much or too quickly
- Feeling nervous or excited
- Drinking carbonated beverages or too much alcohol
- Stress
- A sudden change in temperature
- Swallowing air while sucking on candy or chewing gum
Can some drugs cause hiccups?
Sometimes, the general anesthesia drugs used to sedate you for surgery can cause hiccups. Other drugs that can cause ongoing hiccups include:
- Azithromycin (brand name Zithromax), which is an antibiotic
- Dexamethasone, a corticosteroid used to treat skin, joint, and lung inflammation as well as conditions such as allergies, asthma, arthritis, blood disorders, and adrenal disease
- Low doses of benzodiazepines, a class of drugs used to treat anxiety and seizures
- Dopamine agonists, used to treat movement disorders such as Parkinson's disease
- Certain chemotherapy drugs for cancer
Hiccups in the womb
Around the fourth or fifth month of your pregnancy, you may feel jerking inside your stomach or even see these movements on your stomach. These rhythmic, jerking movements are usually hiccups. When your fetus hiccups, it's a normal response. These hiccups usually go away on their own after a while but may sometimes last as long as an hour.
Hiccups after eating
You may get a temporary case of hiccups after eating:
- Too much
- Too fast
- Spicy foods
- Foods that are too hot or too cold
You can also get hiccups from carbonated drinks or drinking too much alcohol.
Emotional hiccups
The phrenic nerve is used by your brain to regulate the diaphragm. A scare, shock, or nervous reaction can irritate the phrenic nerve and trigger a spasm in your diaphragm, causing hiccups.
Types of Hiccups
Hiccups are typed by how long they last.
Transient hiccups
These are the types of hiccups everyone gets, which are several seconds or minutes long.
Persistent hiccups (long-term hiccups)
Hiccups are usually temporary, but in rare cases, they can stick around -- for a while. It’s usually because of damage or aggravation to the nerves connected to the diaphragm. Various factors, from a hair touching your eardrum to a sore throat, can affect these nerves. In more serious cases, a tumor, goiter, or cyst in the neck can damage them.
Hiccups that last longer than 48 hours can also be because of central nervous system disorders such as encephalitis or meningitis, or metabolic disorders such as diabetes or kidney failure. Drugs such as steroids or some tranquilizers can trigger long-term hiccups too.
Certain procedures, especially ones that require anesthesia, can also give you hiccups. If you’ve been hiccupping for more than 2 days, or if they are severe enough to cause you distress or interfere with eating, breathing, or sleeping, you should see your doctor.
Also, talk to your doctor immediately if you have any kind of stomach pain, fever, shortness of breath, vomiting, or if you are coughing up blood with your hiccups.
Recurrent hiccups
These are hiccups that keep returning and last longer than a couple of minutes.
Hiccups in newborns
Newborn babies typically get hiccups after eating. If your baby eats too much or too fast, their stomach can expand and press on the diaphragm, causing it to spasm. Other times, hiccups may be caused by gastric reflux or by taking in too much air while breastfeeding or bottle-feeding.
How to Get Rid of Hiccups
If you’re hoping that hanging upside down or having a friend scare you will get your hiccups to stop, there’s no scientific proof that these remedies work.
Home remedies
If your hiccups don't stop after a few minutes, some experts believe holding your breath or breathing into a paper bag will help. Both techniques make carbon dioxide build up in your lungs, which might relax the diaphragm.
Other remedies that sometimes work include:
- Taking sips of cold water
- Gargling with ice water
- Drawing your knees to your chest and leaning forward
- Swallowing granulated sugar
- Biting into a lemon
Medications
If all else fails, and your hiccups continue for several days or more, your doctor may try different medications to see if they can put an end to those uncomfortable hiccups. Your doctor will decide which of these medicines might work best for you, depending on what's causing your hiccups.
- Baclofen, used for muscle spasms
- Chlorpromazine, a dopamine regulator
- Gabapentin, which calms the brain's nerve cells
- Metoclopramide, which helps muscles in your digestive tract
- Proton pump inhibitors, which work to reduce stomach acid
Vagal nerve stimulation
Two nerves are involved in hiccups — the phrenic nerve and the vagus nerve. Drinking cold water to get rid of your hiccups is thought to work by overstimulating the vagus nerve. There has been some experimentation with a procedure called vagal (or vagus) nerve stimulation, which is typically used to treat epilepsy, to stop long-term hiccups. Vagal nerve stimulation uses an implanted device to deliver electrical impulses to the vagus nerve. There have been a small number of cases where this treatment has been temporarily or partially effective, but in other cases, it has had no effect at all. Currently, the FDA has not approved vagal nerve stimulation for the treatment of long-term hiccups.
How to get rid of baby hiccups
If your baby's hiccups are minor and not caused by something like reflux (stomach acids flowing back into the esophagus), here are some ways to try to get rid of them:
- Move your baby to a more upright position during feed or prop a newborn up on a pillow
- Burp your baby after every 2 to 3 ounces they drink; breastfeeding mothers should burp before switching sides
- Give your baby a pacifier; sucking it may help relax their diaphragm
- Pat your baby gently on the back
Other hiccup cures
None of these remedies are scientifically proven, but the following are some home remedies believed to stop transient hiccups:
- Pulling your tongue out forcefully
- Triggering your gag reflex
- Using a modified Heimlich maneuver with three thrusts below your rib cage every 10 seconds
- Drinking vinegar
- Eating peanut butter
- Inserting a tube up your nose until it reaches a stopping point for 20 seconds
- Putting a cold compress on your face
- Inducing a cough
When Should You Worry about Hiccups?
See your doctor if your hiccups last longer than 2 days or if they begin to interfere with your sleep, eating, or breathing. Sometimes, prolonged hiccups can be a sign of:
- Nerve damage
- Central nervous system issues
- Metabolic conditions
- Reactions to certain drugs (prescribed or illicit) and alcohol
Why do I keep getting hiccups?
Most of the time, there's no noticeable reason for your hiccups, but heightened emotions (such as fright and excitement), stress, and eating and drinking can all trigger hiccups.
Hiccups Complications
It's rare to have any lasting or harmful complications from hiccups. However, ongoing hiccups can cause persistent discomfort, difficulty eating, reflux, low carbon dioxide levels in your blood, loss of sleep, slow wound healing, and mental health issues. An even rarer complication of particularly forceful hiccups is something called a Mallory-Weiss tear, a bleeding rupture of the lower esophagus.
Takeaways
Most times, hiccups end as quickly as they begin. But sometimes, hiccups can last longer and interfere with eating, sleeping, breathing, swallowing, or talking. Hiccups are caused by irritation or damage to a set of nerves that help your diaphragm to contract, including the vagus and phrenic nerves, which are the part of the central nervous system that manages your body's involuntary responses. If your hiccups last longer than a minute or so, try a home remedy such as holding your breath, drinking water, breathing into a paper bag, or gargling with ice water. If they last longer than 48 hours, contact your doctor.
Hiccups FAQs
How often is too often for hiccups?
If your hiccups come and go frequently and impact your quality of life, you should have them checked out. If you get transient hiccups often, it helps to eat and drink more slowly, eat smaller meals, limit carbonated drinks and alcohol, and avoid very hot or very cold foods.
When should hiccups be a concern?
See your doctor if your hiccups last longer than 2 days or if they interfere with sleep, eating, and breathing.
Is it OK to lie down with hiccups?
Hiccups during sleep are rare. However, if your hiccups interfere with your sleep or breathing, contact your doctor.
How long do hiccups last?
Transient hiccups only last for a minute or two and usually go away without any remedy. Persistent hiccups can impact you for days, weeks, or months.
Where should I rub to get rid of hiccups?
Closing your eyes and gently pressing on your eyeballs is one folk remedy for stopping hiccups. Touching certain pressure points on your body (acupressure) may help too. Do one of these techniques or all of them one at a time.
Jaw: Press the small indent behind your earlobe for a minute or two while taking deep breaths and release.
Chest: Place both index fingers on the indent at the base of your neck and slide them an inch lower; slide your fingers outward until you feel tender points in the muscle layer beneath your collar bones.
Upper lip: Place an index finger in the indent between the tip of your nose and your top lip. Press firmly for 20-30 seconds while taking a deep breath and let go.
