Everyone experiences hiccups from time to time, especially after eating too much food or drinking too much alcohol. But some people get hiccups frequently for no apparent reason, and the attacks can last a long time and be distressing.
Why Hiccups Occur
Hiccups (sometimes spelled hiccoughs) are caused by sudden contractions of the diaphragm. This is the large flat muscle that lies across the body, just below the lungs. At the same time, the glottis (a flap at the top of the windpipe) shuts off the windpipe, causing the ‘hic’ sound.
It used to be thought that the diaphragm itself was the cause. Later, it was believed that the nerves that control the diaphragm (the phrenic nerves) were firing inappropriately. Now it is thought that a ‘hiccups reflex centre’ in the upper spinal cord is responsible.
An Ancient Throwback?
Hiccups may be a throwback to 370 million years ago, when our ancient ancestors lived in the ocean and breathed with gills as well as lungs (Bioessays 2003;25:182–188). They needed to hiccup to push water over their gills without it entering their lungs. Researchers think this mechanism remained because it allows babies to close the windpipe when sucking milk, so milk does not enter the lungs.
Triggers for Hiccups
Hiccups can be triggered by:
- sudden expansion of the stomach by swallowing air while eating
- sudden expansion of the stomach by excessive eating or drinking
- eating foods that are too hot or too cold
- fizzy drinks
- sudden excitement or emotional stress
- acid reflux from the stomach.
If your hiccups are very persistent there could be a medical cause such as:
- conditions that irritate nerves to the diaphragm (such as an enlarged thyroid)
- some medications (such as methyldopa for blood pressure, some tranquillizers)
- uncommonly, a low level of salt in the blood.
How to Stop an Attack of Hiccups
Everyone has their favourite method for curing hiccups. Next time you have an attack try one of the following.
- Find a drinking straw and fill a glass with water. Then press on the front of your ears to close the earhole and drink the entire glass of water without a pause. If you do not have a straw, ask a friend to press on the front of your ears while you drink from the glass without pausing (British Medical Journal 2006;333:1127).
- Pull your tongue fairly forcefully.
- Use a teaspoon to lift the uvula. This is the fleshy tag that hangs down from the back of the roof of the mouth (look at the section on snoring for a picture).
- Hold your breath for as long as possible, then swallow when you feel a hiccup is about to come.
- Pant deeply.
- Breathe into a paper bag ten times, holding the edges of the bag tightly against your face to make a good seal.
- Swallow while holding your nose closed.
- Take a teaspoonful of sugar, swallowed dry.
- Gargle with water mixed with vinegar.
- Bend forward and drink water from the wrong side of a glass.
- Chew and swallow some dry bread.
- Pull your knees up or lean forward to squeeze your chest.
Frequent, Distressing Hiccups
See your doctor if you suffer from frequent attacks of hiccups, or the attacks go on for a long time and distress you. Your doctor will give you a general check-up to make sure that there is no lung or stomach problem that is irritating the phrenic nerve, or any other cause. There are various drugs that can be used to treat extreme cases of hiccups. These include chlorpromazine, haloperidol, baclofen and some anti-epileptic drugs. All these drugs have side effects, and do not work for everyone. In very, very rare cases, surgery to cut the phrenic nerve is needed.
- Charles Osbourne, an American, hiccuped for 69 years and 9 months, from 1922 until his death in 1991
- Babies in the womb start hiccuping from the age of only 8 weeks
- Persistent hiccups are more likely in men than women
- Persistent hiccups usually decrease or disappear during sleep, but resume when the person wakes
First published on: embarrassingproblems.com
Reviewed and edited by: Dr Kevin Barrett
Last updated: October 2020