What are hiccups? – Hiccups are repeated sudden involuntary movements (spasms) of the diaphragm (a thin muscle that separates the chest from the abdomen and plays significant role in breathing). This spasm causes the vocal cords to close suddenly, producing a ‘hic’ sound. 

Type of hiccups

Hiccups can be transient or persistent. Transient hiccups last few minutes or hours and are often of no consequence, as they stop without any form of treatment, while persistent hiccups (which last longer than 24 hours) may manifest as symptoms of certain disease conditions or complications of certain drugs.

What are the causes of hiccups?

Hiccups result from irritation of the nerves controlling the diaphragm. The following may result in transient hiccups:

1. Eating too much or too fast
2. Eating very hot or very cold food
3. Eating spicy foods
4. Too much excitement
5. Swallowing too much air (especially while eating or chewing gum)
6. Drinking excess alcohol or carbonated beverages
7. Smoking

The following may lead to persistent hiccups:

1. Diseases affecting the lungs – Such as pneumonia, pulmonary embolism etc
2. Diseases affecting the intestine – Such as gastritis, gastro-oesophageal reflux disease
3. Diseases affecting the brain – Such as stroke, meningitis, Parkinson’s disease
4. Metabolic disorders that affect normal nerve functioning – Such as electrolyte imbalance, diabetes, kidney disease
5. Cancers in the chest – Such as esophageal or mediastinal tumours
6. Medications – Such as antibiotics (azithromycin), steroids (dexamethasone), sedatives (benzodiazepines), anaesthetic drugs, anti-cancer drugs etc.

What are the symptoms of hiccups?

Hiccups manifests by sudden contraction of the diaphragm that causes jerky chest movement and a ‘hic’ sound from the mouth. 

What are the treatment options for hiccup?

There is yet no specific treatment for transient hiccups. They often go without any form of treatment, when the condition(s) precipitating them resolves. If transient hiccups become worrisome, any of the following simple remedy may be tried:

1. Drinking cold water
2. Holding of breath for a while
3. Breathing into a paper bag

For persistent hiccups, treatment of the underlining conditions may likely lead to resolution of the symptom. Some medications such as omeprazole, chlorpromazine, metoclopramide etc, may help, depending on the cause. It may be necessary to discontinue or change certain medications, if they are suspected to be the cause.

How can hiccups be prevented?

It may be difficult to prevent transient hiccups because many of the causes are common day to day activities. However, the following measures may help:

1. Avoidance of intake of excess alcohol or carbonated beverages
2. Eating moderately and slowly
3. Avoidance of smoking
4. Avoidance of eating too hot or too cold food