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The Truth About Hiccups

Causes and Management
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Hiccups
The word hiccup was derived from the classic sound "hic" which arises as a result of the sudden closure of your vocal cords...

Hiccup can be defined as an involuntary spasmodic contraction of the muscle at the base of the lungs (diaphragm) followed by the rapid closure of the vocal cords. It is this rapid or sudden closure of the vocal cords or voice box that produces the classic or characteristic sound known as "hic".

Medically, hiccup is known as synchronous diaphragmatic flutter or singultus (SDF). It can occur in isolation (that is individually) or in bouts. When in bout, it is often rhythmic, meaning the interval between each successive hiccup is relatively constant.

Hiccups are involuntary contractions of the muscle of the diaphragm which separates your chest from your abdomen, this muscle plays an important role in breathing. During hiccups episode, each contraction of the muscle is followed by a sudden closure of your vocal cords as explained above, which produces the characteristic "hic" sound. Hence the term hiccups. Hiccups can happen when a person's intake of air becomes momentarily blocked. Most times it can occur for no apparent reason. However, its is important to note that prolonged hiccups can indicate a serious medical problem.

Causes

Exactly how or why hiccups happen remains unclear, but some factors have been associated with a higher risk of having them. When a hiccup occurs, it is because there is a sudden, involuntary contraction or spasm of the diaphragm and the closure of the vocal cords or larynx at the same time, and consequently a total closure of the glottis. This results in a sudden rush of air into the lungs, and the familiar "hic" sound.

It is believed that, certain irritations of the nerves that extend from the neck to the chest can cause hiccups. Some of the irritants that may cause hiccups are large meal, alcohol, eating to fast, swallowing air, phrenic nerve damage, stress, stroke, noxious gas, carbonated beverages, sudden excitement, etc.

In some cases, hiccups may be a sign of an underlying medical condition. For most people, a bout of hiccups usually lasts only a few minutes. The most common causes or triggers for hiccups that last less than 48 hours include:


  • Drinking carbonated beverages,
  • Drinking too much alcohol,
  • Eating too much,
  • Excitement or emotional stress,
  • Sudden temperature changes,
  • Swallowing air with chewing gum, smoking or sucking on candy, etc.
However, when a hiccup persist for over two days, you should seek medical advice. It is believed that hiccups that last more than 48 hours may be caused by a variety of factors. Some of such possible factors can be grouped into the following categories.

Nerve damage or irritation

A more particular cause of long-term hiccups is damage to or irritation of the vagus nerves or phrenic nerves, which serve the diaphragm muscle. Factors that may cause damage or irritation to these nerves include:


  • A hair or something else in your ear touching your eardrum,
  • A tumor, cyst or goiter in your neck,
  • Gastroesophageal reflux,
  • Sore throat or laryngitis, etc.


Central nervous system disorders

A tumor or infection in your central nervous system or damage to your central nervous system as a result of trauma can disrupt your body's normal control of the hiccup reflex. Examples include:


  • Encephalitis,
  • Meningitis,
  • Multiple sclerosis,
  • Stroke,
  • Traumatic brain injury,
  • Tumors, etc.


Metabolic disorders and drugs

Long-term hiccups can be triggered by:


  • Alcoholism,
  • Anaesthesia,
  • Barbiturates,
  • Diabetes,
  • Electrolyte imbalance,
  • Kidney disease,
  • Steroids,
  • Tranquilizers, etc.


Remedies

Most of the cases of hiccups just go away after a few minutes or hours with no medical treatment. If they persist, see your doctor. Most people normally experience hiccups from time to time, and the hiccups usually resolve without any form of treatment within few minutes. However, when a hiccup persist for over two days, you should seek medical advice. Hiccups that persistently last over 2 months are known as intractable hiccups. There are a lot of recommended home remedies for treating hiccups. However, non of them are medically proven yet, since they all seem relatively safe, you should try them. Some of the highly recommended home remedies are:


  • Sip cold water slowly or gargle with very cold water,
  • Hold your breath for a short time, breath out, then do it again three or four times, and do this every 20 minutes,
  • While you swallow, place gentle pressure on your nose,
  • Place gentle pressure on your diaphragm,
  • Bite on a lemon,
  • Swallow some granulated sugar,
  • Take a tiny amount of vinegar (just enough to taste),
  • Breathe in and out of a paper bag (but never a plastic bag and never covering your head with the bag),
  • Hold your breath,
  • Sit down and hug your knees as close to your chest as possible for a short time,
  • Lean forward so that you gently compress your chest,
  • Alternative therapies may include acupuncture and hypnosis,
  • Gently pull on the tongue,
  • Biting on a lemon,
  • Rub the eyeballs,
  • Use or inhale smelling salts,
  • Have someone frighten or surprise you,
  • Put your finger in your throat to trigger a gag reflex, etc.


Complications

Some of the most probably complications of hiccups are:


  1. Weight loss and dehydration: If the hiccups are long-term and occur at short intervals, it can become difficult to eat (that is lead to eating disorder)  properly and consequently lead to dehydration and  loss of weight.
  2. Insomnia: If prolonged hiccups persist during the sleeping hours, it can be hard to fall asleep, this will lead sleeping disorder (sleeplessness).
  3. Fatigue: Prolonged hiccups can be exhausting, especially if they make it hard to sleep or eat.
  4. Communication problems: Prolonged and persistent hiccups  can make it extremely  difficult for the person to speak, this will lead to speech disorder.
  5. Depression: Long-term hiccups can increase the risk of developing clinical depression.
  6. Delayed wound healing: Persistent hiccups can make it harder for post-surgical wounds to heal, increasing the risk of infections or bleeding after surgery.


Facts about hiccups

The exact cause of hiccups remains unclear, but chronic hiccups are linked to a wide range of medical conditions, including stroke and gastrointestinal problems.

Most cases resolve without treatment, but prolonged hiccups can lead to complications such as insomnia and depression, speech disorder, etc

If hiccups last for longer than 48 hours, the person should see a doctor, who may prescribe muscle relaxants.

Avoiding alcohol and not eating too quickly can help reduce the chance of hiccups.

The longest lasting hiccups lasted for 68 years.


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