Hiccups

Hiccups

Alternate Names

  • diaphragmatic spasms

Definition

Hiccups are a sound produced by an unintentional contractions of the diaphragm, followed by rapid closing of the vocal cords. The diaphragm is the muscle that separates the abdominal cavity from the chest cavity.

What is going on in the body?

Hiccups can develop when a stimulus triggers the nerves that contract the diaphragm. Air is then inhaled involuntarily. This lowers the diaphragm and allows bursts of air into the lungs. The air closes the vocal cords and creates the characteristic hiccup sound.

Risks

What are the causes and risks of the condition?

The cause of the diaphragm contractions is unknown. The condition can be related to:
  • nervousness
  • overeating
  • esophagitis, or irritation of the lining of the esophagus
  • indigestion
  • drinking carbonated beverages
  • pregnancy
  • drinking alcohol
Sometimes hiccups are a complication of a condition, such as pneumonia. They may occur following chest or stomach surgery. A brain tumor or stroke can interfere with the breathing center in the brain and cause hiccups.

Prevention

What can be done to prevent the condition?

A person who is prone to hiccups should:
  • eat more slowly
  • eat smaller portions
  • stop smoking, if he or she smokes

Diagnosed

How is the condition diagnosed?

If hiccups continue for so long that the person visits a healthcare professional, a medical history and physical exam are done. Tests are not needed unless a disease or disorder is suspected as the cause.

Long Term Effects

What are the long-term effects of the condition?

Most bouts of hiccups are harmless. They begin suddenly, usually without any obvious cause, and usually stop after several seconds or minutes. Frequent, prolonged attacks of hiccups, which are extremely rare, may lead to severe exhaustion.

Other Risks

What are the risks to others?

Hiccups are not contagious, and pose no risk to others.

Treatments

What are the treatments for the condition?

Most of the remedies for the occasional bout of hiccups are based on altering the flow of air passing through the vocal cords. A person may be able to stop ordinary hiccups by breathing deeply or by holding his or her breath for a short time.
Slowly breathing into a paper bag may also be helpful, though it should only be attempted when another person is nearby, to prevent suffocation. Most cases of hiccups go away on their own.
Some natural or home remedies that are said to speed the process include:
  • eating ginger
  • squirting lemon juice to the back of the throat
  • sucking on slices of fresh lemon
  • sipping water and honey
  • swallowing a teaspoon of granulated sugar
Medical treatments are rarely needed. One of several medications may be used in cases of prolonged hiccups. These include:
  • scopolamine (i.e., Scopace),
  • prochlorperazine (i.e., Compazine),
  • chlorpromazine (i.e., Thorazine),
  • haloperidol (i.e., Haldol),
  • phenytoin (i.e., Dilantin, Pehnytek),
  • baclofen (i.e., Kemstro),
  • metoclopramide (i.e., Reglan),
  • nifedipine (i.e., Adalat, Procardia),
  • amitriptyline (i.e., Elavil),
  • gabapentin (i.e., Neurontin), and
  • valproate (i.e., Depacon).

Side Effects

What are the side effects of the treatments?

Side effects depend on the medication used, but may include dry mouth and allergic reaction.

After Treatment

What happens after treatment for the condition?

The person can go back to usual activities after an ordinary bout of hiccups. If an underlying condition is causing the hiccups, it may need to be treated.

Monitor

How is the condition monitored?

The person can monitor hiccups at home, and should tell the health care professional about any new or worsening symptoms.

Sources

Merck Manual Home Edition

The Illustrated Encyclopedia of Natural Remedies, Norman Shealy

Take Care of Yourself, Donald Vickery and James Fries

Dr. Koop's Self-Care Advisor, Time-Life Medical, 1996

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