Most of us have already had hiccups, they appear suddenly and easily become annoying for us and everyone around us. There are endless home remedies to end hiccups, especially online or from your relatives. However most of these methods don’t work properly. Therefore, in this article we present you recommendations from public health authorities, such as Centers for Disease Control (CDC) and Prevention and the British Nacional Health Service (NHS).
Hiccups are characterized by being brief involuntary contractions of the diaphragm and it van be caused by the irritation of the muscles extending from the chest to the neck. This irritation can be caused by many factors, such as eating too fast and as result swallowing air, chewing gum, smoking, excessively eating or drinking, strokes brain tumors, damage on the phrenic nerve or vagus, medication, noxious fumes, anxiety and stress. Babies are especially prone to develop hiccups since they are more sensitive. In this case hiccups can be caused by excessive crying, coughing or gastroesophageal reflux.
Hiccups usually pass on their own, without the need of medical intervention, although if they become frequent, chronic or persistent (lasting more than 3 hours), if you feel like hiccups are interfering with your sleeping pattern, with your eating habits (causing reflux or vomiting), causing severe abdominal pain, fever, shortness of breath, spitting blood or if you feel like your throat is going to close up, you should seek the help of a doctor.
You’ve probably heard of endless home remedies for getting rid of hiccups (like holding your breath, drinking a glass of water quickly, being frightened or surprised, use smelling salts, pulling your tong hardly and many others).
In this article we present you the main causes of hiccups, how you can prevent them and how to easily treat them or making them go away. Also, we will give you recommendations in case they won’t stop. Keep up with us!
1. What are Hiccups?
Medically speaking, hiccups are known as synchronous diaphragmatic flutter or singultus. Physiologically, hiccups occur when there is a sudden involuntary contraction of the diaphragm while the voice box contracts and there is a closing of the vocal folds, causing a short blocking oh the flow of air. These contractions happen repeatedly so the opening between the vocal box and the constriction of the air flow makes a characteristic sound. An easier definition for hiccups is as brief and irritable spasms of the diaphragm occurring for a few seconds or even minutes. Their duration is usually short and don’ require medical assistance.
Usually hiccups aren’t related to any serious problems and their reason to happen sometimes isn’t totally clear to the doctors.
A recent study (from 2012) suggests that, since mammals are the only living beings that suffer with hiccups, it might be a reflex developed to allow them the coordination between suckling milk and breathing to avoid choking. This theory also suggests that this evolution happened to allow the air trapped in the babies’ stomach would escape to allow more milk to be ingested. This hypothesis may suggest that the air bubble that is formed in the stomach stimulates the sensory reflex limb at the receptors all over from the stomach, esophagus and diaphragm, leading to the hiccup. The hiccup created suction in the chest making the air traped in the stomach to escape through the mouth. Infants usually have more hiccups that adults, supporting this theory all along.
A group of scientists believe that the hiccups are a evolutionary remnant of the earlier amphibian respiration. Usually amphibians (like tadpoles) gulp air and water from their gills within a simple motor reflex very similar to the mammal hiccup. This motor develops during the early fetal development even before the motor that allows the normal lung ventilation, this means that the hiccups are an evolutionary antecedent of the modern lung respiration present in mammals.
2. How Can You Get Hiccups?
Hiccups can have many causes to occur, the most common (for the acute cases, the ones that last less than 48 hours) are usually caused by drinking carbonated beverages, drinking excessive amounts of alcohol or eating too much, emotional stress or extreme excitement, sudden temperature changes, swallowing air while eating too fast, chewing gum of sucking candy.
If hiccups last for more than 48 hours there are another causes to look after and usually more to look after at. These causes include nerve damage or irritation (irritation on the vagus nerves or phrenic nerves) that can be caused by a hair or a small object inside your ear and constantly touching your eardrum, tumors, cysts or goiter in the neck, gastroesophageal reflux or even sore throat or laryngitis. Central nervous system disorders are also known for causing long term hiccups, these include tumors or infections in the central nervous system if they cause trauma’s that can disrupt the body’s normal control of hiccups, these include encephalitis, meningitis, multiple sclerosis, stroke, traumatic brain injury, tumors and metabolic disorders and using some drugs.
Longer term hiccups can also be triggered by other factors such as alcoholism, anesthesia, barbiturates, diabetes, electrolyte imbalance, kidney disease, steroids, tranquilizers. Man are way more susceptible to develop long term hiccups.
If you have a surgical history of abdomen surgeries, a comprehensive drug history (with abuse of one or even multiple substances), depression or any other mental disorder, arrhythmia-induced syncope, gastroesophageal reflux, inflammatory bowel disease, hiatus hernia, lost a lot of weight recently, have asthma, pneumonia, pleurisy, myocardial infraction, pericarditis, goitre, pharyngitis, meningitis, multiple sclerosis, hypoglycemia, hyperglycemia, Addison’s disease or suffer from insomnia you have a higher risk of developing hiccups. Mental or emotional issues (anxiety, stress and excitement) or some surgeries (due to the anesthesia or procedures including abdominal organs) can also make you develop hiccups since they can interfere with your brain and abdomen muscles.
3. Treat Hiccups
Fortunately, hiccups (besides being terribly annoying) have easy treatments that you can easily perform at home. Health institutions have recommended treatments to ease the process. One of the recommendations consists in controlling your breathing and posture, try to hold your breath for 10 seconds and then breathe out slowly, repeat this process for three or four times. If it doesn’t result at first, repeat it 20 minutes later. You can also try to breathe into a paper bag, but be careful, don’t put it around your head, only around your mouth. You may also want to try to bring your knees to your chest and hug them for about 2 minutes, the light compression of your chest will lead to improvements in reducing the involuntary contractions. You can also try to eat or drink something light or gargle with iced water.
You’ve probably already heard that placing a couple drops of vinegar in your mouth, placing granulated sugar on the tongue letting it melts and swallowing it, sipping very cold water slowly, drinking all a warm glass of water slowly all the way down, sucking a thin slice of lemon, burping with the help of a fizzy drink, pressuring point on your chest, pulling your tongue or breathing to a paper bag (to increase the CO2 present in your stomach and allow the O2 to get out) can help you to stop your hiccups. These home remedies can easily be performed at any time with satisfactory results. Other people recommend holding your breath while thinking of 3 known bald man or counting from 20 to zero to make your hiccups go away. These methods can be helpful in making hiccups go away.
Although most hiccup cases go away in a few minutes or hours, some take longer to go away and may need the help of a professional. If your hiccups don’t go away, you should seek for a doctor. He would likely prescribe medication if you are unable to eat and/or are losing weight, have constant trouble sleeping or insomnia, display signs and/or symptoms of a clinical depression. The most commonly prescribed drugs to treat hiccups are baclofen (it acts as a muscle relaxant, inhibiting the involuntary contractions), chlorpromazine (an antipsychotic, in case you are dealing with depression or some mental health disorder), gabapentin (prescribed for treating epilepsy and hiccups), haloperidol (another antipsychotic medication), metoclopramide (commonly prescribed to treat nausea).
Generally, doctors will reserve medication as a final resort having tried other options. Medications will also only be prescribed for severe and longer-term hiccups.
Treatment for getting rid of the hiccups depends on how severe the hiccups are.
Keep in mind that hiccups usually stop on their own and most of them don’t need any medical treatment. Although if you have hiccups for more than 2 days your probably suffer from severe or persistent hiccups and you should seek for a doctor, whom probably will manage to make you try some medication. Extreme cases might need surgery to block the phrenic nerve or implanting an electronic stimulator.
4. Prevention of Hiccups
As many other diseases/conditions, hiccups can be prevented. If you want to prevent yourself from having hiccups you should avoid drinking alcoholic beverages, quit or avoid smoking, eating or drinking too quickly, having carbonated drinks, eating spicy foods, have sudden changes in the stomach temperature on eating and/or drinking, aerophagia, sudden changes in your glycemic index, the room temperature, extreme emotions, swallowing air while chewing gum or having candy.
Aside all this prevention recommendation, if you feel like you are suffering from any health condition that may lead to hiccups, you should look out for a doctor.
5. Seeking For Medical Help
In most cases, hiccups don’t need medical assistance, but if you have been suffering from it for an extended period of time and it is affecting your everyday you should seek for consulting your family, children should see a pediatrician.
If you are seeking for a specialist, you might want to look for a otolaryngologist (throat, ear, nose specialist), a gastroenterologist (a doctor whose specialty is the digestive tract), a neurologist (specialist in the brain and nervous system), pulmonologist (lung specialist) or even a psychologist or a psychiatrist.
You should find a doctor if your hiccups are persistent (from 3 hours to 2 days) or if they are interfering with your regular life patterns, like sleeping, eating, causes you reflux or makes you vomit. Be careful if you also feel severe abdominal pain, fever, shortness of breath, spit up blood or feel that your throat is about to close.
Your diagnosis will be based on a physical evaluation, usually laboratory tests aren’t necessary and are only performed when there is a suspect on a severe medical condition. After this the doctor will decide which treatment will be the most indicated to treat your condition.
As we told you before, severe or chronic hiccups won’t be cured at home and some cases might need a special intervention (anesthesia to block the phrenic nerve, surgical implantation of electronic stimulators to the vagus nerve or, as a last resort, disable the phrenic nerve).
6. Prognostic and Outlook
In most cases, hiccups go away on their own in a brief period, meaning that the prognosis is good. Although in some cases they can persist and have a negative impact on your everyday life, for most people they stop by themselves without having any lingering effects on your body and health. They also rarely require medical treatment, but in some cases, it might be needed to avoid worst consequences. If you feel like hiccups are making you have a tough time in your daily activities and cause you social distress you should look for a specialist help.
7. Hiccups in Babies
Babies are extremely sensitive to hiccups and they tend to suffer a lot from them since they don’t understand what is happening either them at the moment. The truth is, hiccups are part of the normal baby development and usually it shouldn’t disturb them much, although it can disrupt feeding and sleeping making them upset and the parents worried.
Since they are more sensitive, hiccups are common during feeding. If this happen you can try to change the baby’s position in order to recover the normal diaphragm movements, you can also try to make the baby burp (as in adults it can be helpful to make hiccups go away) and you can also try to calm the baby down, so they can breathe normally again. If none of this works for about 10 minutes you can try to resume the feeding, since it can be helpful to get rid of hiccups.
One good way to prevent hiccups in babies while feeling them is by giving them food only when they are calm or give them the food slowly, so they don’t swallow air.
But be careful, if your baby is constantly getting hiccups, it can be an indicator of a health condition. In this case you should seek for the help of a pediatrician and give the more information possible, including the regularity of hiccups, when the usually start, if they are upsetting the baby or if they are interfering with feeding or with the normal baby’s sleeping pattern. Excessive hiccups in babies can also be seen in babies born addicted to drugs (cases in where their mothers were drug addicts all the way during pregnancy), they can be a sign of withdrawal or NAS (neonatal abstinence syndrome).
8. Charles Osborne – The Man that Hiccupped for 68 Years!
Hiccups can be boring and disturbing, but they are responsible for some world records. For example, did you know that the world record for continuous hiccupping is 68 years! Can you imagine? The record holder (Charles Osborne) hiccupped continuously for 68 years, from 1922 to 1990. It all started when he was preparing himself to slaughter a 300 pound (about 135 kg) hog in 1992. All sudden the animal collapsed on him and then the hiccup started happening every 10 seconds for 68 years interruptedly. Doctors at the time speculated that two hypothesis where to consider: one of them was that a blood vessel in his brain (a responsible for the control of the abdomen muscle) popped or that a muscle from the abdomen was pulled and didn’t got back to its place. Doctors performed several operations to try to cure the hiccups but all of them failed. Then in 1990 the hiccups just stopped. He ended up dying one year later in 1991 from complications from ulcers.
This is one case that (fortunately) doesn’t happen a lot, it is the only one reported to last so long without finding a specific cause. If you have frequent, severe chronic cases of hiccups you should always try to seek the help of a doctor to make sure everything is ok with your health or if you need to make any complementary examinations to treat any condition. For light cases you can always try the tips we suggested you in this article, we hope they can be helpful for you to get rid of hiccups.