Hiccups (Hiccoughs) - Symptoms, Causes and Diagnosis

Authored by Dr Laurence Knott, 07 Jul 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Prof Cathy Jackson, 07 Jul 2017

Lungs and airways with glottis and diaphragm

Everyone has had hiccups, and knows exactly what they are and what they feel like. They affect women and men equally, although persistent hiccups occur much more commonly in men. They happen mainly in the evening.

There is an important difference between short bouts of hiccups and persistent hiccups (lasting longer than 48 hours). Persistent hiccups are more likely to be linked to an underlying illness and you may need medical tests.

Most people have bouts of hiccups from time to time. In most cases they start for no apparent reason, last a short while, then stop. Sometimes they are due to:

  • Sudden excitement or emotional stress.
  • A temporary swollen stomach caused by overeating or eating too fast, drinking fizzy drinks, or swallowing air.
  • A sudden change in temperature (very hot or cold food or drinks, a cold shower, etc).
  • Alcohol.
  • Excess smoking.

Persistent hiccups are rare.

  • In some cases, persistent hiccups are caused by an underlying disease. Over 100 diseases have been reported to cause hiccups. Some are common, such as acid reflux, and some are rare. You would normally have other symptoms apart from the hiccups.
  • In some cases of persistent hiccups there is no apparent cause. However, the persistent hiccups can become exhausting and distressing.

Examples of conditions which can cause persistent hiccups are:

  • Certain medicines - examples are steroids, tranquillisers, painkillers containing opiates (such as morphine) and methyldopa (for blood pressure).
  • Changes in blood chemistry such as from alcohol, high blood sugar, or lack of calcium or potassium in the blood.
  • Gut problems such as acid reflux, stretching (distension) of the stomach, infection of the gallbladder or infection under the diaphragm.
  • A general anaesthetic.
  • Conditions affecting the neck, chest or tummy (abdomen). For example, surgery, infections (such as sore throat or pneumonia), swellings or tumours in these parts of the body.
  • Some heart conditions - a heart attack or inflammation around the heart.
  • Brain conditions such as stroke, head injury or brain infection.
  • Hiccups which sometimes occur in the late stages of a terminal illness such as when a person is very ill with advanced cancer.

You are unlikely to need any tests unless you have persistent hiccups lasting more than 48 hours or frequent recurring short bouts of hiccups Unless your doctor can find an obvious cause, they will most likely want to do some tests.

The initial tests are usually blood tests, a heart tracing (electrocardiogram, or ECG) and a chest X-ray. These look for changes such as blood chemistry, chest problems or heart disease.

Other tests may be advised, depending on your individual situation and whether any other medical condition is suspected.

Further reading and references

  • Chang FY, Lu CL; Hiccup: mystery, nature and treatment. J Neurogastroenterol Motil. 2012 Apr18(2):123-30. doi: 10.5056/jnm.2012.18.2.123. Epub 2012 Apr 9.

  • Seker MM, Aksoy S, Ozdemir NY, et al; Successful treatment of chronic hiccup with baclofen in cancer patients. Med Oncol. 2011 Mar 26.

  • Asadi-Pooya AA, Petramfar P, Taghipour M; Refractory hiccups due to phenytoin therapy. Neurol India. 2011 Jan-Feb59(1):68.

  • Lin LF, Huang PT; An uncommon cause of hiccups: sarcoidosis presenting solely as hiccups. J Chin Med Assoc. 2010 Dec73(12):647-50.

  • Marinella MA; Diagnosis and management of hiccups in the patient with advanced cancer. J Support Oncol. 2009 Jul-Aug7(4):122-7, 130.

  • Arsanious D, Khoury S, Martinez E, et al; Ultrasound-Guided Phrenic Nerve Block for Intractable Hiccups following Placement of Esophageal Stent for Esophageal Squamous Cell Carcinoma. Pain Physician. 2016 May19(4):E653-6.

Hi, for the last month I have been waking up in the morning with a lot of irritating mucus in my throat, I have to hack it up and too my big surprise it's brown.... Almost dark brown! Shock! it's...

louise12570
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