A hiccup is an automatic action (a reflex) that the body can't control. During a hiccup your diaphragm (the muscle under your lungs that helps you breathe) contracts. Immediately after this the top of your windpipe (your glottis) closes, making the typical 'hic' sound.
What are the symptoms?
Seriously, you want me to describe a hiccup? I think you know what it is. What you may not know is that there is a big difference between a bout of hiccups that lasts for a short time and one that lasts for more than 48 hours. The persistent type is more likely to be caused by an underlying illness and may be more likely to require medication to treat it.
Read more about the symptoms of hiccups.
What causes them?
We've all seen the comedy drunk on TV (or in the mirror) hiccuping and slurring their words. But alcohol is not the only cause of a short bout of hiccups. Sudden excitement, excessive smoking and sudden changes in temperature will do it. So will trying to drink a whole bottle of cola in one go. But what idiot would try that? Certainly not me (hic).
In most cases, no particular cause can be found.
More persistent bouts (lasting longer than 48 hours) don't happen very often. Acid reflux, changes in body chemistry, and conditions affecting the neck, chest, tummy, heart and brain can all cause them. Some medicines and anaesthetics are known causes. Prolonged hiccups can also be a distressing feature of advanced cancer.
Learn more about the causes of hiccups.
What tests do I need?
Chances are you won't need any tests unless your hiccups are frequent or prolonged. If they are, you'll most likely end up with blood tests, a heart tracing and a chest X-ray. If your doctor thinks you have an unusual cause, they may request other tests.
Find out more about the diagnosis of hiccups.
What are the treatment options?
Short bouts of hiccups
Hiccups usually stop without any treatment but someone will suggest putting your fingers in your ears, blocking your nostrils and taking a sip of water from a glass. It may not stop the hiccups but it will provide some wonderful Instagram® moments. Other tricks involving iced water, sugar and lemons have been suggested. If they don't work, you still have the basics for a lovely lemon drizzle cake.
Fortunately, there's a little more scientific evidence backing up the treatments for prolonged bouts of hiccups. Treating any underlying cause is an obvious step. Medicines which relax the diaphragm muscle, such as chlorpromazine or baclofen, may be worth a try. Other approaches include medicines which combat acid reflux, relax the stomach muscles or calm the nerve supply to the diaphragm.
Treatments which do not involve taking medicines and have helped some people include acupuncture, hypnotherapy and a device similar to a pacemaker which has an effect on the phrenic nerve that controls the diaphragm muscle. As a last resort, an injection which blocks the action of the phrenic nerve can be used but this can have an effect on breathing.
Read more about the treatment of hiccups.
Are there any complications?
Short bouts of hiccups don't usually cause complications (unless you're a professional fire-eater).
Longer bouts can be quite exhausting, particularly if they interrupt sleep. If you've just had a tummy operation they can also slow up the healing of the scar.
Find out more about the complications of hiccups.
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.
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