Hiccups

(Singultus)

Definition

Hiccups are spasms of the diaphragm muscle. They are repeated and cannot be controlled. This results in an odd, sometimes uneasy gasping sensation and sound with each hiccup.

Causes

Hiccups are caused by any number of factors that irritate the diaphragm. The diaphragm is a sheet of muscle that separates the abdominal cavity from the chest cavity. Its main function is to help the lungs draw in air during breathing.
Phrenic Nerve and Diaphragm
Phrenic Nerve
Copyright © Nucleus Medical Media, Inc.

Risk Factors

Factors that may increase your chance of getting hiccups include:
  • Drinking a lot of fluids, including alcohol
  • Gastrointestinal conditions, including gastroesophageal reflux disease (GERD)
  • Dehydration
  • Stress or intense emotions
  • Some medications
  • Medical procedures, such as mechanical ventilation and intubation
  • Certain conditions that irritate the brain or nerves, such as goiter, meningitis, multiple sclerosis, or cancer

Symptoms

Hiccups may cause:
  • Spasms of the diaphragm muscle that repeat and cannot be controlled
  • Uneasy gasping and sound with each hiccup

When Should I Call My Doctor?

Call your doctor if your hiccups:
  • Last for more than 2 days
  • Are painful or get in the way of your daily life, such as eating or sleeping

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. You may need tests if the doctor is concerned that the hiccups may be caused by a condition. Your body fluids may be tested. This can be done with blood tests. Images may be taken of your abdomen and chest. This can be done with:

Treatment

Many treatments for hiccups involve stimulating nerves that may be involved. This can be done by:
  • Eating hard to swallow items such as granulated sugar or molasses
  • Sucking on ice cubes
  • Gagging with purpose
  • Valsalva maneuver—holding your breath and bearing down, as you might when having a bowel movement
  • Breathing into a bag
  • Gasping with purpose
Some drugs may help hiccups, including:
  • Antipsychotics
  • Antiseizure medications
  • Medications used to treat nausea
  • Muscle relaxers

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Prevention

It is not known why some people get hiccups. There are no sure ways to prevent developing them. However, if you are prone to hiccups, you might want to avoid:
  • Overfilling your stomach
  • Drinking carbonated beverages or alcohol
  • Becoming overexcited, including stress, intense emotion, heavy laughing, or crying

RESOURCES

Family Doctor—American Academy of Family Physicians
http://familydoctor.org

Genetic and Rare Diseases Information Center—National Center for Advancing Translational Sciences
http://rarediseases.info.nih.gov

CANADIAN RESOURCES

Canadian Institutes of Health Research
http://www.cihr-irsc.gc.ca

Health Canada
http://www.hc-sc.gc.ca

References

Hiccups. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 21, 2013. Accessed January 8, 2015.

What causes hiccups? Kids Health—Nemours Foundation website. Available at: http://kidshealth.org/kid/talk/qa/hiccup.html. Updated August 2014. Accessed January 8, 2015.

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