Hiccups: why do we hiccup?

Most of us have experienced hiccups, an uncomfortable, sometimes embarrassing, but usually short-lived experience. But sometimes hiccups persist for a long period of time and can be a sign of serious underlying disease.

What are hiccups?

Hiccups are bursts of inspiratory (breathing in) activity. The muscles we use when we take in a breath are the intercostal muscles situated between the ribs, and the diaphragm — a sheet of muscle below the lungs. A hiccup is an involuntary contraction of the diaphragm, which is followed by the sudden closure of your vocal cords - this produces the characteristic hiccup sound.

Causes of hiccups

Hiccups are very common and most people will have hiccups at some time. Most simple cases of hiccups come after eating or drinking too much or too quickly. The stomach, which is situated right below the diaphragm, becomes distended and irritates it. This will cause the diaphragm to contract, as it does when we breathe in.

Carbonated fizzy drinks can cause hiccups, and alcohol is another common cause of hiccups. Excess smoking may also cause hiccups. Hot and spicy food, such as curry, may trigger hiccups.

Sometimes hiccups will occur because of a disturbance to the nerve pathways from the brain to the muscles involved. This explains why hiccups may occur with temperature changes or emotional situations. It is also the reason that a sudden shock can sometimes abolish an attack.

Persistent hiccups may signify problems in the brain (such as stroke, tumours, infections or multiple sclerosis), spinal cord or any of the structures around the diaphragm or chest wall. So chronic hiccups that last days, months or even years, may indicate serious underlying disease and should be investigated.

Treatment

Everyone has their own pet remedy for curing hiccups. Simply holding your breath is often effective for short-term bouts of hiccups, but usually they will go away of their own accord. Some people find that touching or gently lifting their uvula (the dangly structure at the back of the throat) with a cotton bud or similar will stop a bout of hiccups, but be aware that this will stimulate the gag reflex.

Other methods include drinking ice cold water, swallowing something sweet like a spoonful of sugar, or sitting down, while leaning forward and pulling your knees up to compress your chest.

If you have hiccups that have gone on for 2 days or longer, or are having recurrent bouts of hiccups, you should see a doctor to find out if there is an underlying cause that needs treating.

What your doctor can do for you

If you are having problems with hiccups, your doctor can:

  • rule out serious underlying diseases that provoke hiccups;
  • prescribe antispasmodics;
  • treat underlying diseases that may be causing hiccups; or
  • refer you to a surgeon who may recommend surgery on the nerves supplying the diaphragm, if you have severe or persistent hiccup attacks.
Last Reviewed: 18 September 2013
Your Doctor. Dr Michael Jones, Medical Editor.

References

1. Patient.co.uk. Hiccups (hiccoughs). Last checked June 2011. http://www.patient.co.uk/health/hiccups-hiccoughs (accessed Aug 2013).
2. Mayo Clinic. Hiccups. Last reviewed June 2011. http://www.mayoclinic.com/health/hiccups/DS00975 (accessed Aug 2013).
Dr Michael Jones

Dr Michael Jones

Medical Editor, Your Doctor.