Hiccups
Definition
A hiccup is an unintentional movement (spasm) of the diaphragm, the muscle at the base of the lungs. The spasm is followed by quick closing of the vocal cords, which produces a distinctive sound.
Alternative Names
Singultus
Considerations
Hiccups often start for no apparent reason and usually disappear after a few minutes. Rarely, hiccups can last for days, weeks, or months. Hiccups are common and normal in newborns and infants.
Causes
- Abdominal surgery
- Any disease or disorder that irritates the nerves that control the diaphragm (such as pleurisy or pneumonia)
- Hot and spicy foods or liquids
- Noxious fumes
- Stroke or tumor affecting the "hiccup center" in the brain
There may be no obvious cause for hiccups.
Home Care
There is no sure way to stop hiccups, but there are a number of common suggestions that may be effective:
- Breathe repeatedly into a paper bag.
- Drink a glass of cold water.
- Eat a teaspoon of sugar.
- Hold your breath.
When to Contact a Medical Professional
Contact your health care provider if hiccups persist for more than a few days.
What to Expect at Your Office Visit
If hiccups persist to the point that you visit your health care provider, a medical history will be taken and a physical examination will be performed.
Medical history questions may include the following:
- Do you get hiccups easily?
- How long has this episode of hiccups lasted?
- Have you recently eaten something that was hot or spicy?
- Have you recently drank carbonated beverages?
- Have you been exposed to any fumes?
- What have you done to try to relieve the hiccups?
- What has been effective for you in the past?
- How effective was the attempt at home treatment?
- Did the hiccups stop for a while and then restart?
- What other symptoms are present?
Diagnostic tests are rarely necessary unless a disease or disorder is suspected as the cause.
To treat persistent hiccups, the health care provider may perform gastric lavage or massage of the carotid sinus in the neck. THIS MUST BE DONE BY THE HEALTH CARE PROVIDER. DO NOT ATTEMPT CAROTID MASSAGE AT HOME!
If hiccups continue, medications such as phenothiazine (especially chlorpromazine), baclofen, or anticonvulsants may help. Tube insertion (nasogastric intubation) may also provide relief.
Very rarely, medical methods fail to treat persistent hiccups. Further treatment may include a phrenic nerve block. The phrenic nerve controls the diaphragm.
References
Pollack MJ. Hiccups. In: Rakel P, Bope ET, eds. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa: Saunders Elsevier;2008:chap 4.Reviewed By: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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