Hiccups

Persistent hiccups (lasting more than 48 hours) are rare but are commonly caused by an underlying disease. Medication can stop persistent hiccups.

What are hiccups?

Hiccups (sometimes spelled hiccoughs) are caused by a sudden contraction of your diaphragm. This is the muscle under your lungs that helps you breathe in. Your glottis (the top of your windpipe) closes immediately after your diaphragm contracts which makes the typical 'hic' sound.

A hiccup is a reflex that you cannot stop. However, unlike other reflexes such as coughing and sneezing, hiccups do not seem to have any useful purpose.

Who gets hiccups?

Short bouts of hiccups
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:

• 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.
• sudden excitement or emotional stress.

Persistent hiccups lasting more than 48 hours
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.

What is the treatment for hiccups?

For short bouts of hiccups
Most cases need no treatment as a bout of hiccups usually soon goes. Popular remedies that may stop a short bout of hiccups include:

• sipping ice water.
• swallowing granulated sugar.
• biting on a lemon.
• breath holding, breathing fast, or breathing into a paper bag.
• gasping after a sudden fright.
• pulling your knees up to your chest.

If you have persistent hiccups
If you have hiccups for more than 24 hours (or if you have frequently recurring short bouts of hiccups) then see a doctor to find out if there is an underlying cause. If the cause is not obvious the doctor is likely to examine you and do some tests. If an underlying cause is found, then treatment of the underlying cause, if possible, may cure the hiccups.

For example, in one research study of 72 people with persistent hiccups it was found that 55 people had a condition of their upper gut. The most common condition was acid reflux (see separate leaflet called 'Acid Reflux and Oesophagitis'). In this study, treatment of the acid reflux with medication stopped the hiccups in 35 of these people.

Medication is sometimes needed to stop persistent hiccups. Various medicines have been used for this. For example, chlorpromazine or haloperidol are medicines which can relax the diaphragm muscle or its nerve supply and may stop persistent hiccups. Other medicines sometimes used include: baclofen, gabapentin, and metoclopramide.

© EMIS and PIP 2005   Updated: September 2005   PRODIGY Validated