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What Causes Hiccups?

January 09, 2016

Story at-a-glance

  • Hiccups are the result of an involuntary spasm of your diaphragm, which causes the space between your vocal cords to close, leading to the characteristic “hic” sound
  • Overeating, acid reflux, drinking alcohol or carbonated beverages, or emotional stress can trigger hiccups
  • In rare cases, long-term hiccups may be caused by traumatic brain injury, tumors, meningitis, multiple sclerosis, and more
  • If your hiccups last longer than 48 hours, see a physician to rule out a potentially serious underlying problem

By Dr. Mercola

Hiccups are the result of an involuntary spasm of your diaphragm, which is a muscle in your chest that plays a role in breathing. As your diaphragm tightens, the space between your vocal cords closes, leading to the characteristic "hic" sound.

The tightening may serve a purpose, helping to rid your gut of trapped air and draw swallowed food down toward your stomach, but most people find hiccups to be more annoying than useful. And, really, no one knows exactly why hiccups occur.

There are many theories, however, like helping to prepare an unborn baby for breathing or, as mentioned, clearing air from your stomach. It's even been suggested that hiccups could be related to "an ancient gill breathing reflex held over from when our ancestors crawled from the ocean."1

As for causes, hiccups are sometimes triggered by external factors, like drinking carbonated beverages, eating too fast (and gulping your food) and chewing gum.

However, hiccups are actually an involuntary movement triggered partly by your autonomic nervous system (which also controls your heartbeat, pupil dilation and other involuntary bodily functions).

Even unborn babies hiccup, which is thought to perhaps help prepare them for breathing. But, while virtually everyone gets hiccups now and again, there's really no hard and fast cure.

What Are the Leading Causes of Hiccups?

Sometimes hiccups occur for seemingly no reason. Other times, you may be able to pinpoint a cause, such as overeating and/or or acid reflux, taking a certain medication or even emotional stress or excitement.

Drinking alcohol is another common cause because it may promote acid reflux, irritate your esophagus and irritate your vagus nerve, which runs from your brain to your abdomen.2 Even a sudden change in temperature can trigger a bout of hiccups.

Dr. Paul Bertrand, neuroscience researcher at RMIT University told The Huffington Post Australia:3

"Overeating or reflux are the most common causes [of hiccups], and the internet is full of other potential causes. In most cases, there is a change in your body (like an overfull stomach) that is communicated to your brain to start the hiccups …

Changes to your the brain can also cause hiccups, and some drugs that act on the brain can cause them. Also, brain trauma (such as stroke) can cause severe hiccups.

Cancer treatment, or drugs used for Parkinson's disease or for treating psychiatric disorders can also change how your brain functions and cause hiccups."

Hiccups Lasting Longer Than 48 Hours May Be Cause for Concern

Most cases of hiccups last only a few minutes to a few hours, but in rare cases they may last for days — or even years. Hiccups that last for more than 48 hours are known as persistent hiccups. Those that last for more than one month are called intractable hiccups.

There's even a case of a 60-year-old man hiccupping virtually non-stop (every three seconds!) for one year.4 Hiccups can even persist during sleep. How often are hiccups serious enough to send someone to the hospital for treatment?

In a study of one U.S. community hospital from 1995 to 2000, only 54 visits (out of more than 100,000) were related to hiccups. Most of the hiccup patients were male, over 50 and had other health conditions.5 According to the Journal of Clinical Sleep Medicine:6

"Chronic persistent hiccups can be debilitating and have been associated with weight loss, insomnia, and fatigue. They can be caused by a wide variety of medical conditions, including central nervous system abnormalities, metabolic imbalances, and chest and abdomen pathology.

Among the medications known to cause hiccups, the most common include corticosteroids, antidepressants, dopaminergics, and opioids."

What Causes Long-Term Hiccups?

Long-term hiccups are most often the result of irritation to the vagus or phrenic nerves, which serve your diaphragm muscle. Such irritation may be caused by gastroesophageal reflux, sore throat, laryngitis, a tumor, cyst or goiter in your neck or even a hair touching your eardrum.7

In other cases, long-term hiccups can be the result of damage, infection or trauma to your central nervous system, which disrupts your body's ability to control the hiccup reflex.

This includes factors such as stroke, traumatic brain injury, tumors, meningitis, multiple sclerosis and more. Up to 9 percent of advanced cancer patients are said to suffer from chronic hiccups.8

Long-term hiccups may also be triggered by the following.9 If you experience hiccups that last longer than 48 hours, you should see a physician to rule out a potentially serious underlying condition.





Electrolyte imbalance

Kidney failure



What's the Best Way to Get Rid of Hiccups?

In severe cases, continuous positive airway pressure (CPAP) treatments have been used. This is because increasing the air pressure in your throat may help to relieve hiccups, which is why the old adage that holding your breath cures hiccups is sometimes quite true.

In fact, in the case of the man with the year-long bout of hiccups, it was CPAP treatment that ultimately cured him. According to the study:10

"CPAP-induced intrathoracic pressure elevation may prevent the pressure drop responsible for hiccups, thereby resulting in either reduced hiccup frequency or complete resolution.

The common practice of breath holding with the mouth and nose closed may also alleviate hiccups through a similar mechanism."

Increasing levels of carbon dioxide in your body may also help stop hiccups, which is why people sometimes try breathing into a paper bag for relief.

Virtually any activity that's capable of interrupting the hiccup reflex — like a good scare, being tickled or drinking water upside down — may also be effective, although none of these are backed by science.

Home Remedies and Other Hiccup 'Cures'

Dr. Tyler Cymet, head of Medical Education at the American Association of Colleges of Osteopathic Medicine, conducted the five-year study on hiccup patients at a community hospital.

He tried many different treatments on the 54 patients — breath holding, medications, and more — but none were effective. He told The Washington Post, "I think the jury is in that nothing works: It starts and stops on its own, and that's about it."11

He has, however, tried various treatments for his patients over the years, including breathing exercises, cognitive behavioral therapy, yoga and Pilates, which together he estimated worked about 20 to 25 percent of the time.12

Anecdotally, some people swear by certain alternative and home remedies as hiccup cures. Among the most popular include:

In addition, there are a surprising number of hiccup remedies that have been studied, albeit often using small numbers. For instance:14

One ambitious teenager has even created a lollipop she calls the "hiccupop," a hiccup remedy made out of water, apple cider vinegar and sugar. Dr. John Birk of the University Health Center of Connecticut told CBS News:19

"There are some cases where it [the hiccupop] might work very nicely. The hiccup itself is a reflex arc and what she is trying to do is break that reflex arc up by sucking on the lollipop and stimulating it with sugar and vinegar and therefore breaking up the reflex arc pathway of the hiccup."

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Sources and References

  • 1, 3 Huffington Post Australia December 17, 2015
  • 2 Shape December 21, 2015
  • 4, 6, 10 J Clin Sleep Med. 2013 Jan 15; 9(1): 92–95.
  • 5 J Natl Med Assoc. 2002 Jun;94(6):480-3.
  • 7, 9 Mayo Clinic, Hiccups
  • 8 Journal of Palliative Medicine. October 2012, 15(10): 1142-1150.
  • 11, 12 Washington Post June 2, 2014
  • 13 Huffington Post May 12, 2013
  • 14 Mind the Science Gap November 5, 2012
  • 15 N Engl J Med 1971; 285:1489
  • 16 N Engl J Med 1981; 305:1654
  • 17 Medical Hypotheses September 19, 2005
  • 18 Ann Emerg Med. 1988 Aug;17(8):872.
  • 19 CBS News May 23, 2012
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