Hiccups

 

 

A hiccup is a sudden onset of repeated involuntary movement (spasm) of the muscle at the base of the lungs (called diaphragm) which is immediately followed by sudden closure of the vocal cord (glottis), which produces a characteristic 'hic' sound.

Hiccups that begin suddenly with no apparent reason and last usually for few minutes (self-limiting) are very common. However, when they continue beyond 48 hours it is considered as persistent (or protracted) hiccups, and if it continues beyond 1 month it is considered as intractable. Intractable hiccups are seen in rare cases.

 

 

Self-limiting hiccups are believed to be caused due to factors like rapid stomach distension or eating too fast or overeating, drinking carbonated drinks, swallowing excessive air (aerophagia), and sudden change in ingested food temperature.

Persistent or intractable hiccups are seen in various diseases, like gastroesophageal reflux disease (GERD), gallbladder disease, inflammation of liver, pancreas and around the heart; metastasis of cancer in the liver, pregnancy, alcoholism, pneumonia, and high urea levels in blood.

 

 

There is sudden onset of a characteristic 'hic' sound which is due to abrupt air rush into lungs. They are rarely accompanied by any other symptoms or visible signs.

 

 

A doctor will take a note of present illness, review symptoms of the patient, and perform physical examination to see signs of chronic illness and neurological problems. No specific test will help in the diagnosis of hiccups, but in case of persistent or intractable hiccups, investigations will be advised depending upon the probable underlying illness.

(a) Imaging: An x-ray and ultrasound of the abdomen might be advised to identify potential causes.

(b) Lab tests: Blood urea levels need to be assessed and urine/blood pregnancy test needs to be done.

 

 

You may be prescribed medications in severe cases. Under home care, hiccups have been seen to stop with:

1. Drinking a glass of water

2. Holding breath for few seconds

3. Eating a tablespoon of sugar

4. Breathing into a paper bag for some time

 

 

Protracted and intractable hiccups usually cause emotional and social distress and serious complications are seen if the underlying illness is not treated effectively. Severe and prolonged hiccups may lead to fatigue, exhaustion, malnutrition, dehydration, and may even be fatal in the severe cases.

If hiccups continue for more than 48 hours without any effect of home care treatment, it is advisable to consult a doctor as there might be need for medical treatment.

 

 

In cases of self-limiting hiccups, the prognosis is excellent. In cases of protracted and intractable hiccups, prognosis depends on the underlying illness.

Hiccups can never really be prevented. Avoiding some of the common triggers can be of help in decreasing intensity and frequency of hiccups. Following are the commonly enlisted triggers:

1. Eating spicy foods

2. Eating large meals

3. Drinking alcohol

4. Eating too fast

5. Sudden temperature changes

6. Smoking cigarettes

7. Speaking while eating

8. Not chewing your food well

 

 

Guinness medical record breaker Charles Osborne of Anthon, Iowa, the USA, (born 1893) had the longest period of hiccups of 68 years. He got his hiccups from 1922, which the doctors tried to cure for several years and finally the hiccups stopped in the year 1990. He got just 1 year without hiccups before he died in 1991 at the age of 97.