Hiccups are caused by the involuntary contraction of the diaphragm muscle, followed by the rapid closure of the vocal cords, which makes that distinct sound. Most of the time, hiccups are nothing more than an annoyance, but if they last longer than a few weeks, it could be a sign of an underlying medical condition. Treatment for hiccups, such as holding your breath or massaging your carotid artery, may help many, but not all.
Hiccups happen to everyone, so there’s no reason for concern — unless they last for weeks.
Hiccups are caused by the diaphragm contracting and the vocal cords snapping shut.
The best ways to stop hiccups include techniques that allow CO2 to build up or stimulate the vagus nerve.
Nearly everyone has had hiccups at some point in their lives. Usually, they are nothing more than an inconvenience and an irritation. They may interfere with eating or talking; though they might be embarrassing, they are typically harmless.
Hiccups occur in people worldwide and people of all ages, including babies in the womb. Scientists don’t know why we hiccup, but they suspect that hiccups may be a reflex left over from when respiratory muscles were formed in the uterus.
Most of the time, hiccups last for minutes or hours. However, on rare occasions, hiccups may last for weeks or even months. In that case, your hiccups may be a sign of an undiagnosed medical condition. Speak with your healthcare provider if your hiccups last longer than a few days.
What happens when you hiccup?
The medical term for hiccups is singulars. They result from an abrupt, involuntary contraction of a large muscular structure underneath your rib cage called the diaphragm. The diaphragm is dome-shaped and mostly made of muscle and fibrous tissues. The diaphragm separates your chest from your abdominal cavity.
The diaphragm has several important bodily functions, and we cannot live without it. It plays an important role in helping you breathe and helps lymphatic fluid flow through the body, which allows your immune system to fight germs. The diaphragm also helps move muscles during childbirth, when having a bowel movement, and when lifting anything heavy.
During a hiccup, the diaphragm contracts suddenly, which causes the glottis, or vocal cords, to snap shut quickly. The diaphragm is triggered to contract by the stimulation of two different nerves in the body: the phrenic nerve, which controls the diaphragm, and the vagus nerve, which controls breathing. However, many things can stimulate the nerve.
What causes hiccups?
Since most hiccup cases are acute, meaning they come on suddenly and then stop within minutes or hours, they have not been the subject of scientific studies. Chronic cases of hiccups have been studied much more thoroughly, so health professionals know more about them.
Usually, hiccups last for a few minutes to a few hours. It is not uncommon for regular, acute hiccups to go on for a whole day or even two days. Rarely, hiccups can become intractable or hard to manage and last longer than a month. Nearly everyone hiccups sometimes, from in-utero to elderly people. Studies show that hiccups lasting longer than several weeks are more likely to happen in older males and people who are taller and heavier than average.
Hiccups happen when your diaphragm suddenly contracts as a result of the vagus or phrenic nerve stimulation. The diaphragm contracting causes your vocal cords to close quickly, which makes the peculiar “hic” sound.
Hiccups can happen for different reasons, including the following:
- Ingesting carbonated drinks;
- Eating too quickly;
- Eating too much food at one time;
- Eating spicy foods;
- Being emotionally excited;
- Feeling stressed;
- Drinking alcohol;
- Gastroesophageal reflux disease (a more intense form of acid reflux);
- Taking particular medications, like chemotherapy or anxiety medicines.
When these lifestyle factors lead to hiccups, it is usually acute hiccups that come on suddenly and then disappear within minutes or hours. If hiccups last longer than two days, they are called persistent hiccups. Intractable hiccups lasting a month or more can signify an underlying medical condition. These types of hiccups are much rarer than normal hiccups.
Causes of intractable hiccups may include:
- Gastrointestinal disorders: gallbladder disease and other issues;
- Medications: certain antibiotics, chemotherapy drugs, painkillers, or anxiety medicine;
- Cardiovascular disorders: aneurysm, heart attack, and others;
- Infectious diseases: H. pylori infection, the flu, or the virus that causes shingles;
- Tumors in the esophagus (throat) or diaphragm;
- Ear, nose, and throat issues: sore throat, irritation from a foreign body, and others;
- Central nervous system disorders: Parkinson's disease, multiple sclerosis, and others;
- Metabolic disorders: diabetes, hypokalemia (low potassium levels), and others.
This list is not exhaustive, and studies are still being conducted to understand what causes intractable hiccups fully. The record for the longest bout of intractable hiccups was over 60 years. If your hiccups last longer than a few days, it’s a good idea to contact your healthcare provider.
The best way to stop hiccups
For average hiccups, many simple steps can be taken to stop them. However, scientific studies show that allowing extra carbon dioxide (CO2) to build up is the most effective. Carbon dioxide is a gas that you naturally expel as you breathe out.
Ways to breathe in more CO2 and get rid of hiccups include:
- Breathing into a paper bag (never plastic);
- Holding your breath;
- Doing the Valsalva maneuver: pinch your nose shut, close your mouth, and try to exhale;
- Doing the supra-supramaximal inspiration technique: inhale completely and hold for ten seconds, then without exhaling, inhale two more times and hold for five seconds each.
Studies also show that stimulating the vagus nerve may be effective at getting rid of hiccups, including:
- Sticking your tongue out and pulling on it gently with your fingers;
- Drinking a cold beverage;
- Massaging your carotid artery: the artery under your jaw where you can feel your heartbeat;
- Gargling with water;
- Eating or drinking something sour, like a pickle or lemon juice.
Most of the time, hiccups are nothing more than a harmless annoyance. Doing things that stimulate the vagus nerve or allowing extra CO2 to build up for short periods has been known to stop hiccups in many people. There is no official guidance on curing hiccups, but these techniques often work. If your hiccups last longer than a few days, reach out to your healthcare provider.