Hiccups

Hiccups are an episode of repeated, uncontrollable spasms of the diaphragm muscle. This results in an odd, sometimes uncomfortable gasping sensation and sound with each hiccup.

Causes

A long list of conditions can result in Hiccups. Some of these include:
  • Bloating of the stomach from carbonated drinks, overeating, or swallowing air
  • Sudden shifts from hot to cold temperatures
  • Over-excitement
  • Stress
  • Heavy crying or laughing
  • Nervous system tumors or infections
  • Abnormalities of the blood's chemical makeup
  • Diabetes
  • Kidney failure
  • Gout
  • Irritation of the nerve that controls the diaphragm's movement
  • Pneumonia
  • Lung cancer
  • Asthma
  • Pleurisy
  • Hernia of the diaphragm
  • Tumors in the chest
  • Heart attack
  • Pericarditis
  • Aneurysm
  • Goiter
  • Stomach ulcer or cancer
  • Inflammatory bowel disease
  • Bowel obstruction
  • Prostate infection or cancer
  • Pancreatitis
  • Pancreatic tumor
  • Emotional or psychiatric problems
  • Medications, such as:
    • Benzodiazepines
    • Steroids
    • Alpha-mehyldopa
    • Barbiturates

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Sex: Men
  • General anesthesia
  • Having surgery
  • Irritation to the nerve that stimulates the diaphragm (vagus nerve)
  • Central nervous system disorders

Symptoms

Symptoms include:
  • Repeated, uncontrollable spasms of the diaphragm muscle
  • Uncomfortable gasping sensation and sound with each hiccup

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. If you have the Hiccups they will be evident during the exam. If the doctor is concerned that the Hiccups may be caused by some underlying illness, you may need tests. These tests might include:
  • Blood tests
  • Liver function tests
  • Chest x-ray – a test that uses radiation to take a picture of structures inside the body
  • CT Scan of the head, chest, and/or abdomen – a type of x-ray that uses a computer to make pictures of the inside of the body
  • Echocardiogram – a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart
  • Bronchoscopy - a thin, lighted tube inserted into the bronchial tubes to examine the lungs and air passages
  • Upper endoscopy – a thin, lighted tube inserted down the throat to examine the stomach and intestine

Treatment

Many treatments for Hiccups involve stimulating various nerves that may be involved. This can be done by:
  • Eating granulated sugar
  • The Valsalva maneuver - holding your breath and bearing down, as you might when having a bowel movement
  • Breathing into a bag
  • Pulling on your tongue
  • Lifting the uvula (the tissue hanging down in the back of your throat) with a spoon
  • Assuming a knees-to-chest position
  • Belching
  • Relieving stomach bloating by having a tube passed through your nose into your stomach
  • Purposefully gasping
  • Some drugs may help resolve hiccups, including:
    • Chlorpromazine
    • Seizure medications
    • Benzodiazepines
    • Metoclopramaide
    • Baclofen
    • General anesthesia

Prevention

It is not known why some people get the hiccups and others don't. There are no sure ways to prevent developing this condition. However, if you're prone to the Hiccups you might want to avoid:
  • Overfilling your stomach
  • Carbonated beverages
  • Sudden changes in temperature
  • Alcohol
  • Over-excitement (including stress, intense emotion, and heavy laughing or crying)