Hiccup

Hiccups occur when the diaphragm suddenly and involuntarily contracts (tightens), resulting in a hiccup sound being produced at the top of the windpipe.

Information written and reviewed by Certified Doctors.

Contents

Introduction

Hiccups occur when the diaphragm suddenly and involuntarily contracts (tightens), resulting in a hiccup sound being produced at the top of the windpipe.

The medical name for hiccups is "singultus".

The diaphragm is a thin membrane of muscle that separates the chest cavity from the abdomen (tummy). It is underneath the ribcage and helps to control breathing.

Hiccups are a reflex action, which means that you do not have any control over them. Hiccups are not usually serious and in most cases only last a few minutes.

Long-lasting hiccups

In rare cases, hiccups can last for a long time. Hiccups that last more than 48 hours can be categorised into:

  • persistent or protracted hiccups – a bout of hiccups that lasts for more than 48 hours
  • intractable hiccups – a bout of hiccups that lasts longer than a month

Who gets hiccups?

Hiccups are common and most people will get them at some point during their life. They can affect people of any age, including babies. Men and women are equally affected by episodes of short-lived hiccups.

However, for reasons that are unclear, persistent and intractable hiccups are more common in men. Intractable hiccups are more common in adults. These types of hiccups can be tiring and upsetting, and can make eating and drinking difficult.

It is important to remember that persistent and intractable hiccups are rare and usually caused by another underlying health condition. In 80% of cases of persistent or intractable hiccups, a cause can be identified. The remaining 20% of cases usually have a psychological cause.

Read more about the causes of hiccups.

Treating hiccups

Most hiccups will pass quickly and usually only last a few minutes. Treatment is not usually required.

However, in cases of persistent or intractable hiccups that last longer than 48 hours, further investigations are needed to identify the cause and appropriate treatment.

Read more about how hiccups are diagnosed.

As well as treatment for underlying conditions, there are also self-help techniques that may help some people to stop common types of hiccups.

Read more information about treating hiccups.

Causes

Hiccups occur when your diaphragm (the thin layer of muscle that separates your chest cavity from your abdomen) suddenly and involuntarily contracts (tightens).

As your diaphragm contracts, it causes you to breathe in air very quickly. The incoming air is stopped when your glottis (the opening between your vocal cords) closes suddenly, producing the characteristic sound of a hiccup.

Short-term hiccups

Most cases of hiccups occur for no apparent reason. Everyone experiences a short bout of hiccups from time to time. This is perfectly normal and nothing to be concerned about.

The most common causes of short-term hiccups are:

  • consuming large amounts of alcohol
  • excessive smoking
  • a bloated stomach – usually as a result of eating or drinking too quickly
  • a sudden change in room temperature
  • a sudden change in the temperature inside your stomach

Sometimes, short-term hiccups may also occur as a result of:

  • shock
  • stress – the feeling of being under pressure
  • excitement

See below for more information about psychological factors that can cause hiccups.

People experiencing short-term hiccups usually get better without the need for treatment.

Long-lasting hiccups

In rare cases, persistent and intractable hiccups can be caused by a more serious underlying condition, such as gastro-oesophageal reflux disease (GORD) (see below). However, in other cases the cause of hiccups remains unknown (idiopathic).

Several conditions can cause hiccups. However, even with testing and investigation an underlying cause can sometimes not be identified.

Possible underlying conditions

Some of the conditions that can cause long-term hiccups include:

  • gastrointestinal conditions – such as gastro-oesophageal reflux disease (GORD), inflammatory bowel disease (IBD) or a small bowel obstruction
  • respiratory conditions – such as asthma, pneumonia or pleurisy
  • conditions affecting the central nervous system – such as stroke, a tumour affecting the brain, encephalitis or a traumatic brain injury
  • a condition causing irritation of the vagus nerve (which could disrupt nerve signals in your body) – such as goitre, pharyngitis or meningitis
  • a psychological reaction – such as shock, fear, grief, excitement, hysterical behaviour, anxiety or stress
  • conditions affecting your metabolism (the way your body digests food) – such as diabetes, hypoglycaemia or hyperglycaemia

Medication

Persistent hiccups can sometimes be caused by a reaction to certain types of medication. For example:

  • anaesthesia – medication given before a surgical operation or procedure that causes a loss of sensation
  • corticosteroids – medication that reduces inflammation (swelling)
  • benzodiazepines – a type of sedative that helps to reduce anxiety
  • barbiturates – a type of sedative sometimes used to prevent seizures (fits)
  • opioids – medication used to treat pain; morphine and methadone are both strong opioids
  • methyldopa – medication used to treat high blood pressure

Possible complications

Prolonged hiccups can sometimes cause a number of complications. For example, in some cases it can lead to:

  • insomnia
  • weight loss, due to difficulty eating
  • exhaustion
  • depression

Visit your doctor or another healthcare professional if you have hiccups that have lasted longer than 48 hours and you are unsure about what is causing them.

Read more about how hiccups are diagnosed.

Diagnosis

Hiccups that last for less than 48 hours and stop on their own do not require a diagnosis from your doctor.

Visit your doctor if you have had hiccups for longer than 48 hours. They will look at your medical history and may carry out a physical examination to try to establish the cause.

Physical examination

The aim of the physical examination is to try to find out what is causing your hiccups, such as identifying any underlying condition that may be contributing to the problem. Areas of your body your doctor may want to examine include:

  • head and neck (including your mouth)
  • chest
  • abdomen (tummy)

Tests

If your doctor suspects your hiccups are due to another condition, they may refer you for tests such as:

Treatment

Most cases of hiccups do not require medical treatment and will usually stop after a short period of time.

Self-care

However, there are steps you can try which may help to stop your hiccups. These include:

  • slowly sipping ice-cold water
  • holding your breath for a short period
  • gently placing pressure on your nose while swallowing
  • gently placing pressure on the diaphragm
  • gargling with water
  • biting on a lemon
  • swallowing granulated sugar
  • tasting vinegar
  • breathing into a paper bag (never place a bag over your head)
  • holding your breath for short periods
  • pulling your knees up to your chest
  • leaning forward to compress your chest

Treating underlying conditions

If an underlying health condition is causing your hiccups, treating it will help to resolve the problem. If your hiccups are persistent, or last longer than 48 hours (intractable), your doctor will investigate whether an underlying condition may be causing them.

Read more information about how hiccups are diagnosed.

Some conditions that cause persistent and intractable hiccups may need to be assessed and treated by a specialist. If this is the case, your doctor will refer you to the appropriate healthcare professional, who will carry out further investigations and recommend appropriate treatment.

Medication

If your hiccups last for 48 hours or more, and your doctor feels it appropriate, you may be prescribed medication. If your child has persistent or intractable hiccups, they will usually have to visit a specialist before being prescribed medication.

Medication for hiccups is often only used when other forms of treatment have failed or if no underlying cause can be found.

Some medicines that you may be prescribed for the treatment of long-term hiccups include:

  • [chlorpromazine]
  • [haloperidol]
  • baclofen
  • metoclopramide
  • gabapentin

Your doctor will usually prescribe a two-week course of medicine for you and they may gradually increase the dosage until your hiccups are brought under control. The length of time you will need to take the medicine will depend on your individual circumstances, including:

  • your age
  • your general health
  • the severity of your hiccups

All medicines can cause side effects. Therefore, before taking any, seek advice from your doctor or pharmacist about potential side effects you may experience.

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