Although most cases of hiccups disappear on their own, we’ve all experienced episodes that were difficult to stop and have tried many of grandma’s remedies. Are you aware that these involuntary spasms can occur from 4 to 60 times a minute and that each person has a specific, lifelong hiccup pattern?

Hiccups are the result of sudden, involuntary spasms of the diaphragm. As this muscle contracts, the opening between the vocal cords snaps shut to stop the inflow of air and this is what creates the hiccup. Singultus is the medical term for hiccups. It is from the Latin word singult which means “the act of catching your breath while sobbing,” a good description of the sound.

Hiccups affect males more often than females and are experienced by persons of every age, from 7 months in the womb to end of life. When hiccups last longer than 48 hours, they are called persistent. Episodes that continue longer than a month are termed intractable.

Causes

According to the Textbook of Palliative Nursing, the underlying problem in 95 percent of cases is gastric distention. A distended stomach pushes against the phrenic nerves of the diaphragm and this irritation often generates the hiccup response.

Those diaphragmatic nerves are especially sensitive to spicy, hot foods. Therefore, a Mexican all-you-can-eat buffet can be double trouble to those susceptible to hiccups.

Possible Triggers

 

  •  

    Eating and drinking too fast, especially if talking at the same time

  • Abdominal distention from eating too much or swallowing air

  • Abdominal surgery

  • Any disease or disorder that irritates the nerves that control the diaphragm, such as pleurisy or pneumonia

  • Nerve damage or irritation – the most common cause of intractable hiccups

  • Noxious fumes

  • Central nervous system disorders – a tumor, infection, or trauma can disable the brain’s ability to control the hiccup reflex

  • Metabolic disorders – especially those causing reduction in kidney function or reduction of carbon dioxide in the blood

  • Surgery – general anesthesia and complications following surgical procedures

  • Emotional issues such as anxiety, stress and excitement

  • Chain smoking, especially in those unaccustomed

  • A rapid temperature change as in going from a heated indoor environment to cold air outside, or vice versa

  • A sudden temperature change within the stomach as in drinking a hot liquid

Issues Surrounding Persistent Hiccups

Persistent hiccups frequently occur in the palliative care population. This is a concern for 10 to 20 percent of cancer patients and it afflicts children more often than adults. Prolonged hiccups can be extremely distressing and have a significant impact on quality of life. Pharmacological approaches are often the most rational therapies when physical measures fail to disrupt the hiccup reflex.

Intractable hiccups can produce anorexia, fatigue and exhaustion, especially when sleep is interrupted. Anxiety, frustration and depression may arise if the important daily needs of eating and sleeping are interfered with. The long-term effects are increasing distress, exhaustion, and wasting from lack of food and rest.

Possible Treatment Options

Relief from most bouts with hiccupping involves hastening the emptying of stomach contents in addition relaxing the diaphragm through medication. Many home remedies and alternative therapies have been found to be effective for some patients some of the time.

Measures for Hiccup Resolution

  • Breathing into a paper bag

  • Sipping ice water or drinking water rapidly

  • Eating soft bread

  • A gentle touch to the palate with a Q-tip

  • Holding your breath.

  • Pulling hard on your tongue.

  • Place ½ teaspoon of sugar or honey on the back of the tongue. You may repeat this 3 times at 2-minute intervals.

  • Sexual intercourse has been noted to be beneficial to some patients.

  • Acupuncture & hypnosis have been successful for some cases of persistent hiccups.

Peppermint tea can reduce the sensation of stomach fullness by relaxing the lower esophagus. This herb also slightly anesthetizes the mucus membranes of the gastrointestinal tract, which aids in reducing irritation that can cause hiccups.

In patients who have susceptibility for hiccups, it is recommended that they avoid eating large meals. Six, small meals throughout the day are preferable to three larger ones to minimize gastric distention. In addition, they should be counseled to eat slowly and breathe deeply.
For More Information:
Hiccups. (2008). E Medicine Health. [On-line] Available: http://www.emedicinehealth.com/hiccups/article_em.htm

Hiccups. (2008). HealthScout.com. [On-line] Available: http://www.healthscout.com/ency/68/296/main.html

Hiccups. (2008). Mayo Clinic. [On-line] Available: http://www.mayoclinic.com/health/hiccups/DS00975