We have undoubtedly, all had hiccups at one time or another. As a kid, I tried every old wives tale in the book to make them go away. I even remember people coming to the hospital after having hiccups for as long as a day and they were at their wit’s end.
A hiccup is an involuntary and intermittent gasp that happens due to spasms of our two main groups of muscles that make us breathe. Those are the intercostal muscles which run between our ribs and the diaphragm, dome shaped muscles that sit under our lungs on each side of our chest. When they spasm and contract, we suck in air really quickly and a structure in our throat closes very abruptly which gives hiccups their characteristic ‘hic’ sound.
Most of us know that when you have hiccups, they hang around for a little while. In some people though, they stick around for much longer. Hiccups that stay with someone for over a month are called intractable. Even those that last longer than several hours can be sufficiently irritating enough to get some help. For those people who have them for a long period of time, hiccups can lead to malnutrition, weight loss, insomnia and fatigue.
Despite how common they are, medical science still hasn’t worked out exactly how hiccups occur. What we do know is that in most cases, only one side of the diaphragm contracts and spasm and that the nerves that drive the diaphragm and the muscles in the throat. We don’t know which parts of the brain are involved just yet.
Interestingly, before they are born, babies can get hiccups and we think this could be a way of exercising the breathing muscles.
Hiccups are probably caused by stretching the stomach too much by over-eating, carbonated beverages or swallowing air (which can happen with chewing gum or smoking). We also tend to associate hiccups with a bout of drinking too much alcohol and this is something that does happen. We also see them with reflux, or after an anesthetic.
Intractable hiccups are uncommon, but they can be associated with other medical problems such as an illness involving the brain, the nerves of the diaphragm or the diaphragm itself. Some cancers that irritate these structures, such as lung cancer, can see the development of hiccups.
Since most of the time, hiccups go away by themselves, they don’t need a trip to the doctor. For those who have them for a long time (weeks or months), it is certainly worthwhile making sure there is no underlying cause.
To treat hiccups, there may actually be some value in the old wives’ tales. Holding your breath, gargling or pulling your knees up to your chest may interrupt the nerves that are over-excited and settle down the diaphragm. There doesn’t seem to be any science as to whether scaring someone or sipping water backwards is at all helpful though.
In cases where hiccups won’t go away, there are medications that we can give to slow down the hiccups which your doctor can use.
All in all, hiccups are mostly pretty benign, and we don’t need to worry about them. If you have had them for a while, be sure to check in with your doctor.