Why We Get Occasional or Constant Hiccups

Hiccups are a reflex involving the phrenic nerve, vagus nerve, or thoracic sympathetic fibers. The causes of hiccups range from acute factors like eating a large meal or drinking carbonated drinks to more persistent factors like central nervous system or gastrointestinal disorders.

This article explains the causes of occasional and constant hiccups and treatment. It also covers what happens when you have hiccups and how long you can expect them to last.

Common Causes of Occasional Hiccups

Common causes of hiccups include how you eat and emotional factors.

Eating and Drinking Habits

Hiccups occur when your stomach distends after eating a large meal or drinking carbonated drinks. If you have a habit of eating quickly or until you are full or drinking sparkling water or soda, you may be more likely to experience occasional hiccups.

In addition, the following foods may trigger the hiccup reflex:

• Alcohol
• Fried foods
• Meat
• Salty foods
• Sour foods
• Spicy foods
• Sweets
  

Emotional Factors

Emotions, such as overexcitement, stress, or anxiety, can lead to hiccups in some people. For example, you may swallow excess air in your enthusiasm when overexcited.

Causes of Constant Hiccups

When hiccups are more often than occasional, they are called persistent or intractable. These painful hiccups typically last longer than a couple of days. Some health conditions can cause persistent hiccups.

Central Nervous System Disorders

Vascular conditions, infections, and structural central nervous system problems, including the following disorders, could lead to chronic hiccups:

• Arteriovenous malformation: Group of abnormally interconnected blood vessels
• Brain abscess: Pus-filled brain infection
• Brain stem neoplasms: Tumors in the brain stem
• Encephalitis: Brain inflammation
• Head trauma: Injury to the brain or skull
• Hemorrhagic stroke: When blood supply to a region of the brain is diminished due to bleeding
• Hydrocephalus: Fluid on the brain
• Intracranial neoplasms: Brain tumors
• Ischemic stroke: When an artery supplying blood to the brain becomes blocked
  
• Meningitis: Inflammation of the meninges, the lining of the brain and spinal cord
• Multiple sclerosis: Progressive neurological disease
• Neurosyphilis: Central nervous system infection
• Subphrenic abscess: Infected fluid above the diaphragm
• Syringomyelia: Spinal cord cyst
• Temporal arteritis: Inflamed arteries by the temples
  

Vagus and Phrenic Nerve Irritation

Since these nerves are involved in the hiccup reflex, any irritation of these nerves could lead to hiccups. Conditions associated with these nerves include:

• Goiter: Enlarged thyroid
• Hair or foreign-body irritation of the tympanic membrane (eardrum)
• Laryngitis: Larynx inflammation resulting in lost voice
• Neck cyst or tumor
• Pharyngitis: Sore throat
  

Gastrointestinal Disorders

Gastrointestinal disorders that may lead to chronic hiccups include:

• Abdominal abscesses
• Aerophagia: Swallowing too much air
• Bowel obstruction
• Esophageal distention
• Esophagitis: Esophagus irritation or swelling
• Gallbladder disease
• Gastric carcinoma: Stomach cancer
• Gastric distention: Enlarged stomach
• Gastritis: Inflamed stomach lining
• Hepatitis
• Inflammatory bowel disease
• Pancreatic cancer
• Pancreatitis: Pancreas inflammation
• Peptic ulcer disease: Open sores in the stomach and small intestine
  

Thoracic Disorders

Thoracic disorders involve the lungs, heart, esophagus, chest wall, diaphragm, and great vessels. These types of conditions can cause chronic hiccups and include:

• Aortic aneurysm: Dilated aorta, the body's main artery
• Asthma
• Bronchitis
• Chest trauma
• Empyema: Pus between membranes lining the lungs
• Enlarged lymph nodes
• Mediastinal tumors: Growths between the lungs
• Mediastinitis: Swelling and irritation in the chest between the lungs
• Pleuritis: Inflammation of the membrane covering the lungs and chest
• Pneumonia
  
• Pulmonary embolism: Blood clot in the lungs

Cardiovascular Disorders

Heart conditions, including myocardial infarction (heart attack) and pericarditis (inflammation of the pericardium, the protective sac around the heart), can also cause hiccups.

Infections and Toxicity

Some infections and toxins can also lead to persistent hiccups. These include:

• Alcohol
• Diabetes mellitus
• Herpes zoster (shingles)
• Hypocalcemia (low calcium)
• Hypocapnia (reduced carbon dioxide in blood)
• Hyponatremia (low sodium)
• Influenza
• Malaria
• Tuberculosis
• Uremia (reduced kidney function)

Postoperative

Many factors related to surgery can cause postoperative hiccups. This includes anesthesia, intubation (inserting a tube through a patient's nose or mouth and down into the airway), neck stretching, and abdominal distention.

Drugs

Some drugs can also cause persistent hiccups, including:

• Alpha methyldopa (blood pressure medication)
• Chemotherapy (for example, carboplatin)
• Dexamethasone (corticosteroid)
• Short-acting barbiturates
• Valium (diazepam)
  

Psychological

Psychological disorders that may lead to chronic hiccups include:

• Anorexia nervosa
• Excitement
• Malingering (exaggeration of illness)
• Schizophrenia
• Stress

Things to Try to Stop Hiccups

The good news is there are many tactics for getting rid of hiccups.

At-Home Treatment

At-home treatments include:

• Pressing on your eyeballs
• Using the Valsalva maneuver (breathe out forcefully while holding your mouth and nose closed)
• Plugging your ears
• Swallowing ice
• Breathing into a paper bag
• Sucking on a lemon
• Pulling on your tongue
• Pulling your knees to your chest

A Word From Verywell

Scaring someone has been used to try and treat hiccups, despite the lack of real evidence in its success. In theory, it makes physiological sense, but I would suggest trying some of the other methods first to get rid of hiccups mentioned in this article

— MICHAEL MENNA, DO, MEDICAL EXPERT BOARD

Medical Treatment

Persistent hiccups may require treating the underlying medical condition causing them. In addition, some medications may help. These include:

• Anticonvulsants (for epilepsy and seizure disorders)
• Baclofen (medicine for pain and muscle spasms)
• Chlorpromazine (antipsychotic)
• Defoaming agents (for stomach distention)
• Dexamethasone (corticosteroid)
• Gabapentin (medication for seizures and nerve pain)
• Haldol (haloperidol (antipsychotic)
• Lidocaine (local anesthesia)
• Methylphenidate (attention deficit hyperactivity disorder, or ADHD, medication)
• Midazolam (used for procedural sedation)
• Nifedipine (high blood pressure medicine)
  
• Prokinetic agents (gastroesophageal reflux disease, or GERD, medication)
• Proton pump inhibitors
  
• Zoloft (sertraline, an antidepressant)

While the list is long, it's worth noting that chlorpromazine is the only drug approved by the Food and Drug Administration (FDA) for hiccups.

What’s Happening During Hiccups?

When you hiccup, your body makes an involuntary movement (called a reflex). The first movement happens with your diaphragm (the muscle at the bottom of your lungs). Next, your vocal cords quickly close, making the notable "hic" sound. This reflex occurs when certain nerves are stimulated.

How Long Do Hiccups Last?

Occasional hiccups are short-lived, usually lasting no longer than 48 hours. Intractable hiccups can last longer than a month.

Summary

There are many causes of hiccups, from food to emotions to medical conditions. Fortunately, there are many remedies for getting rid of hiccups, and they will eventually go away. A cause may need to be determined for persistent hiccups in order to treat the underlying condition and relieve the hiccups.