What are hiccups?
Hiccups are those repetitive sounds that are made as involuntary inhalations and exhalations occur. The medical name for them is singultus. For most people, these tend to occur when gas is trapped in the stomach and then suddenly released with either a small or theatrical belch. Obviously, the fact that the diaphragm (respiratory muscle under the lungs and on top of the stomach) can wiggle like this and get rid of gas trapped in the stomach (besides exiting from the opposite end, the rectum) is a plus, except, of course, for anyone “downwind.” If gas just kept building up in the stomach, the stomach would be damaged and you would experience chronic gas pain, which is never pleasant.
Should I try to have someone startle me to stop hiccupping?
The result of a startle is to take a deep breath and hold it. Controlling your breathing, (i.e. making it fast or slow, shallow or deep) may sometimes break a spasm of the diaphragm.
When are hiccups a problem?
Hiccups that recur daily or even hourly, fall into this category. When someone has chronic hiccups, there are a couple of places to look for the likely culprits. First, the diaphragm is controlled by the brain. Damage to the brain, by strokes, tumors, or seizures, can cause hiccups. Conditions that alter body chemistry, and therefore brain chemistry, can also lead to brain dysfunction manifested as hiccups. These include toxins, electrolyte imbalances, and organ failure (such as kidney failure). Second, there can be direct irritation to the diaphragm. This can come from the chest cavity, from a pneumonia or a lung abscess or from abnormal fluid collections under the diaphragm (subphrenic abscess). Tumors in the gastrointestinal tract, from the esophagus to the stomach may also lead to hiccups. Finally, simple irritation of the diaphragm itself can lead to spasm of this muscle and hiccups.
What tests might be done to evaluate chronic hiccups?
Common tests may include an upper endoscopy (camera in the esophagus and stomach), a swallowing evaluation, routine blood work and a CAT scan of the head, chest and or abdomen. You may also receive medication trials with antacids, medications that decrease muscle spasm (including some anti-seizure medications), and/or other muscle relaxants. Medical interventions may also include mechanical ventilation or general anesthesia. Some patients with severe hiccups may be evaluated for treatment of the nerve to the diaphragm or pacing of the diaphragm.
Self-Check for Managing Hiccups
- I have taken medication for 1-2 days for heartburn or gas without relief.
- I have written a list of all my other symptoms- gas, belching, heartburn, constipation, change in urine, tremor, loss of appetite, nausea, constipation, numbness, weakness, or confusion.
- I have a friend or family member who can come with me to my doctor appointment if I have a difficult time talking due to hiccups.
Managing Doctors
- Primary Care
- Gastrointestinal
- Pulmonary
- Neurology
- Renal
- Anesthesia
- Surgery