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Singultus Content Supplied by NHS Choices
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 diaphragm is a thin membrane of muscle that separates the chest cavity from the abdomen (tummy). It is located underneath the ribcage and helps to control breathing.

The medical name for hiccups is "singultus".

What causes hiccups

Hiccups are very common and most people will get them at some point during their life. They can affect people of any age, including babies.

Hiccups often occur without any obvious trigger, although short episodes have been linked with:

  • drinking alcohol
  • smoking
  • having a bloated stomach
  • eating too quickly or eating spicy foods
  • drinking hot or fizzy drinks
  • emotions, such as stress, fear or excitement

In rare cases, hiccups can last for a long time. If hiccups last for more than 48 hours they are known as "persistent" or "protracted" hiccups, and hiccups that last longer than a month are called "intractable" hiccups.

These longer-lasting hiccups have been linked with a number of underlying medical conditions and some medications.

Read more about the causes of hiccups.

When to seek medical advice

Hiccups are not usually serious and in most cases only last a few minutes.

However, you should see your GP if you have hiccups that recur frequently or last longer than 48 hours so they can try to identify a possible cause and determine whether any further investigation or treatment is necessary.

How hiccups are treated

Most hiccups will pass quickly and won't need any specific treatment.

If your hiccups are troublesome, there are some things you can do that may help, such as:

  • sipping ice-cold water
  • holding your breath for a short period
  • biting on a lemon
  • swallowing granulated sugar
  • tasting vinegar
  • pulling your knees up to your chest

For longer-lasting hiccups, identifying and treating any identifiable cause may help, and there are also a number of medications that are sometimes used specifically to control hiccups.

Read more about treating hiccups.


Causes of hiccups

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 air in 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.

Causes of 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.

In some cases however, short-term hiccups may appear to have a specific trigger, such as:

  • drinking alcohol
  • smoking
  • having a bloated stomach
  • eating too quickly or eating spicy foods
  • drinking hot or fizzy drinks
  • swallowing air - for example, while chewing gum
  • a sudden change in room temperature
  • a sudden change in the temperature inside your stomach - for example, eating something hot followed by a cold drink
  • emotions, such as stress, fear or excitement

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

Causes of long-lasting hiccups

In rare cases, hiccups that last 48 hours or longer can be caused by an underlying condition or a medication you are taking, although in many cases a cause is not identified.

Underlying conditions

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

Medication

Persistent hiccups can sometimes also be caused by a reaction to certain types of medication, such as:

  • anaesthesia - medication given before a surgical operation or procedure that causes a loss of sensation or consciousness
  • 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 (hypertension)
  • chemotherapy medications - medicines used to kill cancer cells

If an underlying cause of long-lasting hiccups can be identified, treating this cause can help improve the problem.

Read more about treating hiccups.


Treating hiccups

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

However, some simple techniques may help if your hiccups are particularly troublesome, and medical treatments are available if the problem is long-lasting.

Self-help techniques

There are a number of things you can try yourself initially that may help to stop your hiccups. These include:

  • sipping ice-cold water
  • holding your breath for a short period
  • biting on a lemon
  • swallowing granulated sugar
  • tasting vinegar
  • breathing into a paper bag (never place a bag over your head)
  • pulling your knees up to your chest
  • leaning forward to compress your chest

However, while some people do find that these techniques can be helpful, they have not been tested in medical studies and it's not clear how effective they actually are.

Treating long-lasting hiccups

If an underlying health condition is causing your hiccups, treating it may help to resolve the problem.

For example, if you are diagnosed with gastro-oesophageal reflux disease (GORD), you may be prescribed a medication called a proton pump inhibitor (PPI) to reduce the amount of acid produced by your stomach.

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

Medication for hiccups

If other treatments have failed, or no underlying cause can be found, your GP may offer you medication to specifically treat your hiccups.

A number of different medications are used to help treat hiccups, although there isn't much high-quality evidence to suggest these are consistently effective.

Some medicines that may be used include:

Your GP will usually prescribe one of these medications for several weeks, during which time they may gradually increase your dose until your hiccups are brought under control. Your dose will then be slowly reduced until you can stop taking the medication.

If your hiccups return as your dose is being reduced or after treatment stops, your GP may recommend increasing your dose again or restarting treatment.

Your GP may suggest trying an alternative medication if the first medicine you try doesn't help to resolve your hiccups.

All the medicines used for hiccups can cause side effects, so make sure you speak to your GP about the potential side effects you may experience before starting treatment.


 
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