Linda Crampton is a writer and former teacher with a first-class honors degree in biology. She writes about the scientific basis of disease.
An Annoying and Embarrassing Problem
Hiccups are annoying and embarrassing for the sufferer and often amusing for observers. Short bouts of hiccuping are usually harmless. An extended episode or frequent occurrences of the disorder may be a sign of a medical problem, however. Fortunately, techniques for eliminating hiccups exist and may be very helpful.
There are many different causes for hiccups, including lifestyle factors, such as eating or drinking too much, certain diseases and disorders, and problems which irritate the nerves controlling the diaphragm. The diaphragm is the main muscle of inhalation.
Even though hiccuping is a very common process, scientists don’t completely understand it. They know that the diaphragm undergoes spasms during a hiccup attack and that the vocal cords produce the sound, but they think that the brain also plays a role in the attack.
The Diaphragm, Inhalation, and Exhalation
The diaphragm is a sheet-like muscle that lies under the lungs and is dome-shaped when it's relaxed. Understanding how the diaphragm works can be helpful in understanding how a hiccup is produced.
When the diaphragm contracts during inhalation, it moves downwards and causes the lungs to expand. The air molecules left in the lungs after the last exhalation then spread out to fill the extra space. This reduces the air pressure in the lungs. Since air is now at a higher pressure outside the body than inside the lungs, air moves into the lungs through the nose and mouth.
At the start of exhalation, the diaphragm relaxes and moves upwards again. As it moves, it presses against the lungs, pushing air out of the lungs and into the outside world.
The Vocal Cords and Sound Production
The vocal cords are also important in the production of a hiccup. The trachea, or windpipe, is the tube that transports inhaled air to the lungs. At the start of the trachea is an expanded region called the larynx, or voice box. The larynx contains the two vocal cords (also known as vocal folds), which are positioned across the diameter of the air passage.
When we aren't producing a sound, the vocal cords are separated by a v-shaped space. This space allows air to pass into and out of the trachea. When we need to make sounds, the vocal cords move closer together. A complex combination of exhalation, vocal cord vibrations, and muscle actions produces our speech.
How Is a Hiccup Produced?
The basic mechanics of the hiccuping process are known, but not the details. A hiccup results when the diaphragm undergoes a spasm (a sudden, strong, and involuntary contraction). The spasm is followed by the vocal cords slamming together, which produces the hiccup sound. The diaphragm spasms and the hiccups occur at a rate of about 4 to 60 times a minute, but most fall in the range of 15 to 30 times a minute.
Hiccups occur in animals as well as humans and also occur in the human fetus. They are common in newborn babies. The number of hiccuping episodes gradually decreases over the first few months of a baby’s life.
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Potential Causes of Hiccups
Many factors can potentially cause a hiccup attack. They don't cause hiccups in everybody or every time that a person is exposed to them, though. The most common factors are listed below.
- Eating too much food
- Eating too quickly
- Swallowing air while eating
- Eating very spicy food
- Drinking carbonated drinks
- Drinking an excessive amount of alcohol
- Chewing gum
- Experiencing a sudden temperature change in the stomach or in the room
- Experiencing emotional stress
- Smoking excessively
An overfilled or bloated stomach can interfere with the normal action of the diaphragm, since the stomach is located underneath this muscle. Irritation of the diaphragm can also cause hiccups.
Be able to hiccup silently, or at least without alerting neighbors to your situation. The first hiccup is an exception.
— Marilyn vos Savant
Health Problems That May Cause Singultus
The scientific name for hiccups is singultus. Multiple health problems can cause the condition. Experiencing the disorder doesn't necessarily mean that we have one of the problems, however. The information below is given for general interest.
Health problems such as heartburn or acid reflux (movement of stomach acid up into the esophagus) can produce hiccups. Stomach ulcers and intestinal problems such as duodenal ulcers and inflammatory bowel disease can produce the same effect.
Hiccups may be triggered by any process that irritates the phrenic nerve, which travels from the spinal cord in the neck to the diaphragm, or the vagus nerve, which travels from the brain to the diaphragm and to other parts of the body. A swelling in the neck, such as a goiter, cyst, or tumor, may be responsible for the irritation. Hiccups can also be triggered by a disorder in the throat or chest cavity such as a sore throat or a respiratory disease such as pneumonia, asthma, or bronchitis.
Problems in the brain such as a stroke, meningitis, encephalitis, multiple sclerosis, or a tumor are other potential causes of hiccups. Metabolic problems such as hypoglycemia and hyperglycemia and certain medications may also trigger the problem. Even heart and kidney disorders and some types of surgery have been linked to hiccups.
How Long Does the Problem Last?
Generally, a "hiccup bout" is an episode of hiccups that lasts for a few seconds to forty-eight hours. Health experts recommend that after hiccuping for forty-eight hours, a person should seek medical attention. If hiccups last for several days or weeks, they are said to be persistent. If they last for more than a month, they are classified as intractable.
Even if the condition isn't linked to any serious disease, long-term hiccups may lead to sleep disturbances and can be exhausting. A severe and chronic hiccuping problem can also cause malnutrition, dehydration, and weight loss. Acid reflux, aspiration pneumonia, and heart irregularities have arisen in some people with severe, untreated hiccups.
The longest known episode of hiccups lasted for sixty-eight years. Charles Osborne from Iowa hiccuped from 1922 until 1990. Though it must have been very annoying for him, it doesn't seem to have interfered with his survival. He died in 1991.
Tips for Getting Rid of Hiccups
I rarely experience hiccups myself, but when I do they don't last for long and disappear on their own. Patience solves my problem. For people who don't want to wait, home remedies may be effective, though I haven't tried them. Some possible remedies are given below.
Some home treatments rely on increasing the carbon dioxide level in the blood or on stimulating the vagus nerve. For example, holding one's breath or breathing into a paper (but not plastic) bag raises the carbon dioxide level in the blood. The National Health Service in the UK recommends the latter step but adds a warning that we shouldn't put the bag over our head.
Firmly pulling the tongue may stimulate the vagus nerve. A teaspoon of sugar placed on the back of the tongue, drinking ice-cold water, biting a lemon, or drinking vinegar stimulates the back of the throat and ends some hiccup bouts.
Leaning forward to compress the chest or raising the knees to the chest ends hiccups in some people. Even drinking from the far side of a glass has been reported to cure the problem. This process may be helpful because it forces the abdominal muscles to contract. If a person is startled, their hiccups may stop due to a sudden contraction of the diaphragm. Mental distraction may also be a successful technique for stopping the problem.
People who have hiccups and warning signs should see a doctor right away. People without warning signs should see a doctor if hiccups last more than 2 or 3 days.
— Jonathan Gotfried, MD, via the Merck Manual
Possible Medical Treatments
In a few cases, hiccups are too severe, persistent, or frequent to simply wait for them to end or to be relieved by a home remedy. In some cases, they may be accompanied by potentially serious symptoms. The “warning signs” mentioned in the quote above include “neurologic symptoms (such as headache, weakness, numbness, and loss of balance).”
Doctors have several ways to treat the disorder. Relieving any underlying health condition that may be responsible for the problem is important. In addition, there are several medications that can reportedly be very effective at providing relief.
Acupuncture is another treatment that has helped some people with hiccups that won’t go away. There have also been reports of people cured after hypnosis. A doctor should be the first person to visit if you have a hiccupping problem, however. The doctor can diagnose other health problems and answer questions about potential treatments for hiccups.
Preventing a Hiccup Attack
To reduce the chance of a hiccup attack, don’t overfill your stomach, avoid very spicy food, restrict alcohol consumption, and don't smoke. Avoid any personal triggers, such as drinking carbonated beverages, eating or drinking too fast, or chewing gum. If you have persistent, unexplained ailments that might be responsible for hiccups, visit a doctor to find a diagnosis and a treatment.
For many people, hiccups are an inconvenience but not a permanent problem. Even without a home treatment, a hiccup attack often disappears on its own. For some people an attack can be more problematic, however. Medical practitioners have a range of treatment options that may provide relief. It's important to visit one if necessary.
- Hiccup information from the Mayo Clinic
- Facts about hiccups from WebMD
- Hiccup advice from the NHS (National Health Service)
- Information about the disorder from the Merck Manual
- Singultus information from the NIH (National Institutes of Health)
- The hiccups of Charles Osborne from BBC News
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2011 Linda Crampton
Linda Crampton (author) from British Columbia, Canada on August 28, 2012:
Thank you for the comment, ignugent17. I appreciate the visit!
ignugent17 on August 28, 2012:
This is useful and interesting. My mother will give us water when we have hiccups and I did not know that sometimes it becomes serious. Thanks for the information.
Linda Crampton (author) from British Columbia, Canada on March 04, 2011:
Hi, Truckstop Sally. Some people do seem to be more prone to hiccups than other people! Thanks for commenting.
Truckstop Sally on March 04, 2011:
Interesting to think about! I have never been much of a hiccup-er. And I'm sorry to say I often over-fill my stomach, eat spicy foods, and drink. I must be immune.
Linda Crampton (author) from British Columbia, Canada on February 20, 2011:
Hi, kashmir56. Yes, I find hiccups annoying too! Thank you very much for your comment.
Thomas Silvia from Massachusetts on February 20, 2011:
Hi AliciaC thanks for all this great information and advice,hiccup can be very annoying and it is always nice to know good ways to stop it .
Great hub thumbs up !!!