Are Hiccups Good or Bad?

Hiccups are caused by involuntary or uncontrolled repetitive contractions of the diaphragm. 

• The diaphragm is a dome-like muscular structure that lies right under the lower surface of the lungs. It acts as a partition between the chest (thorax) and the abdomen. 
• The diaphragm helps regulate breathing. It contracts when you inhale, allowing air to enter the lungs, and relaxes or recoils to cause exhalation or release of air from the lungs.
• As you breathe in, air enters through your trachea (windpipe) into the lungs. The upper end of the trachea is protected by a leaf-like flap called the epiglottis. The epiglottis ensures that no food or fluids enter the trachea.

During a hiccup, the diaphragm contracts repetitively causing sudden uncontrolled inhalation. At the end of the inhalation, the epiglottis abruptly shuts the upper end of the trachea (called glottis) causing the typical “hic” sound. The frequency of hiccups in a person is generally constant and may range from 4 to 60 in a minute.

The causes of hiccups may vary depending on how long the bouts last.

Causes of short-term hiccups

These include hiccup bouts that do not last beyond 48 hours, which may be caused by:

• Eating or drinking too quickly
• Consuming fizzy beverages
• Drinking very cold or hot beverages 
• Having too hot, fatty, or spicy foods
• Alcohol consumption
• Overeating
• Emotional stress or excitement
• Toxic fume inhalation
• Pregnancy
• Swallowing a lot of air such as while chewing gum or smoking
• Certain medications (such as anxiety medications, steroids, or chemotherapy)

Causes of long-term hiccups

Hiccups that last for more than two days (over 48 hours) may suggest an underlying health issue, which may be caused by:

• Liver diseases such as hepatitis or tumors
• Esophagitis (inflammation of the esophagus)
• Sore throat
• Acid reflux or gastroesophageal reflux disease
• Laryngitis (inflammation of the larynx)
• Brain conditions such as brain injury (traumatic brain injury), brain tumor, and stroke
• Kidney failure
• Chronic stress or anxiety
• Post-surgery
• Smoking or nicotine consumption
• Hyperthyroidism (an overactive thyroid gland)
• Pneumonia
• Hiatal hernia
• Injury or damage to the nerves that control the diaphragm (vagus or phrenic nerves)
• Foreign body in the ear
• Diabetes
• Electrolyte imbalance
• Terminal illness such as advanced cancer

Hiccups generally last for a few seconds to minutes.

• Babies or infants up to 12 months of age get hiccups quite often, which can be managed by feeding them.
• Babies older than six months may be given some water.
• For bottle-fed babies, make sure that the nipple doesn’t have an air bubble. 
• Breastfed babies must be properly latched while feeding.

Keeping the baby upright for 15 to 20 minutes after feeding and rubbing their back may help relieve and prevent hiccups. If hiccups in babies do not go away or are accompanied by other signs (such as refusal to feeds, arching of the back, or inconsolable crying), consult your pediatrician.

For older children, teens, and adults, brief bouts of hiccups or those lasting less than 48 hours can be managed at home by:

• Holding the breath for a few seconds (5 to 10 seconds)
• Breathing in a paper bag for some time
• Drinking a few sips of cold water
• Performing the Valsalva maneuver (try breathing out forcefully through the mouth while keeping your mouth closed and nose pinched)
• Swallowing a little dry sugar
• Biting into a lemon
• Gargling with cold water
• Applying gentle and firm pressure on the eyeballs
• Pulling on your tongue
• Doing the knee-to-chest maneuver; sit comfortably and try to compress your chest by leaning forward or pulling your knees to the chest (hold this position for 30 seconds to one minute)
• Drinking water through a special type of rigid straw (an inflexible tube with a valve)

If your hiccups do not get relieved within three hours or worsen with time, contact your doctor. Contact your doctor immediately if your hiccups are causing severe symptoms such as unbearable pain or shortness of breath.

Your doctor will determine the underlying cause of hiccups and give appropriate medications (such as antacids for acid reflux) or perform requisite procedures (such as foreign body removal from the ear). Besides addressing the underlying condition, they may prescribe medications that help stop hiccups (such as baclofen, metoclopramide, chlorpromazine, and gabapentin).

Some people have reported benefits from hypnotherapy or acupuncture. Hiccups that do not go away may be treated with surgical procedures (such as phrenic nerve block).