Chronic hiccups can be caused by underlying medical conditions such as GERD, pericarditis, and hiatal hernias. They can also occur without an obvious cause, but can cause stress and fatigue. Treatment options include muscle relaxants, benzodiazepines, acupuncture, and nerve stimulation.
Chronic hiccups, usually defined as hiccups that last more than 48 hours, can occur due to an underlying medical condition, although sometimes they occur without an obvious cause. Conditions such as gastroesophageal reflux, pericarditis and hiatal hernias can cause repeated hiccups. People suffering from this condition are generally advised to seek medical attention, in order to rule out the possibility that a serious underlying disease could be the cause. When chronic hiccups occur without an obvious cause, they aren’t usually considered a cause for medical concern. However, chronic hiccups can cause stress and fatigue in sufferers.
Perhaps the most common cause of chronic hiccups is gastroesophageal reflux disease (GERD). GERD can cause acid from the stomach to back up into the esophagus. GERD usually causes other symptoms than hiccups. These additional symptoms may include chest pain, heartburn, difficulty swallowing, pain or nausea after eating, and a sour taste in the back of the throat. GERD can cause permanent damage to the esophagus and contribute to esophageal cancer.
Pericarditis, a condition that can cause inflammation of the membrane surrounding the heart, can also cause persistent hiccups. A number of factors can contribute to pericarditis, including injury, radiation therapy, viral infection, or a heart attack. Additional symptoms may include stabbing chest pains, fever, cough, and fatigue. Serious and even life-threatening complications can occur.
Hiatal hernias, which generally occur in the diaphragm muscle, can be another cause of chronic hiccups. Such a hernia can cause the stomach, or part of the stomach, to travel into the chest cavity through a hole in the diaphragm, and possibly lodge there. Additional symptoms may include abdominal pain, a sour taste in the back of the throat, frequent burping, choking, vomiting, difficulty swallowing, and coughing.
A number of other medical conditions can lead to persistent hiccups, including hypoglycemia, diabetes, gastroenteritis, laryngitis, and pharyngitis. Sometimes, persistent hiccups occur without a recognizable cause, and these are known as chronic idiopathic hiccups.
While doctors believe chronic idiopathic hiccups aren’t harmful, they can disrupt sleep, contributing to fatigue and exhaustion. Patients who are particularly distressed by chronic hiccups can be given treatment. Muscle relaxants may be given to help slow or stop the jerking movement of the diaphragm that causes hiccups.
Benzodiazepines may be given to some patients, especially those experiencing hiccups as a complication of terminal illness. Acupuncture, hypnotherapy, and vagus or phrenic nerve stimulation have been used to relieve persistent hiccups. In extreme cases, a phrenic nerve block can stop persistent hiccups, although this procedure often carries dangerous risks.
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