Hiccups are caused by muscle spasms in the diaphragm, controlled by the phrenic nerve. Common causes include overeating, swallowing air, and irritants like cigarette smoke. Long-lasting episodes can be related to serious health conditions and should be checked by a doctor. Drinking water, eating something hard to swallow, and stretching the diaphragm are popular cures. Muscle relaxants, sedatives, or anticonvulsant drugs may be given by healthcare providers if hiccups don’t stop by normal means.
Hiccups are caused by uncontrollable muscle spasms in the diaphragm. The phrenic nerve controls the diaphragm and is directly responsible for these spasms, forcing rapid inspiration, resulting in hiccups. While generally not dangerous, long-lasting episodes can be related to some serious health conditions and should be checked by a doctor.
What happens in the body
The diaphragm is a muscle that extends across the abdomen below the lungs. When a person breathes in, the diaphragm contracts, creating suction that draws air into the lungs. The phrenic nerve is what controls movement in this muscle, and when the nerve gets irritated, the diaphragm can contract sharply. When air is suddenly pulled into the lungs, it passes the vocal folds where it can cause an involuntary sound, often heard as a “hic”. This process repeats until the diaphragm and nerve relax. Most episodes are over within minutes, but some rare cases can last for days or weeks.
Common causes
Food can be a major cause of spasms in the diaphragm. Some people experience fits of hiccups when they overeat, as food puts pressure on the digestive muscles. Spicy, hot, or cold foods can also irritate the phrenic nerve and cause problems for some people.
Swallowing air appears to cause hiccups in some cases. Eating or drinking too quickly can cause spasms, because swallowed air can put sudden pressure in the abdomen. Some foods with large pockets of air, such as sourdough bread, can also cause the diaphragm to contract. Drinking alcoholic, carbonated, or cold beverages is sometimes linked to a higher chance of hiccups.
Occasionally, a sore or narrowed throat can cause a spasm of the phrenic nerve. Common irritants include cigarette smoke, seasonal allergies, stuffy throat, or a sore throat caused by a cold. While having hiccups with a sore throat isn’t usually dangerous, if the person’s throat starts to feel tight or breathing becomes difficult, they should see a doctor quickly.
Some prescription or over-the-counter medications can also cause hiccups. Some common medications related to hiccups are those designed to treat digestive problems, including medications for acid reflux and nausea. The relaxing effect of sleeping pills can also disturb the diaphragm, causing long-term spasms.
Cause rare
In some cases, hiccups can be the result of a serious health condition. Nerve disorders, such as multiple sclerosis or meningitis, can affect the way the phrenic nerve works and can cause fits of hiccups that last for days. Traumatic injuries or serious illnesses can also cause nerve damage. While doctors aren’t sure the reason for the connection, some metabolic disorders are also linked to extensive hiccups. Alcoholism, diabetes and steroid use are all also linked to severe episodes of muscle spasms in the diaphragm.
Medical complications
When hiccups last a long time, they can cause health and lifestyle complications. People with continuous spasms may have difficulty eating, drinking, sleeping, and functioning normally during daily activities. Additionally, the constant spasms can exhaust your muscles, leading to muscle pain and weakness. Anyone who has a hiccup that doesn’t go away within a day or two should speak to a healthcare professional.
Treatment
Drinking water is often cited as a way to end an episode, though the method can vary. Some people suggest drinking a glass of water in small sips, or tilting your head upside down and drinking from the opposite side of the glass. Eating something, often something hard to swallow, is another possible cure. Some people get relief by chewing on a bite of sugar, while others ingest a spoonful of honey instead. Peanut butter, jam, wasabi, and hot sauce are all foods that some people say will stop hiccups, too.
Stretching the diaphragm by holding the breath and raising the arms is another popular cure. Some people recommend taking short, quick breaths or breathing into a paper bag. Holding your breath for up to 30 seconds is sometimes recommended, as rising carbon dioxide levels can help calm your diaphragm and prevent further spasms. If apnea or fast breathing methods are used, the person should remember that dizziness is a problem. It may be helpful to try these treatments while sitting.
Scaring or frightening someone is one possible method of relieving hiccups, but it’s not always a good idea. In some cases, scaring a person can make the condition worse or annoy the person for attempting assistance. Instead, to help the body relax, some people recommend focusing on a difficult mental or physical task, like saying the alphabet backwards or tying a difficult overhand knot. In theory, this can take the mind off the physical symptoms, stopping the spasms.
If a patient has hiccups that don’t stop by normal means, health care providers may give muscle relaxants, sedatives, or anticonvulsant drugs. The goal is to break the cycle of spasms so that the diaphragm begins to function normally again. If all other methods fail, a surgeon can operate to disable the phrenic nerve, but this is quite unusual.
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