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A social embarrassment they may be, but in the vast majority of cases the “hiccup” is just that – a temporary interruption. Between the lungs and abdomen below sits the diaphragm, a large, powerful dome-shaped muscle that is critical in changing thoracic pressures to assist in breathing. As it contracts and flattens, it draws air into the lungs, sucking it in like a vacuum cleaner. A glitch in the system – again, the temptation to use “hiccup” is too much – results in a spasm in the diaphragm muscle. It’s a reflex, similar to that triggered when a doctor taps your knee with a tendon hammer.
This sudden indrawing of air forces the space between your vocal cords (the glottis) shut, resulting in that well-known “hic” sound. They’re better known to men, who are almost four times more likely to experience hiccups than women, but fortunately only about 3 per cent of healthy individuals suffer with recurrent hiccups. Short-lived cases may last from just a few minutes – that may seem like an eternity – up to 48 hours. Those lasting more than a couple of days need further investigation. Irritation to the diaphragm muscle itself or the nerves that supply it may be responsible in those with persisting symptoms.
Hiccups are seen from the earliest days of life and are especially frequent in young babies. Common causes in adults vary from psychological shock or even grief to acid reflux, sudden change in temperature, fizzy drinks, excessive food, excessive alcohol or aerophagia – swallowing air. Persistent hiccups can be caused by infections; tumours; metabolic, lung and heart disease; or even processes affecting the nervous system such as Parkinson’s or multiple sclerosis.
To alleviate that nerve-diaphragm short circuit, guidelines recommend many of those bits of
Wisdom handed down over generations. Childhood memories of trying to drink a glass of water upside down are fortunately not included. Techniques aim to either increase pressure on the diaphragm or stimulate the nerves involved. Options include briefly holding your breath, breathing into a paper bag, sipping ice water, tasting vinegar or bitter lemon or pulling your knees up to your chest. Preventing the initial onset is critical, so reduce the intake of fizzy drinks or alcohol and manage any symptoms of heartburn and reflux with antacids or indigestion remedies available over the counter in the pharmacy or supermarket.
It seems almost futile to reiterate the importance of seeking medical attention if hiccups persist for more than 48 hours. By this stage, most patients and anyone in their close proximity are beginning to experience severe frustration with the persisting hic. A night without sleep accompanied by the rhythmic irritation of a hiccup is not conducive to anyone’s physical or mental wellbeing. Such symptoms need medical investigation in an attempt to determine a cause or at the very least exclude any underlying disease process that needs attention. Medication can be prescribed in an attempt to relieve the constant irritation, but this should be used only alongside ongoing investigation for the underlying culprit.
Disclaimer: The information in this article is for general information and educational purposes only. It does not constitute medical advice, diagnosis, or treatment for any individual. Readers must always consult their GP or a qualified healthcare professional for personal medical concerns.