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Why Can't I Stop Hiccupping? Hiccup Symptoms & Causes

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Last updated June 11, 2022

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What causes painful hiccups? Why do I have hiccups for no reason? Learn about the causes of hiccups, hiccup symptoms and why hiccups are common in infants.

3 most common cause(s)

Chronic Kidney Disease
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Barrett's esophagus
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Achalasia

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Symptoms of hiccups

Hiccups, also called hiccoughs or singultus, can appear out of nowhere and for no apparent reason. These short, barking little coughs can be rather embarrassing and are often used in comedy suggesting drunkenness, even though they often occur without touching alcohol.

Hiccups are a spasm of the diaphragm, the large muscle that allows you to breathe and separates the chest from the abdomen. They may seem to serve no purpose in adults; however, hiccups may be part of a reflex that allows newborns to drink milk and breathe at the same time (older children and adults cannot do this). The "hiccup reflex" may allow air to be expelled from the stomach while the baby is nursing, thus preventing pain from swallowed air and allowing babies to consume more milk. In adults, they're usually just annoying.

Common characteristics of hiccups

Hiccups are a brief and involuntary spasm of your diaphragm. They can likely be described by the following details.

  • Frequency: The time between individual hiccups is usually constant — that is, there's a regular rhythm with a certain number of seconds between each one.
  • Sound: The "hic" sound happens because the spasms also cause your vocal cords to close suddenly with each spasm.
  • Pain or discomfort: There may be some pain or discomfort with each spasm, especially if the hiccups have gone on for an hour or more.

Duration of symptoms

More often than not, your hiccups will be a temporary annoyance.

  • Temporary: Hiccups usually last minutes but can last a few hours.
  • Longer-lasting: In unusual cases, they may persist for a few days.
  • Chronic: Rarely, hiccups may go on for months. The condition is then called intractable, persistent, or chronic hiccups.

Who is most often affected by hiccups?

Hiccups are very common in children, especially infants. Otherwise, men seem to be affected more often than women, though hiccups can happen to anyone.

Are hiccups serious?

The severity of your hiccups is ultimately dependent on the cause.

  • Not serious: Hiccups may be a little embarrassing but are rarely serious. Nearly everyone has a bout of hiccups from time to time.
  • Moderately serious: If hiccups happen frequently and there are other troubling or unusual symptoms, you should see a medical provider.
  • Serious: A case of intractable hiccups — which means they never stop — may sound odd, but it's actually no joke. Severe, persistent hiccups are not only annoying, but may have a serious cause, which needs to be discovered. A medical provider can help you find the cause and will recommend treatment.

Causes of hiccups

Many conditions can have hiccups as a symptom. almost all of them are things that can cause irritation of the nerves of the diaphragm, but sometimes hiccups are due to the nerves to the diaphragm or the brain's hiccup center being irritated.

Respiratory system causes

Issues with the respiratory system can result in hiccups.

  • Infection: Such as in the chest that irritates the diaphragm
  • Tumors: Such as those in the chest that irritate the diaphragm
  • A hiatal hernia: This is a separation in the muscles of the diaphragm.
  • Severe or lengthy coughing

Involuntary, or autonomic, nervous system causes

The main causes of this nature involve disorders of the nerves innervating the diaphragm (the phrenic nerve) or disorders in the brain's centers dealing with the diaphragm.

Digestive system causes

Issues with the digestive system may result in hiccups.

  • Overeating or eating too quickly
  • Swallowing air: Especially when chewing gum or eating hard candy
  • A tumor in the abdomen: This can irritate the diaphragm.
  • Heartburn: Also known as gastroesophageal reflux disease or GERD
  • Talking while eating
  • Spicy foods
  • Carbonated drinks

Other causes

Other various causes that can result in hiccups include the following.

  • Severe emotional stress
  • Going suddenly from warm air to very cold air
  • Pregnancy
  • Surgery: Especially of the abdominal organs
  • Medications
  • Alcohol use and abuse

This list does not constitute medical advice and may not accurately represent what you have.

Acute episode of hiccups

An episode of hiccups is caused by involuntary contraction of the diaphragm with rapid closure of the airway by the epiglottis. An acute episode (lasting less than 48 hours) is very common, and most often tied to rapid eating, holding breath, or alcohol consumption.

Rarity: Rare

Top Symptoms: hiccups

Symptoms that always occur with acute episode of hiccups: hiccups

Urgency: Wait and watch

Persistent hiccups

Hiccups are caused by the involuntary contraction of the diaphragm, with rapid closure of the airway, by the epiglottis. Hiccups lasting longer than 48 hours are called Persistent Hiccups.

Rarity: Rare

Top Symptoms: hiccups

Symptoms that always occur with persistent hiccups: hiccups

Urgency: Primary care doctor

Intractable hiccups

A bout of hiccups involves involuntary contraction of the diaphragm and rapid closure of the airway by the epiglottis. Hiccups lasting longer than one month are called "intractable" and may be connected to a broad range of different underlying conditions.

The most effective way to stop intractable hiccups is to find and treat the underlying cause or condition. Make an appointment in the next few days to see a physician and discuss the possible causes for your hiccups with a physician.

Rarity: Ultra rare

Top Symptoms: hiccups

Symptoms that always occur with intractable hiccups: hiccups

Urgency: Primary care doctor

Chronic kidney disease

Chronic kidney disease is a general term for kidney damage caused over time by other illnesses, especially high blood pressure and diabetes. Eventually kidney function becomes impaired and wastes are no longer properly filtered from the blood, leading to serious illness.

Most susceptible are those over age 50 with high blood pressure, diabetes, obesity, and/or a family history of kidney disease.

Symptoms include fatigue; difficulty concentrating; poor appetite; muscle cramps at night; dry, itchy skin; swollen eyes, feet, and ankles; and increased urination.

Left untreated, chronic kidney disease results in serious illness, kidney failure, and death. It is important to see a medical provider as soon as symptoms begin.

Diagnosis is made through physical examination; a blood test called Glomerular Filtration Rate (GFR;) ultrasound or CT scan of the kidneys; and sometimes a kidney biopsy.

Treatment includes medications for high blood pressure, high cholesterol, and fluid retention, and a low-protein diet to reduce the work the kidneys must do. Dialysis and kidney transplant are only done if there is kidney failure.

Barrett's esophagus

Barrett esophagus is a condition in which the tissue lining the esophagus changes. These changes occur after longstanding gastro-esophageal reflux. Symptoms of gastro-esophageal reflux can be regurgitation, heartburn. Barretts esophagus is associated with a risk of developing malignant esophageal disease.

You should visit your primary care physician to discuss these symptoms and if screening for this condition is useful. Your doctor will likely advise you to start preventive actions if you are at risk of developing Barretts esophagus. These actions usually include life style adjustments and medications.

Rarity: Common

Top Symptoms: nausea, regurgitation, heartburn, sore throat, dry cough

Urgency: Primary care doctor

Achalasia

Achalasia is a disorder of the esophagus, the tube that carries food from the mouth to the stomach. This condition affects the ability of the esophagus to move food into the stomach.

You should visit your primary care physician within the next 24 hours, where imaging and exploration of your swallowing issues can be fully worked up. With diagnosis, treatment is typically surgical and outcomes are good.

Rarity: Ultra rare

Top Symptoms: pain below the ribs, regurgitation, unintentional weight loss, heartburn, deep chest pain, behind the breast bone

Urgency: Primary care doctor

Hiccups treatments and relief

When hiccups are an emergency

Seek immediate treatment in the emergency room or call 911 if:

  • You have hiccups which have been going on for days or weeks
  • You also have symptoms of other serious illness: Such as chest pain, shortness of breath, uncontrolled vomiting or trouble swallowing

When to see a doctor for hiccups

You should schedule an appointment for:

  • Hiccups that are persistent, but not accompanied by other symptoms: A medical provider can sometimes prescribe medication or other treatment to help stop them.
  • Acupuncture: Some people have found acupuncture to be helpful for many conditions, including persistent hiccups.
  • Hypnosis: As with trying to quit smoking, hypnosis can help some cases of hiccups as well.

You can address your hiccup symptoms at home and they are quite likely to resolve. Try the following.

  • Small sips of ice-cold water
  • Holding your breath for as long as you can
  • Breathing into a paper bag
  • Swallowing a teaspoon of sugar

FAQs about hiccups

What causes hiccups?

Hiccups (singultus) are caused by involuntary contraction of the diaphragm, which causes outflow of air then closure of the vocal cords, resulting in the "hic" sound as air rushes against them. Hiccups can be caused by any number of medical conditions or nothing at all. The exact neurological mechanism of a hiccup is unknown. The mechanism usually involves contraction of one side of the diaphragm. They can occur when some sort of stimulus (e.g. food, gas, stomach overdistention following eating, or a sudden surprise) activates nerves connected to the diaphragm. Hiccups maybe associated with infection or irritation of the nerves in the diaphragm or neck.

How to get rid of hiccups?

Common methods to try to control hiccups are holding one's breath, covering one's nose and mouth and bearing down (as if when having a bowel movement), drinking cold water, pressing on the eyeballs, and certain physical maneuvers such as pulling the knees forward or leaning forward to compress the chest. Other commonly tried remedies include getting frightened or drinking a carbonated beverage.

Why do newborns get hiccups?

Overfeeding is a common reason that newborns get hiccups. Specifically, distending the stomach too quickly can lead to hiccups. Additionally, any possible causes of hiccups in adults (e.g. fear, increased bowel gas, or swallowed air while eating) can trigger hiccups in babies. As for ways to stop hiccups, burping the baby may be effective for controlling hiccups caused by gas. Giving the baby a pacifier or cold water may help.

Are prolonged hiccups a sign of something more serious?

Persistent (>48 hours) and intractable (>1 month) hiccups (singultus) can be a sign of something more concerning than simple physiological hiccups. If you have experienced any of these prolonged states of hiccups, consider visiting a medical professional for evaluation.

When should you contact a doctor for hiccups?

If your hiccups have lasted longer than 48 hours without stopping, you should schedule an appointment with your physician. This can be a sign of something more serious. However, you should keep in mind that the majority of cases of prolonged hiccups do not yield a diagnosis. If possible, it can be helpful to have someone monitor whether your hiccups are occurring during sleep. Hiccups during sleep can be a sign of an underlying cause that is worth getting evaluated by a doctor.

Questions your doctor may ask about hiccups

  • What is your body mass?
  • Have you or do you suffer from gastroesophageal reflux disease (GERD)?
  • Do you currently smoke?
  • Are you having difficulty concentrating or thinking through daily activities?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Peter Steinberg is a board-certified urologist and the director of endourology and kidney stone management at Beth Israel Deaconess Medical Center. He is also an Assistant Professor at Harvard Medical School. He received his undergraduate degree in biochemistry from Middlebury College (1999) and graduated from University of Pennsylvania Medical School (2003). He completed a urology residency a...
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References

  1. Hiccups. U.S. National Library of Medicine: MedlinePlus. Updated December 23, 2015. MedlinePlus Link
  2. Chronic Hiccups. Genetic and Rare Diseases Information Center. GARD Link
  3. Hiccups, Chronic. National Organization for Rare Disorders. Published 2005. NORD Link
  4. Woelk CJ. Managing Hiccups. Canadian Family Physician. 2011;57(6):672-675. NCBI Link
  5. Chang FY, Lu CL. Hiccup: Mystery, Nature and Treatment. Journal of Neurogastroenterology and Motility. 2012;18(2):123-130. NCBI Link