Hiccups: What are They, Why do They Happen, and How to Get Rid of Them

The medical term for hiccups is “Singultus,” a Latin term meaning “to catch one’s breath while sobbing.”1 Hiccups are involuntary contractions of the diaphragm, the muscle that separates the chest from the abdomen. When you hiccup, your diaphragm contracts suddenly, causing your glottis (the opening to your windpipe) to close. This creates the characteristic “hic” sound. Hiccups can be caused by a variety of things, including:

  • Eating a large meal (causes stomach distention)
  • Carbonated beverages
  • Alcohol
  • Spicy or acidic foods
  • Excitement
  • Stress
  • Anxiety (overexcitement)
  • Sudden changes in temperature
  • Medical conditions, such as gastroesophageal reflux disease (GERD), asthma, hiatal hernia, and pneumonia

Most hiccups go away on their own within a few minutes or hours. However, if your hiccups last for more than 48 hours, or if they are severe or accompanied by other symptoms, such as chest pain, difficulty swallowing, or shortness of breath, you should see a doctor. Acute hiccups (lasting less than 48 hours) are typically self-limited and resolve spontaneously. Hiccups lasting greater than 48 hours or longer may indicate a more serious, underlying condition that should be investigated.

I saw a patient several times for hiccups when I did the night shift. He would arrive and ask to see me for an injection of Reglan (Metoclopramide) for his intractable hiccups. His history supported a previous workout by his primary care provider for more ominous causes and he was diagnosed with idiopathic (unknown cause) hiccups. One night, he arrived, and this was the third night in a row. The night was slow, so I sat down and convinced him to stick around, and together let’s look a little deeper into his hiccups. His case was compelling….how did he continue to have hiccups, relieved by Reglan, but cyclically return repeatedly? Well, his case was unique. He took a benzodiazepine to sleep at night and a side effect is hiccups. Hence, the reason I saw him on the night shift after he would wake up from hiccups. I threw the net out as ER docs say including blood work, chest x-ray, and CT brain scan and everything was normal. I scratched my head, talked to one of my partners, and re-evaluated him. A repeat physical exam demonstrated a pulsatile abdominal mass. Ultrasound and CT scan of his abdomen confirmed an abdominal aortic aneurysm. The puzzle was solved. In medicine, common things are common, but we see zebras occasionally.

Remedies

Here are some home remedies that may help to get rid of hiccups:

  • Drink a glass of water slowly.
  • Hold your breath for 10-20 seconds.
  • Breathe into a paper bag.
  • Gargle with salt water.
  • Swallow a spoonful of sugar.
  • Bite into a lemon wedge.
  • Sit up straight and pull your knees up to your chest.
  • Put ice on your chest.

If you have tried all of these home remedies and your hiccups are still not gone, see a doctor. They may prescribe medication or recommend other treatments.

Prevention

Here are some tips to help prevent hiccups:

  • Eat and drink slowly.
  • Avoid carbonated beverages and alcohol.
  • Eat small, frequent meals.
  • Avoid spicy and acidic foods.
  • Manage stress and anxiety.

Hiccups are usually harmless, but they can be annoying and embarrassing. By understanding what causes them and how to treat them, you can manage your hiccups quickly and easily.

SOURCES

1. Cole JA, Plewa MC. Singultus. [Updated 2023 Jul 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538225/

2. Howes D. Hiccups: a new explanation for the mysterious reflex. Bioessays. 2012 Jun;34(6):451-3. doi: 10.1002/bies.201100194. Epub 2012 Feb 29. PMID: 22377831; PMCID: PMC3504071.