What’s up with hiccups?

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If you do an Internet search on “hiccups” you’ll find lots of supposed cures for this aoying but usually fast-passing condition — one site lists 250 of them! One thing you won’t find, though, is a good reason for why we hiccup.

Hiccupping is a more complex reflex than it might seem: a sudden contraction or spasm of the diaphragm and the muscles between the ribs makes you inhale quickly and involuntarily. It ends with “glottic closure” — the space in the throat near the vocal cords snaps shut, producing the typical hiccup sound. The technical term for hiccups (singultus) comes from a Latin word (singult) that means catching your breath while crying, which seems like a pretty good description of the sound of hiccupping.

In most cases hiccups seem to serve no purpose and go away on their own, usually after 30 or more hiccups. Any of the following may cause a short bout of hiccups:

• an overly full stomach, due to too much food, too much alcohol, or too much air in the stomach
• sudden changes in temperature, either outside your body or internally
• smoking cigarettes
• excitement, stress, or other heightened emotions.

Making hiccups go away

Of the many, many ways to get rid of hiccups, here are a few you can try that are logical, considering the muscles and tissues involved:

• Stimulating the nasopharynx, or the uppermost region of the throat, by pulling on your tongue, swallowing granulated sugar, gargling with water, sipping ice water, drinking from the far side of a glass, or biting on a lemon (not all at once, of course)
• Stimulating the skin that covers the spinal nerves near the neck by tapping or rubbing the back of the neck
• Stimulating the pharynx, or back of the throat, by gently poking it with a long cotton swab
• Interrupting your normal respiratory cycle by holding your breath, breathing into a paper bag (which increases the amount of carbon dioxide you inhale), gasping in fright, or pulling your knees up to your chest and leaning forward
• Distracting your mind from the fact that you have the hiccups.

And when hiccups won’t go away…

Occasionally, hiccups just won’t go away. A farmer in Iowa reportedly had hiccups for 60-plus years. Imagine that aoying, interrupting gasp for air coming every few seconds for 60 years! Luckily, even long-lasting hiccups don’t usually signal a medical problem. Very rarely, though, persistent hiccups may be a sign of disease, usually something that causes irritation of one of the nerves in the chest. Examples include laryngitis, goiters (enlargement of the thyroid gland), tumors in the neck, infections near the diaphragm, and hiatal hernia (usually accompanied by heartburn). Hiccups can also be triggered by excess alcohol use, kidney failure, and infections (especially ear infections). Rarer causes are aortic aneurysms and multiple sclerosis.

Persistent hiccups can also cause problems of their own. Think about it — hiccupping can make it difficult to eat, drink, and sleep, all things you need to do to keep healthy.

If you have hiccups that won’t go away on their own, your doctor will look for problems that may be causing them, and then try to fix that problem. Your doctor may also prescribe a medication (there are some that can reduce hiccups) — or tell you to stop taking a particular drug, because there are medications that can set off the hiccups.

Surgery for persistent hiccups is also an option, though one that’s exercised rarely. Two examples are a “nerve block” that stops the phrenic nerve (the major nerve supply for the diaphragm) from sending signals so that the diaphragm stops contracting, and implantation of a pacemaker to make the diaphragm contract in a more rhythmic pattern.

The bottom line

So, to review: we don’t know why we hiccup and we don’t know how to reliably get rid of them. They are as mysterious as they are universal. And it seems that just about everyone has a cure. Here’s my favorite: waiting a few minutes.