Hiccup cures that work — and ones you really WON’T want to try!

For most of us, hiccups are merely a temporary and occassionally embarrassing inconvenience that passes within minutes. But in a small minority of cases, they can last for days — even months. Last year, prolonged hiccups were among the 22,000 ‘potentially trivial’ incidents seen in A&E, according to NHS statistics.

While this might initially sound like a waste of hospital time, such hiccupping may indicate a deeper medical problem — which is why the NHS recommends people seek medical advice if their hiccups last for more than 48 hours.

Hiccups are an automatic reflex: during an episode your diaphragm (the muscle under your lungs that helps you breathe) contracts. Immediately after, the top of your windpipe (the glottis) closes, making a ‘ hic’ sound. But while we know the physical mechanism, scientists have still not fathomed what it’s for.

Last october, the journal Anesthesia and Analgesia reported that the three most popular (though controversial) current theories all suggest hiccupping has primitive roots.

These are: they developed to stop us swallowing amniotic fluid as babies in the womb; or as a reflex that prepares the foetus for breathing air when it is born; or that they are even an evolutionary leftover from our aquatic forebears who breathed through gills.

There is often no obvious reason why we get normal, short-term hiccups but some people’s are triggered by specific stimuli such as eating, drinking, stress and strong emotions such as excitement.

The causes of prolonged hiccups, however, can be a symptom of serious underlying illness or injury. For example, the longest recorded case in medical history blighted the life of Charles osborne, an Iowa farmer who hiccupped continuously for 68 years.

Aged 29, he fell over while working on his farm. Upon standing up, he began hiccupping, and continued for the next seven decades — an estimated 24,000 times per day.

In the late Seventies, a specialist determined his fall had ‘destroyed a small area in the brain stem, inhibiting the hiccup response’. His hiccups stopped completely in 1990, for no apparent reason. A year later, aged 97, osborne died.

More recently, in 2006, Christopher Sands, an English singer based in the U.S., began to hiccup once every two seconds for 12 hours a day. He would often pass out from a lack of oxygen to the brain and it stopped him performing, driving or living any kind of normal life.

Sands’ hiccuping was only cured in 2010 when a team of brain surgeons in Sheffield located and removed the culprit: a tumour deep in his brain stem. The op enabled Sands to return to playing guitar and singing.

In 2011, York- based GP Dr Tillmann Jacobi encountered another mysterious case of hiccups. His patient, 72, complained of hiccups after meals that had become so strong he feared he might vomit. The GP prescribed the man a musclerelaxing drug, baclofen.

When the patient returned a fortnight later, Dr Jacobi referred him to a gastroenterologist. Sadly, a tumour was found in his oesophagus that was too advanced to be treated. The man died.

‘This demonstrates that hiccups are not always trivial,’ Dr Jacobi warned. Indeed, persistent hiccups can be a sign of heart muscle damage or heart attack (heart damage stimulates the vagus nerve, involved in triggering hiccups) or of a pulmonary embolism — a potentially lethal blockage of an artery in the lungs (it’s believed this may stimulate another nerve involved in triggering hiccups).

Hiccups can also have psychiatric causes — and it is this wide variety of causes that helps explain why medics have struggled to develop treatments. Analysis of previous research by the prestigious Cochrane Library in 2012 warned of insufficient evidence that any drug or non-drug approach is effective.

For short- term hiccups, the evidence for most of the commonly suggested and sometimes bizarre cures is similarly slim, says Dr Jacobi. In 2006 the Ig Nobel Prize for Medicine was awarded to a cure for hiccups — digital rectal massage — a cure that sounds worse than the symptom.

Some of the latest ideas include pulling your tongue to trigger a gag reflex, or a cold compress to the face — but convincing evidence? Don’t hold your breath.

HOW TO BEAT HICCUPS

BrEATHE into a paper bag. This raises blood levels of carbon dioxide — thought to calm nerves and help the diaphragm relax.

PULL your knees up to your chest and lean forward.

SWALLoW granulated sugar. It’s thought the sugar stimulates the vagus nerve, which takes signals from the brain to the stomach, and tricks the brain into emptying your stomach — relieving pressure on the diaphragm.

BITE on a lemon, taste vinegar or drink cold water; it might help by stimulating the vagus nerve.

HoLD your breath for a short time. This forces the diaphragm to flatten, helping it relax.