Hiccups almost always go away on their own
DEAR DOCTOR K » I regularly get hiccups. Sometimes they last a long time. Is this cause for concern?
DEAR READER » As annoying as hiccups may be, they rarely signal a serious underlying problem.
Hiccups are caused by an abnormal reflex of the diaphragm and the rib muscles. The diaphragm is a layer of muscle that sits underneath your lungs and at the top of your abdomen. It plays an important role in breathing. When the diaphragm moves downward into the abdomen, it helps pull air into the lungs. When it rises upward, it helps expel air from the lungs.
There are also muscles that hold the ribs together. Take in a deep breath. See how your ribs moved outward? That was caused by the contraction of the rib muscles. The outward movement of the ribs also helps pull air into the lungs.
Hiccups involve a sudden contraction or spasm of the diaphragm and the muscles between the ribs. The spasm makes you inhale quickly and involuntarily. As air is suddenly sucked into your lungs, the space in the throat near the vocal cords snaps shut. This is what produces the typical hiccup sound.
Many everyday situations can trigger hiccups: • Emotional stress or excitement • Stretching of the stomach (after overeating, drinking carbonated beverages or swallowing air)
• Abrupt changes in temperature (as with drinking a hot beverage) • Alcohol bingeing • Smoking If your hiccups come and go, they are most likely a result of your eating habits and digestive function. Try to eat less, or more slowly. Also, limit your alcohol intake. (Three glasses of wine greatly increases my likelihood of getting hiccups.) Avoiding carbonated beverages may also help.
If your hiccups last longer than 48 hours, an underlying medical problem becomes more likely. Examples include laryngitis, an enlarged thyroid gland, tumors in the neck, infections near the diaphragm and hiatus hernia. Hiatus hernia usually occurs along with gastro-esophageal reflux disease (GERD).
Treating a disorder that may be triggering hiccups is usually the first course of action. Say, for example, that GERD or an infection is triggering your hiccups. Medication treatment for GERD or antibiotic treatment of the infection may reduce or even eliminate them.
Certain medications may cause hiccups, and discontinuing them can be an effective cure. Examples include midazolam (a relative of Valium), some types of chemotherapy and the heart medication digoxin.
If your hiccups aren’t triggered by a medical condition and aren’t particularly bothersome, there is no urgency to “cure” yourself. Hiccups will almost always go away on their own. But if you are bothered by them, the following strategies may help: • Holding your breath • Breathing into a bag • Swallowing sugar (my remedy of choice) • Biting on a lemon • Gargling ice water • Tickling your hard palate with a cotton swab
• Drinking from the opposite side of a glass
If you still can’t find relief, talk to your doctor. Certain medications can help reduce hiccups.