Hiccup home remedies, causes and drugs

Hiccup or singultus (from singult in Latin meaning catching breath while sobbing.) is an involuntary nuisance bodily action of no functional value. Most hiccups resolve spontaneously without any active intervention. Hiccups may occur even prior to birth.

Hiccup frequency varies with individual (4 to 20 per minute, going as high as 60/minute in some cases). Similarly the duration of hiccups is variable from few minutes to hours, days and even weeks.

An episode of hiccups may last as long as 48 hours. Some patients have persistent hiccups lasting as long as one month. Intractable hiccup episodes may continue beyond 2 months in rare cases.

How hiccups occur?

Hiccups occur due to contraction of muscles of diaphragm and inspiratory respiratory muscles causing sudden inspiration with closure of the glottis. What provokes a bout of hiccups remains an enigma. “Hiccup reflex arc” comprising of connection of intercostal muscles with multiple nervous connections including phrenic and vagus nerves, sympathetic nervous system, central nervous system (probably brain stem especially respiratory centers. has been implicated.

What causes hiccups?

A bout of hiccup is usually instigated by distention of the stomach as a result overeating or excessive air in stomach due to carbonated beverages, swallowing air. Simple things like upper respiratory infection or a hair in ear in contact with ear drum can provoke an episode. Gastroesophageal reflux disease (GERD), and hiatal hernia have also been implicated. More serious causes include tumors and infections throat, ears and brain. AIDS is another possible cause.

Other stimulants include a drugs, toxins, alcoholism, kidney failure, sudden excitement and changes in temperature, alcohol intake, and tobacco use. Stress has also been implicated.

Failure to identify a cause for persistent or intractable hiccups may suggest a psychogenic etiology. Occurrence of hiccups during sleep makes a psychogenic cause less likely.

Investigations: Most episodes of hiccups are brief, self-limiting and don’t require investigations. Work up should be undertaken in cases of persistent and intractable hiccups. This generally includes a thorough history and physical exam, as well as simple labs like complete blood count (CBC), comprehensive metabolic panel., liver and pulmonary function tests, drug and tox screen. The use of x rays, CT or MRI scans, EEG, lumbar puncture, EGD (esophagogastroduodenoscopy or upper GI scope) needs to be individualized. Treatment of hiccups — There is paucity of rigorously tested scientific data on this subject. Of course if an underlying cause is found, treatment can be directed at that the cause.

Drug options:These include chlorpromazine, antireflux or anti GERD heartburn medications like Prilosex, muscle relaxants like Baclofen, prokinetic like metoclopramide (Reglan), antidepressants and antiepileptic agents.

One AIDS patient used marijuana to get rid of his hiccups.

Home or non-drug remedies: These time tested home remedies for hiccups have been passed on through the generations.

My favorite is closing the ears with your fingers/hands while drinking water through a straw.

Other popular home remedies include:

• Take a deep breath and hold as long as you can
• Gargle with ice water
• Pull the tongue
• Valsalva
• Bite on lemon

There are also reports of successful use of alternative and complementary therapies like hypnosis and acupuncture.

As a last resort, surgery as well as implantation of breathing pacemakers and vagus nerve stimulators have been undertaken.

Do you know of someone with a major hiccup problem? Do you know of a home remedy that works for you. Please share with us.

Comments

[Wendy]

This us something I usually would keep to myself, but with this article I couldn't resist. From eating at the dinner table with my grandma at a young age, my grandma would make some very strange sounds that sounded like burps and one hiccup. As I grew older I tried many different tricks (drinking a cup of water upside down, holding my breath, etc) and nothing worked. Not until I inherently started to burp after the very first hiccup. This completely stopped all hiccups thereafter. This is what I have done for over 15 years now and its worked every time. Thanks Grandma!

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[Dr. Harold E. Grupe Jr.]

Anil, you've left out the most authoratative source for curing hiccups, by Dr. Janet Travell (recently deceased, but she was still lecturing into her 90's) who described the trigger points for hiccups in a publication called Postgraduate Medicine, I believe. The cure has worked for me for over 30 years, and is done by inverting a teaspoon, sucking on it (a little honey helps) and moving it carefully back along the roof of your mouth until the tip of the spoon can raise the uvula. That is the trigger point, and this maneuver stops the hiccups.

Thanks for listening, and I hope you can check this out and share it with your readers. BTW, I was Chairman of Periodontics there at Univ. of MS Medical Center for 17 years, and retired shortly before you came to chair the gastroenterology dept. there