Why Do We Get Hiccups?
Hiccups occur when your diaphragm (the muscle below your lungs) suddenly contracts involuntarily, causing a quick intake of breath that's immediately stopped by your vocal cords snapping shut - creating the 'hic' sound. Common triggers include eating too fast, drinking carbonated beverages, swallowing air, sudden temperature changes, excitement, or stress. Most hiccups resolve on their own within minutes.
Key Takeaways
- The diaphragm is a dome-shaped muscle essential for breathing.
- Persistent hiccups lasting more than 48 hours may indicate an underlying condition and warrant medical attention.
- Chronic hiccups can be caused by nerve damage, brain tumors, kidney failure, or certain medications.
Explanation
The diaphragm is a dome-shaped muscle essential for breathing. It normally contracts smoothly, drawing air into the lungs. Hiccups happen when something irritates the nerves controlling the diaphragm (primarily the phrenic nerve and vagus nerve), causing it to contract suddenly and involuntarily.
Common triggers irritate these nerves in different ways: eating quickly or overeating stretches the stomach which presses against the diaphragm; carbonated drinks release gas that distends the stomach; alcohol relaxes the esophageal sphincter allowing stomach contents to irritate nerves; and temperature changes (hot then cold food) can stimulate nerve reactions.
The evolutionary purpose of hiccups is debated. One theory suggests they're a vestigial reflex from when our ancestors lived in water - the hiccup pattern resembles gill ventilation in tadpoles. Another theory proposes hiccups help nursing babies expel swallowed air. Today, occasional hiccups serve no known function and are essentially a neurological glitch.
Popular remedies work by interrupting the reflex arc between the phrenic and vagus nerves. Holding your breath raises CO2 levels in the blood, which can reset the diaphragm's rhythm. Drinking cold water stimulates the vagus nerve in the throat. Breathing into a paper bag also increases CO2 concentration. A 2006 study found that digital rectal massage stimulates the vagus nerve and stopped intractable hiccups in some patients, though more practical methods are understandably preferred.
Medical treatment becomes necessary when hiccups persist beyond 48 hours, a condition called persistent hiccups, or beyond one month, termed intractable hiccups. Medications used include chlorpromazine (the only FDA-approved drug for hiccups), baclofen (a muscle relaxant), and gabapentin (an anti-seizure medication). In rare cases, phrenic nerve stimulation or surgical intervention may be needed. The underlying cause of chronic hiccups ranges from gastroesophageal reflux to central nervous system disorders, making diagnosis essential before treatment.
Things to Know
- Persistent hiccups lasting more than 48 hours may indicate an underlying condition and warrant medical attention.
- Chronic hiccups can be caused by nerve damage, brain tumors, kidney failure, or certain medications.
- Newborns and infants hiccup frequently (often after feeding) - this is normal and typically not concerning.
- The longest recorded hiccup case lasted 68 years (Charles Osborne, 1922-1990).