What Causes Hiccups?
Have you noticed a sudden hic hic sound after consuming a large lump of food or alcohol, causing a tight feeling in the chest? They happen due to an involuntary contraction in the diaphragm, which plays an important role in breathing and separates our abdomen and the chest. They can be triggered due to various really, starting from specific food items to over full belly, consumption of carbonated drinks, or spastic muscle contraction. Some may be a sign of an intra-abdominal-abscess or an infection under the diaphragm.
Normally hiccups are caused due to some external factor that has hit your airway or food pipe, due to which the diaphragm starts to contact. Doctors explain that hic-ups follow from stimuli that starch the stomach, which may be caused due to reasons like swallowing air or eating food too fast. Some also associate it with intense emotions and our response to them, like laughing too much or sobbing.
So this involuntary contraction in the diaphragm happens due to a sudden closure in the vocal cords and the glottis opening between them. This initiates a sudden intake of air, but the closer of the vocal cords stops it from going inside the windpipe and reaching the lungs. This is called the glottis closure, causing the hic sound. However, there are no such medical ways to treat the hiccups until now, but there are many home remedies that surely work.
Anatomy and Physiology Of Hiccups
We did understand the cause behind hiccups in the above paragraph. Now let us understand the whole process according to medical terms. When you hiccup, your body goes through something unusual that happens in your body. The diaphragm, which is the muscle located underneath your lungs, contracts or pulls downwards. When this happens, it stretches and opens the lungs, and this forces air into our airways. Within 35 milliseconds of this happening, our airways close off, specifically the glottis that is near our vocal cords. The air that comes and hits these closed vocal cords, we get that hiccupping sound. Now, what causes all this? The nerve stimulating the diaphragm to contract and pull down is called the phrenic nerve. This comes out of the neck and stimulates the diaphragm to contract. There’s another nerve called the vagus nerve, which comes out of our brain steam and travels down to our vocal cords to speak to the esophagus, which then speaks to our stomach to contact and perform various activities. It also receives information and signals from the stomach, esophagus, and vocal cords and sends them back to the brainstem. Therefore, when we hiccup, there is a reflex arm happening inside. Some kind of infection or irritation in the stomach and esophagus area stimulates signals of the vagus nerve to be sent to the brain stem. This triggers the hiccups center located in the grain and sends outward signals to the phrenic nerve, which influences the diaphragm to contract, bring the air in then close off the glottis.
Now the question arises, why does our body do this anyways? There are a couple of theories based on this. One of them is that we tend to hiccup more often in the uterus; the fetus inside the mother’s womb hiccups too, usually within the 1st and 2nd trimester, and it slowly reduces. But why do we hiccup in the womb? Maybe because we are practicing how to use our diaphragm for breathing. The marvelous fact here is that we do not breathe when we are inside the mother’s womb, as we get all the oxygen from the placenta. The second theory is that it is potentially a mechanism to trap air out of the stomach because when we hiccup, we have a significant decrease in pressure in the thoracic cavity. It tends to force out the air inside the stomach or maybe air trapped in the esophagus, pushing it outwards. Another theory suggests that it is an evolutionary throwback; we no longer use it for anything useful. Maybe it is to practice using our gills when we used to have millions of years back.
There might be many such reasons behind them, but the conclusion is that they are extremely annoying and painful is last long.
Facts related to Hiccups
Have you noticed that no one can hiccup for a single time? Almost every mammal gets them. You will be surprised to learn that a baby has hiccups more than an adult, and they can count to 60 hiccups per minute. Hiccups are temporary, and some may last for a long time: according to the Guinness World Records, Charles Osborne from Anthon hiccupped continuously from 1922 to 1990 for 68 long years, maybe because the nerves connected to the diaphragm were aggravated. Some may cause extreme chest pain and stomach pain. In such cases, consult a doctor and take immediate cure or medication.
26 ways to treat or stop hiccups
Medical science has no proven evidence to cure hiccups. However, there are numerous ways you can stop them. They may sometimes stop if the highest part of the throat, called the nasopharynx, gets stimulated and stops the reflex action. Let’s see what methods we can apply to stop these annoying sounds.
1. Slow Breaths- This trick is helpful in many cases. All you have to do is intake deep breaths and exhale slowly. This will disrupt your respiratory system, calm down the spasm in the diaphragm and stop the hiccups.
2. Chilled water- A glass of chilled water can also help stop the hiccup as it stimulates the highest part of the throat. However, be aware if you are sensitive to chilled water.
3. Breath into a paper bag- Remember to use a paper bag and not a plastic one. Put a paper bag near your mouth and breathe in and out. This raises the Carbon Dioxide in your lungs and relaxes the diaphragm, thus stopping the hiccups.
4. Try Valsalva Maneuver- This technique is also used to calm down the heart when it’s beating really fast. But it also helps some people to stop the hiccups. Hold your nose, close your mouth, and breathe out strongly through your mouth, which causes a disruption in your respiratory system. You will feel the ears pop as you perform this. However, it has few risk factors if you perform them on a regular basis. One of them is low blood pressure. Some may also feel lightheaded or experience syncope, alternatively known as a loss of consciousness. So be careful before you do so!
5. Sugar- Who doesn’t love sweets! Amazingly, these help in getting rid of hiccups too. Keep a spoonful of sugar in your mouth and wait until it dissolves. This helps the phrenic nerves to “reorganize” themselves. Drink a glass of water, and whoosh! Hiccups are gone!
6. Slice of Lemon- Lemons are rich in Vitamin C and have a tangy flavor, which makes you wink without your permission! You can try a slice of lemon juice. The sour taste of lemon may help distract the brain from stopping the spasm in the diaphragm. This technique is proven to help 14 out of 16 people! So the next time you get embarrassed by these unwanted sounds, try to suck onto a lemon.
7. Squeeze your chest- This method helps to put some pressure on the diaphragm. Lean or bend to squeeze your chest.
8. Swallow with an open mouth- Sit down comfortably and put your back behind. Keep your mouth open and swallow when needed. This may take some time, but ultimately you will manage to get rid of them.
9. Scare it away- Well, this trick is aged old and works in many cases. Getting scared genuinely causes an adrenalin rush and disruption in the breathing pattern. The brain also gets distracted by another external stimulus, stopping the hiccups.
10. Essential oils- Essential oils are magical! Defuse some drops of lavender or eucalyptus and breathe in deeply. This will calm not only your diaphragm but also your stress.
11. Pull your tongue out, Hold your tongue out for some time, and repeat it two to three times. This trick will help to stimulate nerves and muscles in your throat.
12. Warm milk- Believe it or not, warm milk has a great calming effect and may help you calm those annoying hiccups too. But when a hungry baby drinks milk too fast, it may cause him or her to have hiccups. In such a case, try other methods.
13. Headstand- This is also called the Sirsasana and should be performed by those who are well trained and practiced in the field only. If you know how to do it, stand on your head for some time. In a way, the diaphragm turns upside down, stopping the spasms. Apart from being helpful in stopping hiccups, there are other benefits of performing this exercise. It stimulates the lymphatic system, relieves stress and depression, makes the upper body stronger, activates the pituitary and pineal glands, and boosts the blood flow to your brain, which increases the focus and makes your shoulder and hands stronger too.
14. Try honey or peanut butter- This trick is yummy and effective at the same time, especially for the kids. Take a spoon of peanut butter or honey and keep it in your mouth until it dissolves.
15. Press your palm- Try the pressure way to stop the hiccups. Put some pressure on your thumb for some time and do some acupressure. It may surely help if done in the right way.
16. Gargle water- Gargling some cold water may stimulate the nasopharynx and cause the hiccups to stop.
17. Ice cube- This has a similar effect to chilled water. Try to suck a cube of ice or keep an ice cube in your mouth for some time.
18. Tap or rub behind your neck- This may cause the phrenic nerve to be stimulated and hence stopping the hiccups.
19. Distraction- Another effective way to get rid of hiccups is to not think about them. Well, that is a really difficult task. However, you can distract yourself by being engaged with some different stuff or activity.
20. Knee hugs- Sit and bend your knees in such a way to put pressure on your chest and diaphragm.
21. Avoid carbonated drinks- This is prevention from hiccups and is proven. Carbonated drinks are known to trigger such spasms in the diaphragm. So avoiding them as much as possible will be wise.
22. Drink from the opposite side of the glass – Try to drink from the opposite side of the glass. Take a glass of cold water and bend down. Get the glass near your chin and try to drink the water. Try to do this a few more times or as required to ease hiccups.
23. Vinegar- Try a drop of apple cider vinegar or synthetic vinegar at your tongue tip. It won’t taste great, but it will surely help.
24. Swallow the air- Fill your lungs with air by opening your mouth wide open. Swallow twice in a row and slowly exhale through your nostrils. Try this 2-3 times. This method is effective and works for many people.
25. Drink with a straw- Sip water with the help of a straw and drink immediately when it reaches your mouth. Do this as required.
26. Orgasm- Strange but proven that having an orgasm helps many men get rid of hiccups instantly.
In reality, there is no proof from medical science on why hiccups actually happen, and there is no cure either. However, if they last for a prolonged time, it can be a clear indication of some underlying serious health issue, like cysts or even a tumor. If hiccups last for a long time, they may cause serious chest and stomach pains, which need immediate treatment and medication.
When must you go to the doctor?
If hiccups continue for more than two days or 48 hours, they can cause issues in breathing, eating, and sleeping. The chest and throat feel tight and heavy, causing them to feel very uncomfortable. It can be caused damage or irritation of the phrenic nerve or vagus nerve, which serves the diaphragm muscle. Apart from food, alcohol, and spicy food being the reason, there are other reasons the diaphragm can contract. The following can be the other reasons behind hiccups-
- Development of a tumor, cyst, or goiter in your neck
- An inflammation of your voice box causing sore throat (larynx) or laryngitis
- nervous system disorder
- Infection in the liver, bowel, stomach, or diaphragm
- Cancer
- Anxiety
- Mental disorder
- Extreme alcohol consumption and other metabolic disorders and drugs include
- Diabetes
- Kidney disease
- Steroids
- Tranquilizers
- Anesthesia
- Electrolyte imbalance
- Issues in the nerves that control breathing
- A hair or any other object in the ear touching the dear drum
- Pneumonia
Symptoms Of Hiccups
Hiccups are a single or a series of breathing diaphragm spasms that is usually rhythmic. It may also cause a brief but painful, frequent, or occasional interruption in normal breathing with a slight tightening sensation in the throat, chest, and/or abdomen.
Diagnosis
Hiccups that last less than 48 hours and normal and can be treated with the above mention remedies or will vanish on their own. But if hiccups continue for more than 2 days or 48 hours and need medical attention. To know the cause behind the chronic hiccups, the doctor will perform a physical examination and a neurological examination to check your balance and coordination, eyesight, muscle tone, strength, and reflexes. If the doctor finds an underlining medical condition, the doctor may prescribe more tests like-
- Blood test to check signs of diabetes, infection, or kidney disease
- Imaging tests like X-ray, CT scan, or even MRI scans to detect the anatomical abnormalities that may be affecting the vagus nerve, phrenic nerve, or diaphragm.
- Endoscopic test to detect any issues in the windpipe or esophagus.
Chronic Hiccups
Hiccups can also be chronic and may last for days or months. This can happen at any age, usually above 50 years of age, and can go from mild to serious, causing issues like anxiety, insomnia, weight loss, and serious chest pain. It disrupts the regular way of living and annoys the one suffering from it. A person may feel exhausted if the condition persists for a long time. Older people and small kids tend to suffer more if they have a chronic hiccup. Many times, the exact cause of such ongoing hiccups and undetected, but in some cases, they can be treated with medicines like Baclofen, Chlorpromazine, and Metoclopramide. Acupuncture is also a good way to get rid of hiccups, but no such remedy is proven medically. In case all these medications do not work, or your body does not respond to them, the doctor may inject medication into your phrenic nerve to block the nerve’s actions to stop the hiccups temporarily.
Another way to treat this chronic condition is the surgical implantation of a battery-operating device that would deliver mild electrical stimulation to the vagus nerve. This procedure is used to treat epilepsy. But amazingly, this has been quite helpful in controlling persisting hiccups.
Chronic hiccups are a rare medical condition that has limited research, which can give an effect and treatment. Some studies have found that singultus or Hiccups may also be an indication of some central nervous system damage. Medication may or may not work in such cases, and surgery remains the last option.
Chronic hiccups can also cause Gastroesophageal reflux. This is a condition when the stomach acids leak up to the food pipe, causing a burning sensation in the chest, heartburn, frequent bloating, feeling nauseous, an unpleasant taste in the mouth, pain while swallowing, and foul breath. This can be cured with antacids.
Underlying infection or tumor in the central nervous system (CNS) or damage to the central nervous system as a result of trauma disrupts the body’s normal control of the hiccup reflex. This may be because by-
- Stroke
- Tumor
- Encephalitis
- Traumatic brain injury
- Meningitis
- Multiple sclerosis
Conclusion
In the above article, we got some information about hiccups and remedies to get rid of them. We also learned the possible serious medical conditions that may trigger hiccups, which include ulcers and cancer in the abdomen and throat region. Whatever the reason may be, the next time you face an awkward situation in public, try any of the remedies mentioned above. If you notice your hiccups persist for a longer time, visit the doctor soon and get the required medical attention right away!
FAQs
Q:1. I have been having hiccups for the past 3 4 days; am I sick?
In this case, you must consult the doctor as soon as possible if it can be anything like a tumor, cyst or goiter, laryngitis, Cancer, issues in the nerves that control, pneumonia, infection, or maybe a tumor in the central nervous system. It might be affecting your daily lifestyle. Try drinking some cold water or try the lemon hack and rush for medical help.
Q:2. Can stress be a result of hiccups?
There are many reasons behind hiccups, and stress and anxiety are one of them too, which can last a long time or eradicate within a few days as well. Do not panic so much. If you feel the hiccups are not leaving your way, reach out for medications.
References
https://www.webmd.com/digestive-disorders/why-do-i-hiccup
https://my.clevelandclinic.org/health/diseases/17672-hiccups
https://www.medicalnewstoday.com/articles/181573
https://www.nhs.uk/conditions/hiccups/
https://my.clevelandclinic.org/health/diseases/17672-hiccups
https://www.webmd.com/digestive-disorders/hiccups-treatment
https://www.healthline.com/health/how-to-get-rid-of-hiccups
https://www.medicalnewstoday.com/articles/9896
https://www.readersdigest.ca/health/conditions/7-ways-get-rid-hiccups/
