Hiccups – what are they telling you?

Mostly harmless

Everyone gets hiccups in their life. The majority of the time they are completely harmless and are more of an irritant than a symptom of an underlying condition, but, if you experience hiccups that last more than 48 hours this could potentially signal serious health complications.

“You should seek advice from your health care provider if your hiccups progress from happening every once in a while to becoming persistent or intractable,” said Timothy Pfanner, MD, assistant professor of medicine at the Texas A&M Health Science Center College of Medicine. Pfanner regularly gives advice on all matters relating to his speciality, gastroenterology.

Finding the causes

Food and drink, especially rich, fatty food, curries, fizzy drinks and alcohol, are among the common irritants that send the diaphragm into spasm.

A sudden change in room temperature, downing a cold drink after hot food, and smoking can also trigger a bout. Some people tend to hiccup when stressed or overexcited.

Smokers and those  who consume large amounts of alcohol are also more prone to hiccups.

“Anything that causes your stomach to become distended can cause hiccups,” says Pfanner. “Smokers are prone because they are constantly swallowing air. Drinking alcohol can induce hiccups because it irritates the esophagus and may result in a flare-up of acid reflux.”

Acid reflux disease is a common culprit behind hiccups, and surprisingly, ear infections may cause them as well. When the tempanic membrane (the membrane in the ear that vibrates in response to sound waves) becomes irritated this can result in hiccups.

“This membrane can become irritated due to infection – especially if a hair makes its way into the ear and sits next to the membrane,” Pfanner said. “This is a very common cause for hiccups that don’t subside.”

If your hiccups last more than two days…

“Generally, when someone is diagnosed with intractable hiccups, we start worrying that something more serious is going on internally,” Pfanner said. “However, since intractable hiccups are also a symptom of acid reflux disease it’s always important to discuss your symptoms with your physician.”

Cancer is never a word thrown around lightly, and according to Pfanner, intractable hiccups could be a symptom of certain cancers. “Sometimes we see intractable hiccups in patients diagnosed with cancers of the brain, lymph nodes or stomach cancer,” he said. “They can also indicate stroke. It’s still unclear why many of these incidents occur.”

Since hiccups convulse the muscles that control the diaphragm, patients who experience persistent or intractable hiccups can suffer nerve damage in the nerve that controls these muscles. “This may also point to a tumor in the neck or goiter,” Pfanner said.

Pesky hiccups that refuse to subside may even be symptoms of heart muscle damage or a heart attack. “Persistent or intractable hiccups can indicate inflammation around the heart or a pending heart attack,” Pfanner said. “That’s why we always want patients who are experiencing these type of hiccups to immediately consult their health care provider.”

But don’t panic

While hiccups can rarely be tell-tale signs of serious health complications, common hiccups are more of a nuisance than a health risk.

There’s no sure fire cure when the hiccups strike but to quickly ease your occasional hiccup woes, there are a few different things you can try. The two most popular are:

Hold your breath. Doing this for a short period of time forces the diaphragm to flatten and lengthen. Stretching the diaphragm in this way can help it to relax and stop going into spasm.

Breathe into a bag. Breathing in and out of a paper bag ten times or so raises the carbon dioxide level in the blood. This is thought to calm the nerves and helps the diaphragm relax.

Deep slow breathing. If a bag isn’t you bag deep slow breathing can help relax the diaphragm. Place you hand on your belly and try to direct your breath there, slowly inhaling and exhaling. To aid relaxation  try inhaling lavender, lemon grass, juniper or peppermint essential oil – sprinkle a few drops on a  hankie or tissue and breath in and out slowly.

Put some honey under your tongue. The theory is that the sudden rush of sweetness stimulates the vagus nerve and tricks your brain into emptying your stomach, taking pressure off the diaphragm.

Stimulate the vagus nerve. The vagus nerve is one of 12 cranial nerves. It is the longest of the cranial nerves, extending from the brainstem to the abdomen by way of multiple organs including the heart, esophagus, and lungs. irritation of the vagus nerve is thought to have some role in hicups. Pressing a cotton swab in the back of the throat to induce a gag reflex will stimulate this nerve. But if that doesn’t appeal try swallowing roughly chewed, very dry bread or crackers or granulated sugar. Pressing lightly on the eyeballs, according to Pfanner, will also activate your vagus nerve and result in a reflex that can hinders the spasm of hiccups.