Overview
Hiccups are involuntary spasms or sudden movements of the diaphragm, which is the muscle that separates the chest from the stomach area. These spasms cause the vocal cords to close suddenly, resulting in a "hic" sound. Hiccups are usually brief and harmless but, in rare cases, they may persist for an extended period, leading to weight loss and extreme fatigue. Causes of long-term hiccups include nerve damage or irritation, central nervous system disorders, metabolic issues, and certain drug or alcohol problems.
Understanding the disease
Symptoms
The symptoms of hiccups include uncontrolled spasms in your diaphragm and a "hic" sound, as well as sometimes feeling a slight tightening sensation in your chest, stomach area, or throat.
Risk Factors
Risk factors for developing hiccups include being male, experiencing mental or emotional issues such as anxiety, stress, or excitement, undergoing surgery, and having certain medical conditions such as alcohol use disorder, diabetes, electrolyte imbalances, kidney disease, and certain tumors or infections in the central nervous system.
Development
Hiccups develop when the diaphragm, a muscle that separates the chest from the stomach area, experiences repeated spasms or sudden movements. These spasms are usually caused by irritation or damage to the diaphragm muscle, the nerves that supply it, or other factors that disrupt the normal functioning of the body's hiccup reflex. Hiccups can be triggered by various factors, such as eating a large meal, drinking alcoholic or carbonated beverages, or getting excited suddenly. In some cases, hiccups may be a sign of an underlying medical issue. When hiccups last for an extended period, typically more than 48 hours, they can result in weight loss and extreme tiredness. There are several possible causes for long-term hiccups, including nerve damage or irritation, central nervous system disorders, metabolic issues, and certain drug and alcohol problems. For example, damage or irritation to the vagus nerves or phrenic nerves, which supply the diaphragm muscle, can lead to long-term hiccups. Other factors that may cause long-term hiccups include inflammation of the brain, stroke, multiple sclerosis, and kidney disease. Certain drugs, such as sedatives, anesthesia drugs, or dexamethasone, can also cause long-term hiccups.
Assessment and Diagnosis
Triage
You should see a doctor if hiccups last more than 48 hours or if they cause issues with eating, sleeping, or breathing.
Diagnosis
To diagnose hiccups, your healthcare provider may perform a physical exam to check your balance, coordination, muscle strength, reflexes, and senses. If the hiccups are thought to be caused by an underlying medical condition, further tests may be recommended, including blood tests, imaging tests such as a chest X-ray, CT, or MRI, or endoscopic tests. These tests help identify any issues with the diaphragm, phrenic nerve, or vagus nerve that may be causing the hiccups.
Management and Treatment
Complications
Hiccups, when they last for an extended period, can lead to various complications. These may include:
- Weight loss: Ongoing hiccups can make it difficult to eat and drink, leading to a significant loss of weight.
- Extreme tiredness: Prolonged hiccups can result in exhaustion due to the constant disruption of normal breathing patterns, sleep, and overall well-being.
- Interference with daily activities: Hiccups can interfere with eating, drinking, sleeping, and speaking, making it difficult to perform daily tasks and activities.
- Worsening of pain: Hiccups can exacerbate existing pain, especially if they are associated with underlying medical conditions. It is important to consult a healthcare professional if hiccups persist for an extended period, as they may indicate an underlying issue that needs to be addressed.
Treatment
There are various home remedies and medical treatments for hiccups. For most cases, hiccups usually resolve on their own within a few minutes or hours. However, if hiccups persist for an extended period, medical intervention may be necessary. Home Remedies:
- Hold your breath: Take a deep breath and hold it for about 10 seconds.
- Drink water: Sip water slowly.
- Eat sugary foods: Try a spoonful of sugar, honey, or a sweet candy.
- Gently rub your ears: This may help to distract the diaphragm.
- Take deep breaths: Inhale slowly and deeply, and exhale slowly through pursed lips. Medical Treatments:
- Medications: Depending on the underlying cause, your healthcare provider may prescribe medications to help alleviate hiccups.
- Injections: In some cases, a healthcare provider may administer an injection of a specific medication to the muscle to help stop hiccups.
- Nerve blocks: For severe cases, a nerve block may be performed to temporarily interrupt the nerve signals causing the hiccups. It is essential to consult a healthcare provider if hiccups persist for an extended period or are causing significant discomfort or interference with daily activities.