Hiccups or singultus is a condition when a person makes an accidental 'hic' sound . Hiccups can last for seconds or minutes, up to 48 hours.

Hiccups are common in everyone, including babies and children. In addition to making a 'hic' sound , hiccups can also cause pressure in the chest, stomach, and throat.

Hiccups are generally harmless. However, hiccups that last for a long time can be a symptom of a serious illness.

Causes of Hiccups

The muscle that separates the stomach and chest (diaphragm) has an important role in the human respiratory system. The diaphragm muscles will fall (contract) when breathing, and rise again (relax) when exhaling.

Hiccups occur when the diaphragm muscles contract involuntarily and suddenly. This condition causes air to enter the lungs too quickly so that the respiratory valves close and cause a 'hic' sound.

Apart from adults, hiccups are also quite common in  babies . However, hiccups in babies generally go away on their own. Some studies even state that hiccups in babies are normal and part of the process of growth and development.

Sudden diaphragmatic muscle contractions, whether temporary or prolonged, can be triggered by many things. Temporary hiccups can be triggered by the following conditions:

  • Eat too much or too fast
  • Eat hot and spicy food
  • Consuming soft drinks or alcohol
  • Swallowing air when chewing or sucking candy
  • Swallowing too much air ( aerophagia )
  • Experiencing a sudden change in temperature
  • Feeling nervous, overly excited, or stressed

Meanwhile hiccups that last for more than 2 days can be triggered by:

  • Digestive system disorders, such as gastritis,  stomach ulcers , pancreatitis, pancreatic cancer, stomach cancer, inflammatory bowel disease, intestinal blockage, or hepatitis
  • Metabolic disorders, such as alcoholism , diabetes, or electrolyte disturbances
  • Kidney disorders, such as chronic kidney failure
  • Nerve disorders, for example due to inflammation of the airways, or due to a tumor or cyst in the neck
  • Disorders of the brain, such as hemorrhagic stroke , inflammation and infection of the brain, brain tumors , multiple sclerosis , and hydrocephalus
  • Disorders of the chest cavity, eg pneumonia,  bronchitis , tuberculosis, asthma, chest injuries, and pulmonary embolism
  • Heart problems, such as heart attacks and inflammation of the lining of the heart
  • Mental disorders, such as personality disorders, anxiety, and stress
  • History of surgery to the chest or abdomen

Apart from the medical conditions above, prolonged hiccups can also occur due to side effects of using drugs, including:

  • Steroids
  • Dope
  • Tranquilizers, such as diazepam and lorazepam
  • Chemotherapy drugs
  • Methyldopa
  • Dexamethasone

Symptoms of Hiccups

Hiccups are a symptom that can sometimes be accompanied by pressure in the chest, stomach or throat. Hiccups generally last a few minutes, but they can last longer.

Under certain conditions, hiccups can last for more than 2 days or even more than 1 month. This condition is called prolonged (persistent) hiccups. Although rare, this condition can make sufferers experience fatigue and stress.

When to see a doctor

Check with your doctor if your hiccups last more than 48 hours. Especially if hiccups come repeatedly and interfere with your daily activities, such as eating, sleeping, or even breathing.

You are also advised to immediately go to the hospital emergency room if you experience hiccups accompanied by the following signs and symptoms:

  • Stomach ache
  • Fever
  • Vomit
  • Hard to breathe
  • Coughing up blood
  • Headache
  • Fatigue
  • Numb
  • Lost balance

Diagnosis of Hiccups

Hiccups that occur temporarily will disappear by themselves without further examination or treatment. Meanwhile, prolonged hiccups require further examination to find out the underlying cause.

First of all, the doctor will ask questions related to symptoms, medical history and history of drug use. The doctor will also perform a physical examination, especially neurological examination related to balance and coordination, muscle strength, reflexes, sensory nerves, and vision.

Next, the doctor will run several supporting tests to find out the cause of the hiccups, namely:

  • Blood tests, to look for signs of infection, liver and kidney function
  • Scanning, to detect abnormalities that affect the nerves, namely X-rays,  CT scans , or MRI
  • Endoscopy, to see the condition of the esophagus or respiratory tract
  • Electrocardiography (EKG), to check heart conditions

Hiccups Treatment

Temporary hiccups can go away on their own without special treatment. However, there are several ways you can get rid of hiccups faster, such as:

  • Hold your breath
  • Take a deep breath
  • Gargle with ice water
  • Drink water quickly
  • Drink cold water slowly
  • Consume warm water and honey
  • Breathe using a paper bag
  • Consume 1 teaspoon of sugar
  • Eating fresh ginger
  • Sucking lemon slices

Meanwhile, hiccups that last a long time or are caused by an illness require special treatment, one of which is by administering drugs to calm the diaphragm, namely:

  • Chlorpromazine
  • Diphenhydramine
  • Metoclopramide
  • Baclofen
  • Gabapentin
  • Nifedipine

If the above drugs have not been able to overcome the hiccups, the doctor will inject an anesthetic directly into the nerve that controls the contraction of the diaphragm. Meanwhile, if the hiccups are caused by disease, then the treatment is to overcome the disease.

Hiccups Complications

Prolonged hiccups can cause several complications in sufferers, such as:

  • Fatigue
  • Lack of sleep
  • Disturbance of comfort
  • Difficulty in performing daily activities, such as eating or drinking
  • Dehydration
  • Nutritional deficiencies
  • Weight loss
  • Surgical wound healing is hampered
  • Acid reflux disease ( GERD )
  • Alkalosis

Hiccups Prevention

There is no specific proven way to prevent hiccups. However, there are steps you can take to avoid conditions that can trigger hiccups, including:

  • Avoid eating and drinking excessively or eating too quickly.
  • Avoid drinking fizzy drinks.
  • Avoid consuming alcoholic beverages.
  • Protect yourself from sudden changes in temperature.
  • Stay calm and avoid situations that can trigger emotional and physical reactions.
  • Carry out routine health checks so that you can immediately receive treatment if you are diagnosed with a disease.
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