Hiccups

A hiccup is an unintentional movement (spasm) of the diaphragm, the muscle at the base of the lungs. The spasm is followed by quick closing of the vocal cords, which produces a distinctive sound.

Singultus

Hiccups often start for no apparent reason and usually disappear after a few minutes. Rarely, hiccups can last for days, weeks, or months. Hiccups are common and normal in newborns and infants.

• Abdominal surgery
• Disease or disorder that irritates the nerves that control the diaphragm (such as pleurisy or pneumonia)
• Hot and spicy foods or liquids
• Harmful fumes
• Stroke or tumor affecting the brain

There may be no obvious cause for hiccups.

There is no sure way to stop hiccups, but there are a number of common suggestions that may be effective:

• Breathe repeatedly into a paper bag.
• Drink a glass of cold water.
• Eat a teaspoon of sugar.
• Hold your breath.

Contact your health care provider if hiccups persist for more than a few days.

If hiccups persist to the point that you visit your health care provider, a medical history will be taken and a physical examination will be performed.

Medical history questions may include the following:

• Do you get hiccups easily?
• How long has this episode of hiccups lasted?
• Have you recently eaten something that was hot or spicy?
• Have you recently drank carbonated beverages?
• Have you been exposed to any fumes?
• What have you done to try to relieve the hiccups?
• What has been effective for you in the past?
• How effective was the attempt at home treatment?
• Did the hiccups stop for a while and then restart?
• What other symptoms are present?

Diagnostic tests are rarely necessary unless a disease or disorder is suspected as the cause.

To treat persistent hiccups, the health care provider may perform gastric lavage or massage of the carotid sinus in the neck. Do not try carotid massage by yourself. This must be done by a health care provider.

If hiccups continue, medications such as phenothiazine (especially chlorpromazine), baclofen, or anticonvulsants may help. Tube insertion (nasogastric intubation) may also provide relief.

Very rarely, medical methods fail to treat persistent hiccups. Further treatment may include a phrenic nerve block. The phrenic nerve controls the diaphragm.

Rucker JC. Cranial neuropathies. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann; 2008:chap 74.

Review Date: 01/31/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.