Hiccups: Causes, Diagnosis, and Treatment

Hiccups are instinctive contractions of the muscle that separates your chest from your abdomen called the diaphragm. It plays an important role in breathing. Each involuntary contraction is followed by a sudden closure of your vocal cords, which gives off the distinctive “hic” sound.

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Hiccups may result from eating a large meal, drinking alcoholic or carbonated beverages or sudden excitement. In some cases, hiccups may be a sign of an underlying medical condition. For most people, a spell of hiccups usually lasts only a few minutes.


Hiccupping is a symptom which may sometimes be accompanied by a slight tightening sensation in your chest, abdomen or throat.


The most common triggers for hiccups that last less than 48 hours include:

  • Drinking alcohol excessively
  • Drinking carbonated beverages
  • Eating too much
  • Excitement or emotional stress
  • Sudden temperature changes
  • Swallowing air with chewing gum or sucking on candy

When hiccups that last more than 48 hours, it may be caused by a range of factors, which can be classified into the following categories.

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Nerve damage or irritation

Hiccups that lasts for long may cause damage or irritation of the vagus nerves or phrenic nerves, which serve the diaphragm muscle. Factors that may cause damage or irritation to these nerves include:

  • Sore throat or laryngitis
  • A hair or something else in your ear touching your eardrum
  • Gastroesophageal reflux
  • A tumor, cyst or goiter in your neck

Central nervous system disorders

A tumor in or damage to your central nervous system as a result of trauma can upset your body’s normal control of the hiccup reflex. Examples include:

  • Meningitis
  • Encephalitis
  • Tumors
  • Stroke
  • Multiple sclerosis
  • Traumatic brain injury

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Metabolic disorders and drugs

Protracted hiccups can be caused by:

  • Anesthesia
  • Diabetes
  • Alcoholism
  • Kidney disease
  • Barbiturates
  • Electrolyte imbalance
  • Steroids
  • Tranquilizers

 When to see a doctor

You should see your doctor if your hiccups last more than 48 hours or if they are so severe that they cause breathing, eating, or sleeping difficulties.

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Risk factors

Men are more likely to develop long-term hiccups than are women. Other factors that may increase your risk of hiccups include:

  • Mental or emotional issues.Anxiety, stress and excitement have been associated with some cases of short-term and long-term hiccups.
  • Some people develop hiccups after undergoing general anesthesia or after procedures that involve abdominal organs.


Protracted hiccups may interfere with:

  • Speech
  • Eating
  • Sleeping
  • Wound healing after surgery


During the physical exam, your doctor may perform a neurological exam to check your muscle strength and tone. He or she may also check your reflexes, coordination and sense of touch and sight. If your doctor suspects that an underlying medical condition may be responsible for your hiccups, they may recommend one or more of the following tests.

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Laboratory tests: Samples of your blood may be checked for signs of infection, diabetes or kidney disease.

Imaging tests: Imaging tests may detect anatomical abnormalities that may be affecting the vagus nerve, phrenic nerve or diaphragm. Imaging tests may include computerized tomography (CT), chest X-ray or magnetic resonance imaging (MRI)

Endoscopic tests: These tests can be performed using a thin, flexible tube containing a tiny camera, which is passed down your throat to check for problems in your esophagus or windpipe.


Most cases of hiccups resolve on their own without medical intervention. If an underlying medical condition is causing your hiccups, treatment of that illness may eliminate the hiccups. The following treatments may be considered for hiccups that have lasted longer than two days.


Drugs that may be used to treat long-term hiccups include baclofen, chlorpromazine and metoclopramide.

Surgical and other procedures

If less aggressive treatments aren’t active, your doctor may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups. Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it has also helped control persistent hiccups.

Home remedies

Although there’s no certain way to stop hiccups, if you have a bout of hiccups that lasts longer than a few minutes, the following home remedies may provide relief:

  • Drink at least 2-3 glasses of water in a stretch
  • Breathe into a paper bag
  • Gargle with ice water
  • Hold your breath
  • Sip cold water

If you have chronic hiccups, lifestyle changes may help:

  • Avoid carbonated beverages and gas-producing foods
  • Eat smaller meals

Alternative medicine

When long-term hiccups don’t respond to other remedies, alternative treatments, such as hypnosis and acupuncture, may help.





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