Hiccups - Causes, Symptoms, Treatment

Published: 16th July 2008
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Hiccups are sudden, involuntary contractions of the diaphragm muscle. As the muscle contracts repeatedly, the opening between your vocal cords snaps shut to check the inflow of air and makes the hiccup sound. Irritation of the nerves that extend from the neck to the chest can cause hiccups.



A hiccup bout is any episode lasting more than a few minutes. If hiccups last longer than 48 hours, they are considered persistent or protracted. Hiccups lasting longer than one month are termed intractable. The longest recorded attack is 6 decades.



What causes hiccups?



Mild hiccups are a reaction to hot and spicy foods or too much alcohol. They may be caused by psychological or organic causes. Disease conditions that affect the kidney, chest, abdomen or heart can cause hiccups. The diaphragm may contract by stimulation either by impulses from the brain or by irritation anywhere along the vagus nerve. The vagus sends a signal to the phrenic nerve that sends the nerve impulse to the diaphragm. The diaphragm then goes into a sharp contraction causing the hiccup.



The vagus nerve impulse pattern in the throat causes spasms of the diaphragm which lead to a case of hiccups. By interrupting this pattern many people have success stopping hiccups. This is probably why very sweet or tart remedies seem to work well.



Symptoms



The characteristic sound of a hiccup, sometimes preceded by a small tightening sensation in your chest, abdomen or throat, are the only signs and symptoms associated with hiccups. People may have as few as four hiccups a minute or, rarely, as many as 60 hiccups a minute.



How are hiccups treated?



Most bouts of hiccups go away on their own within a few minutes to a few hours and do not require any treatment. Many home remedies are used to treat hiccups. Most of them involve increasing the level of carbon dioxide in the blood, which usually stops hiccups. Some of these remedies include:



* Holding your breath and counting slowly to 10.

* Breathing repeatedly into a paper bag for a limited period of time.

* Quickly drinking a glass of cold water.



Hiccups are usually not serious and require no medical attention. However, if the hiccups last for a long time (over three hours), occur with abdominal pain, interfere with your sleep or eating, or you start spitting up blood, you should definitely see a doctor.



Hiccups are treated medically only in severe and persistent (termed "intractable") cases, such as in the case of a 15 year old girl who in 2007 hiccuped continuously for five weeks. Haloperidol (Haldol, an anti-psychotic and sedative), metoclopramide (Reglan, a gastrointestinal stimulant), and chlorpromazine (Thorazine, an anti-psychotic with strong sedative effects) are used in cases of intractable hiccups. In severe or resistant cases, baclofen, an anti-spasmodic, is sometimes required to suppress hiccups.



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