Hiccups are sudden and sometimes painful contractions of the diaphragm. The diaphragm is a thin layer of muscle that separates the chest from the abdomen (belly). When we breathe, the diaphragm muscle moves up and down as we take air in and push it out. When you hiccup there is a loud sound in the throat as air is suddenly sucked in.
Most of the time one or a few hiccups happen because the diaphragm muscle is irritated, often by something as simple as a very cold, very fast, or very big drink. Eating too fast or too much, eating hot and spicy foods or liquids, drinking carbonated or alcoholic beverages, sudden excitement, or a sudden change in temperature may trigger hiccups.
Sometimes the hiccups don't stop and they last for hours. In these cases it is necessary to look for the cause and there are many possibilities. The most common causes are related to problems with a nerve or a chemical imbalance in the blood. These problems may overstimulate the diaphragm. This causes the diaphragm muscle to contract too often and too vigorously.
Examples of the wide variety of things that can cause prolonged hiccups are: a foreign body in the ear touching the eardrum, kidney failure, pneumonia, and abdominal surgery.
Everyone has hiccups from time to time. Usually they need no diagnosis or treatment. But when hiccups last several hours, you should tell your healthcare provider. If you also have chest pain or abdominal pain that continues between the hiccups, you need to call your healthcare provider or 911 right away.
Your provider will ask about your medical history and your medicines. You will have a thorough exam of your nervous system. You may have blood and urine tests to look for a chemical imbalance or kidney problems.
The treatment depends on the cause. If there is a specific cause, such as a kidney problem or pneumonia, treating the medical problem may cure the hiccups.
Sometimes gently pulling on the tongue will stop the hiccups. This affects the nerves that control the diaphragm.
Medicines that decrease nervous system activity, such as seizure medicines or sedatives, are also sometimes prescribed to try to give relief.
Most of the time, hiccups are harmless. Hiccups usually start suddenly and stop after a few seconds or minutes. Prolonged attacks are more serious. Call your healthcare provider if hiccups last longer than 48 hours or if you have frequent, repeated attacks.
If you are being treated for hiccups that have lasted several hours or longer, follow your healthcare provider's directions for stopping the hiccups.
If you tend to have hiccups often, try to avoid the things that may cause them, such as overeating, eating or drinking too fast, or drinking alcohol. You may be able to figure out what causes your hiccups and avoid that activity.