There Is No one of us does not suffer from hiccups from time to time, usually after an attack of laughter, panic or improper swallowing. It usually stops on its own, but sometimes the hiccups can last for long hours and cause embarrassment and much suffering. So why is this happening and how can we stop it?
Hiccups (as opposed to burping or in the vernacular “grapes”) is the phenomenon of rapid air entry that repeats itself every few seconds. This phenomenon can not only embarrass, but cause nervousness, and even life-threatening, for example, when it happens in the middle of driving.
Responsible for hiccups is the diaphragm, the same large dome-shaped muscle that lies beneath our lungs, and is responsible for breathing. As hiccups move the diaphragm downward, the lungs swell, and a sudden burst of air penetrates the lungs. Along the way, the same stream of air passes through the vocal cords’ contraction, creating the loud hiccup sound.
So why is this happening? When this occurs temporarily, the most common causes are laughter, anxiety, panic, improper ingestion of a large lump of food. But sometimes these hiccups last chronically, and they are caused due to psychological problems, stomach problems, alcoholism, anorexia nervosa or irritation of various nerve fibres that affect the diaphragm.
Many theories have revolved around the need for hiccups. One holds that the same rapid movement of the diaphragm is intended to release a large lump of food that is stuck in the oesophagus and does not move downward toward the stomach. The lump of food causes pressure on the parathyroid nerve causing the hiccup reflex. Thus, there is a change in pressure in the chest that causes the lump of food to go down.
Ultrasound tests on embryos showed that they, too, were playing. One hypothesis claims that the hiccup is intended to train the fetus’ respiratory system prior to its release into the world. However, these are only hypotheses that of course have not been proven.
There are many factors that trigger the hiccup reflex, including drinking too cold drinks, eating too hot or spicy foods, prolonged laughter, blood salt disorders, alcohol consumption, prolonged cough, cancers and diseases of the nervous system. And also brain injury.
There are also medications that can cause hiccups, including sedatives, and steroids. Recurrent hiccups may also occur following surgery.
What can be done before seeking medical help?
- Stop breathing.
- Back up the top of the pharynx using a gargle of water or swallowing a teaspoon of dry sugar.
- Increase the stimulation of the vagal nerve by gently and carefully pressing the eyes.
- Eliminate diaphragm stimulation by pulling the knees toward the chest and moving forward to press on the chest.
- In case the hiccups persist you can try a variety of medications including chlorpromazine (an antipsychotic drug that has been found to be effective in stopping hiccups), metoclopramide (pram in that increases stomach motility), microphonic (muscle relaxant).
In rare cases, many other medications can be tried.
Complementary medicine also offers soothing methods for relieving hiccups that you can try, including acupuncture, which while there is not enough research behind it, can help. In severe cases, the patient is sent for surgery in which the nerve affecting the diaphragmatic contraction is blocked.