Hiccough:



(Alternative terms for "hiccough" and "hiccups" include: "hickup" and "singultus".)

 Hiccups happen when the diaphragm, the muscle that separates the chest from the abdomen, suddenly contracts. When that happens, air is taken in, and then the voice box closes shut, which is what causes the "hic" sound. There are different types of hiccups, named after how long they last:

Types:

A "regular" bout of hiccups can last up to 48 hours

"Persistent hiccups" last longer than 48 hours and up to a month

"Intractable hiccups" last longer than a month

In most cases, hiccups go away on their own with no lasting effects. But in some people, they can last a long time and lead to problems such as poor nutrition, tiredness, and reduced appetite.


Why Do Hiccups Happen?

Hiccups can happen for a lot of reasons -- some of them are physical, and some emotional. That’s because the actual irritation happens in the nerve connecting the brain to the diaphragm. Some common causes include:

  • Eating too much or too quickly
  • Feeling nervous or excited
  • Drinking carbonated beverages or too much alcohol
  • Stress
  • A sudden change in temperature
  • Swallowing air while sucking on candy or chewing gum

Folk remedies:

There are many superstitious and folk remedies for hiccups, including headstanding, drinking a glass of water upside-down, being frightened by someone, breathing into a bag, eating a large spoonful of peanut butter and placing sugar on or under the tongue.

A simple treatment involves increasing the partial pressure of CO2 and inhibiting diaphragm activity by holding one’s breath or rebreathing into a paper bag. Other potential remedies suggested by NHS Choices include pulling your knees up to your chest and leaning forward, sipping ice-cold water and swallowing some granulated sugar.


Treatment

Hiccups are normally waited out, as any fit of them will usually pass quickly. Folkloric 'cures' for hiccups are common and varied, but no effective standard for stopping hiccups has been documented. Hiccups are treated medically only in severe and persistent (termed "intractable") cases.

Numerous medical remedies exist but no particular treatment is known to be especially effective, generally because of a paucity of high-quality evidence.[16][17] Many drugs have been used, such as baclofen, chlorpromazine, metoclopramide, gabapentin, and various proton-pump inhibitors. Hiccups that are secondary to some other cause, like gastroesophageal reflux disease or esophageal webs, are dealt with by treating the underlying disorder. The phrenic nerve can be blocked temporarily with injection of 0.5% procaine, or permanently with bilateral phrenicotomy or other forms of surgical destruction. Even this rather drastic treatment does not cure some cases, however.

Haloperidol, metoclopramide, and chlorpromazine are used in cases of intractable hiccups. Effective treatment with sedatives often requires a dose that renders the person either unconscious or highly lethargic. Hence, medicating with sedatives is only appropriate short-term, as the affected individual cannot continue with normal life activities while under their effect.

A vagus nerve stimulator has been used with an intractable case of hiccups. "It sends rhythmic bursts of electricity to the brain by way of the vagus nerve, which passes through the neck. The Food and Drug Administration approved the vagus nerve stimulator in 1997 as a way to control seizures in some patients with epilepsy."[18]

Persistent digital rectal massage has also been proven effective in terminating intractable hiccups