Hiccups —They often appear out of the blue and are transient in nature — yet sometimes they decide to stay past their welcome.Now we are tasked with evicting an unwelcome guest!
A hiccup is a powerful and involuntary spasm of the muscle at the base of the lungs known as your diaphragm, this is then followed by the rapid closure of your vocal cords.
Hiccups may last for a few hours, occasionally a day or two, and pose no more issue than being a nuisance. Hiccups That continuously occurs for more than two days and less than a month are known as persistent hiccups.
On rare occasions, hiccups persist even longer than a month or recur frequently over an extended period of time, these are known as intractable hiccups.
Why do we get the hiccups?
The etiology and pathophysiology of hiccups remain fluid and elusive. The National Institute of Health (NCBI) states that hiccups are caused by; gastric distention, spicy foods, and neural dysfunction that often resolve themselves without any treatment. Also implicated are chewing gum, smoking, alcohol, ingesting very hot substances soon after ingesting very cold, medications, and many other disease processes. Hiccups associated with certain diseases or those that occur as a consequence of surgery, or, are life-restricting should be treated.
The best treatment for persistent or intractable hiccups should be directed toward the specific known cause. If the hiccup is due to an infection, that can be treated, if due to brainstem lesions, or biochemical abnormalities they may all respond to treatment. Problems with inhalation and exhalation and the phrenic and vagus nerves may be implicated intractable hiccups.
Interesting fact: males are affected with issues of chronic hiccups than females.
How is a diagnosis made?
Hiccups are usually diagnosed based on your verbal account of their presence, chest X-rays, electrocardiogram (EKG), lab tests, and radiology tests.
Some treatments are:
- Holding your breath
- Being purposely frightened
- Drinking a glass of water continuously without pausing to breathe
- Inhaling pepper to induce sneezing
- Eating a lemon
- Breathing into a paper bag
- Splashing your face with cold water
- Peppermint (relaxes the lower esophageal sphincter)
- Proton-pump inhibitors
- Steroids (in some instances only)
- Radiation (in the case of tumors for e.g.)
What can I do to prevent future attacks?
There is not much you can do to prevent suffering from hiccups in the future. If you are on a medical management program, continue management under the guidance of your care provider. For transient attacks of hiccups, try the home/anecdotal remedies listed above.
Everyone gets hiccups sometimes. They annoy us briefly and pass quickly. When they persist they severely pose an issue to our activities of daily living impacting our lives negatively. Chronic hiccups can leave us; fatigued, with sleep disorders, dehydration, and depressed. Post-surgically, hiccuping can lead to poor wound healing due to constant pressure on the surgical site.
Often, persistent/intractable hiccups have no known etiology, therefore medical management is on a trial basis of wait and see. If they are persistent and bothersome, many medications as well as anecdotal options may provide relief or at best a respite.