Usually it’s nothing to worry about, but don’t ignore persistent, painful hiccups.
Alice was hiccupping loudly after many meals. It was embarrassing, and after a few weeks, became worrying. Although she knew she was eating quickly, she didn’t realize that she was gulping air at the same time, hyperventilating out of anxiety. Her hiccups were in effect a message to slow down and practice relaxation techniques.
Hiccups are familiar to all of us but not well understood. The “hic” sound occurs when the diaphragm muscle between your chest and abdomen contracts and your vocal cords suddenly close. People can hiccup anywhere from four to 60 times in a minute.
Anyone can get a case of hiccups after overeating, especially if the food is spicy, or very hot or cold, while chewing gum, or if the temperature of the air changes suddenly (say it’s July in Austin, Texas, and you’ve just walked into air conditioning). They might come when you’re slugging carbonated drinks or alcohol, or, like Alice, you might be gulping air when you eat.
There are also several little-known reasons for frequent hiccup attacks. You may have acid reflux, also called gastroesophageal reflux disease, or GERD. Normally a muscle at the base of your esophagus, a channel that connects the throat and the stomach, controls when food flows down. If it is weak or relaxes at the wrong moment, the food and acid in your stomach may flow backwards into your esophagus. Other signs of GERD are heartburn, a persistent cough or sore or irritated throat, or morning hoarseness.
Over-the-counter remedies to reduce gas can help temporarily but aren’t a solution for GERD. Try low-tech solutions: Lose weight, eat your meals at least three hours before you lie down, and avoid foods that trigger you, often onions, chocolate, or anything fatty. See a doctor for other remedies.
In the midst of an attack, you’ll be advised to hold your breath, or drink water fast. One effective hiccup remedy is to suck up water through a straw while plugging your ears with your fingers. A more discreet cure is to bite into a piece of lemon. You can easily ask for lemon at a restaurant and bite a piece before dropping it into your water. Drinking lemon-flavored water may help, if the bite doesn’t.
Persistent, painful hiccups warrant talking to a doctor. Besides GERD, they may be a sign of a tumor or kidney disease. Some medications that cause acid reflux, including the common anti-anxiety benzodiazepines, can lead to hiccups.
In women, they may be an early sign of stroke. If a woman who is hiccupping also complains of chest pain and feeling numb, call 911, advises Anil Minocha, MD, author of “Dr. M’s Seven-X Plan for Digestive Health.”
If you and your doctor aren’t sure why you’re having frequent hiccups or long attacks, your doctor may order blood tests to find signs of infection, diabetes, or kidney disease, liver function tests, a chest image or scan, or an endoscopy or bronchoscopy, when a doctor looks through a scope at your esophagus, windpipe, stomach, and intestine, or lungs and airways.
Sometimes no cause can be found but hiccups persist. In a 2015 survey of 15 studies, researchers concluded that more research was needed, but for persistent cases the best line of defense might be one of two drugs: baclofen, an anti-spasm and muscle relaxant; or gabapentin, which, depending on the brand, has been used to treat nerve pain, restless leg syndrome, and seizures.
Some people get hiccups that go on and on. A Iowa farmer named Charles Osborne hiccupped for nearly 70 years, probably because of a brain injury that damaged a part of the brain that inhibits the hiccup response. None of the usual home remedies worked. A well-intentioned friend once shot off two barrels of a shotgun right behind him. "It scared me some," Osborne told People magazine, "but it didn't scare the hiccups out of me."
June 07, 2016
Janet O’Dell, RN