Hiccups are involuntary contractions of the diaphragm muscle. The diaphragm muscle is a large muscle in your abdomen that plays a large role in breathing. With each contraction of the diaphragm, the vocal cords close causing the “hic” sound. Hiccups can be caused by alcoholic or carbonated beverages, sudden excitement, or large meals. Rarely, hiccups can be a sign of an underlying medical condition. Most of the time, hiccups only last for minutes, but occasionally hiccups may last for days or weeks, even months in rare cases. In these cases, the condition may cause weight loss and exhaustion. Hiccups lasting more than 48 hours may be caused by nerve damage, central nervous system disorders, or metabolic disorders and drugs.
Nerve damage conditions causing long lasting hiccups usually include damage to the vagus or phrenic nerves which innervate the diaphragm. Conditions that may damage or irritate these nerves include a tumor, cyst, or goiter in the neck, gastroesophageal reflux, laryngitis, or something touching your ear drum. Central nervous system disorders may arise from damage caused by trauma and can cause the body to lose control of its hiccup reflex. Central nervous system disorders include conditions like encephalitis, meningitis, multiple sclerosis, strokes, tumors, and traumatic brain injuries. Metabolic disorders and drugs may also induce long term hiccups. These include conditions and drugs like alcoholism, anesthesia, barbiturates, diabetes, electrolyte imbalances, steroids, kidney disease, and tranquilizers.
Most hiccups will resolve on their own without needing any treatment. However, if there is an underlying medical condition causing the hiccups, then treatment of that condition should resolve the hiccups as well. Medications can be used in cases when hiccups have lasted longer than usual. Some of these medications include baclofen, chlorpromazine, and metoclopramide. If these medications do not work, then an injection of an anesthetic may be used to block the phrenic nerve.
This article reviewed by Dr. Jim Liu, MD and Ms. Deb Dooley, APRN.
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April 8, 2023