Hiccups: Causes, Types, & Treatments.

Hiccups are not only brief attacks that mostly affect you for a couple of minutes after eating, but they can also be a sign of another disease, particularly if they last for hours or days. 

In this article, I’ve gathered, simplified, and refined everything you need to know about your hiccups and how to reach a conclusion about its cause. Keep reading. 

Types of Hiccups.

Hiccups occur due to sudden contraction of the muscles responsible for inspiration (mainly the diaphragm). The exact cause and benefits of hiccup bouts that happen to almost everyone are still not known.

Hiccups occur in infants inside the uterus before birth. One theory suggests that hiccups may help prepare the fetus’s respiratory muscle for future respiration after birth (reference).

A supporting fact for this theory is that premature infants spend 2.5% of their time hiccuping (reference).

Two main types of hiccups according to the duration:

• Acute Hiccups (hiccup bouts): attacks of hiccups that last for minutes or hours (not exceeding 48 hours).
  Acute hiccups are very common; they are often not caused by a serious disease.
• Chronic (interactable) hiccups: it lasts more than 48H (often for more than a month). This type of hiccup is secondary to chronic diseases and conditions (either psychological or organic diseases).

MORE:

• How Long Do Hiccups Last? 7 Scenarios Explained.
• 5 Emotional (Psychological) Causes of Hiccups & How to Recognize them.

Causes.

1. Acute Hiccups (hiccup bouts):

• The most common pattern of hiccups.
• Not caused by severe diseases.
• Men are typically affected more than women (reference).
• Common in “TALL” persons! (reference).
• Causes are as simple as over-eating and over-drinking of spiritual or carbonated drinks.
• They resolve on their own within a few minutes.

2. Chronic (persistent or intractable) hiccups:

• It lasts for more than 48 hours.
• It is often a symptom of a severe physical or psychological disease.
• It may interrupt your eating, drinking, sleeping, or even conversations.
• Persistent hiccups may also cause insomnia, fatigue, and mental stress (impairing your quality of life).

MORE: What are constant hiccups?

The causes of chronic or persistent hiccups are in the table below (reference):

The most common causes of persistent hiccups are:

1. Brain stroke.
2. Throat inflammation (pharyngitis).
3. Psychological diseases.
4. AIcohol abuse.
5. Enlarged thoracic lymph nodes.
6. Encephalitis.
7. Renal failure.
8. Enlarged thyroid gland (goiter).

Treatment of Hiccups.

A. treatment of Hiccup bouts (<48 Hours).

1. NO Treatment.

Acute hiccups are often self-limiting; they may last for a few minutes and then resolve on their own.

2. Physical Methods:

The prevention of Co2 from leaving your lungs helps terminate acute hiccups (reference). Also, techniques that irritate your nasopharynx and uvula increase vagal stimulation or relieve diaphragmatic irritation help stop hiccups.

These methods are safe and can be effective within seconds or methods. They have no Side effects.

The list of physical techniques that relieve acute hiccups is in the table below:

NOTE: There are no Randomized clinical trials that confirm the efficacy of the above methods. Small observational studies or case reports only suggest them. However, They are safe to use and can be effective.

MORE:10 Effective Ways to Stop Hiccups Instantly at Home.

B. Chronic or prolonged hiccup treatment.

1. Define the cause.

Hiccups that continue for hours require you to consult your doctor. Simple or acute hiccups are occasional findings in most people. However, prolonged hiccups often reflect a disease (See the list of causes above).

So, the Treatment of prolonged hiccups is essentially the identification and treatment of the original cause. You cannot diagnose the cause of chronic hiccups by yourself.

You should see a doctor so he can:

• Take a thorough medical history.
• Perform a physical examination.
• Request any necessary laboratory or imaging investigations.

Your doctor will perform the required three steps to identify the cause. Then, he will plan for the treatment (For example, Treatment of pharyngitis will improve hiccups).

2. Physical methods (temporary solution).

Physical methods such as breath holding, Valsalva maneuver, and others (discussed above) may help reduce chronic hiccups.

You can use them as safe remedies for hiccups while waiting for the investigations or your doctor’s appointment.

3. Medications to stop hiccups.

Often, your doctor will prescribe drugs to control hiccups that last for more than 48 hours. Medications are necessary for almost all cases of persistent hiccups unless there is an apparent cause that can be cured (such as a Foreign body inside your ear).

Examples of drugs that can help persistent hiccups (the majority are prescription drugs):

Notes on Treatment of Persistent Hiccups.

• Medications are important to stop persistent hiccups, However, identifications and treatment of the cause are more important. 
• Your doctor will start with one or more of the first-line medications (Baclofen, Metoclopramide, and gabapentin). 
• These first-line medications are often prescribed for 5 to 10 days.
• If there is a good response, your doctor will discontinue the drug. However, if Hiccup recurs after stopping the medication, your doctor may prescribe them for longer periods. 

4. Other treatments for refractory hiccups:

• Adjustment of the medications or combining more than one drug.
• Acupuncture.
• Hypnotherapy.
• Implantation of a vagus nerve stimulator. 
• Phrenic nerve blocking.