How Long Do Hiccups Last? 7 Scenarios Explained.
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What you need to know:
Hiccups occur to almost everyone. However, we still don’t understand its causes, mechanisms, or significance precisely.
In general, hiccup bouts last for a few minutes to a few hours. However, in rare cases, hiccups last more than two days (persistent hiccups) or even months or years (intractable hiccups).
Two main categories (types) of hiccups exist:
- First, the widespread (benign) type of hiccups lasts for a few minutes or hours. It is a self-limiting bout of hiccups that usually resolve on its own.
- Second, the chronic type of hiccup (lasting for more than 48hours). It is often secondary to a disease or condition affecting the vagus and phrenic nerves.
Vagus and phrenic nerves supply the diaphragm, respiratory muscles, and epiglottis, responsible for hiccups.
1 . Acute hiccups (hiccup bouts).
Acute hiccups are by far the most widespread type of hiccups. It represents almost 99% of the cases of hiccups.
The exact cause of hiccups is unknown. However, it is triggered by gastric distension as with:
- Eating too much food.
- Drinking too much alcoholoor carbonated drinks.
- Eating spicy or fried food.
- Sudden excitement or emotion change.
- Sudden temperature change.
Acute hiccups or hiccups bouts last for a few minutes to hours. The maximum duration of acute hiccups is 48 hours. This is the most common pattern of hiccups.
Acute hiccups often resolve on their own (self-limiting). Also, you can try these home-based treatments for hiccups. See a doctor if hiccups last more than two days or keep coming and going.
2. Persistent Hiccups.
The Types of hiccups are as follows:
- Acute hiccups: Lasting less than two days.
- Chronic persistent hiccups: lasting anytime between 2 days and one month.
- Chronic intractable hiccups: lasting more than one month.
So, the hiccups that last for days or weeks (a maximum of one month) are called persistent hiccups. Persistent hiccups are a subtype of chronic hiccups.
Chronic hiccups (persistent and intractable hiccups) are often caused by diseases affecting the nerves supplying the diaphragm and respiratory muscles (vagus and phrenic nerves).
The causes of chronic persistent and chronic intractable hiccups are in the table below (reference):
Causes of Chronic Hiccups.
|1. Digestive system||– Gastric distension|
– Chronic gastritis and peptic ulcer disease.
– GERD and esophagitis.
– Stomach or esophageal cancer.
– Pancreatitis and pancreatic cancer.
– Gallbladder diseases (as gallstone disease).
– Inflammatory bowel disease, Bowel obstruction.
|2. Toxic/ Metabolic.||– Alcoholoabuse.|
– Diabetes Mellitus.
– Renal failure.
– Hypocalcemia, Hyponatremia (↓ sodium).
|3. Neurological diseases||– Cerebral stroke.|
– Severe head trauma.
– Brain tumors.
– Multiple sclerosis.
– Infections (brain abscess, meningitis, encephalitis).
– Malformation of brain blood vessels.
– Inflammations of the vessel wall (as temporal arteritis)
|4. Diseases in the Chest||– Pneumonia, bronchitis.|
– enlarged lymph nodes around the esophagus (mediastinal LNs).
– Bronchial asthma.
– Inflammation of the lung envelope (pleurisy) or pus (empyema).
– Tumors and trauma of the mediastinum.
|5. Vagus & phrenic nerve irritation||– Pharyngitis and laryngitis.|
– FB or hair inside the air (irritation of eardrum).
– Enlarged thyroid gland (goiter).
– Neck cysts or neck tumors.
|6. Drugs that cause Hiccups||– Chemotherapy (as carboplatin).|
– Corticosteroids(as dexamethasone).
– Some anti-hypertensives such as Alphamethyldopa.
– Sedativesosuch as Barbituratesoandodiazipam.
|7. Psychogenic||– Anorexia Nervosa.|
– Post-traumatic stress disorder.
– Extreme excitement, stress.
– Schizophrenia, conversion reactions.
|8. After operations||– General Anaesthesia (anesthetic medications affect digestive system motility).|
– Insertion of the endotracheal tube (during general anesthesia).
|9. Others.||– Myocardial infarction (heart attack).|
– Inflammation of the membrane surrounding your heart (pericarditis).
– Access under the diaphragm (subphrenic abscess).
– Malaria, TB, Herpes Zoster, and Covid-19 (reference).
3. Chronic intractable hiccups.
In severe cases, hiccups may last for months or even years (despite treatment). Chronic intractable hiccups often follow an intermittent course (come and go in attacks) or less commonly become continuous.
However, this is a rare condition. And it is often caused by a severe disease affecting the nerve supply to the respiratory muscles.
This type is often resistant to treatment, including prescription drugs. Identifying and treating the cause is the best strategy for intractable hiccups.
4. The duration of hiccups in preterm babies and newborns.
Hiccups start as early as during the intra-uterine life. One of the theories suggests that hiccup is aimed to train the fetal respiratory muscles and diaphragm (reference).
That’s why hiccups are very common among preterm babies. One study estimated that full-term newborn babies spend 2.5% of their time hiccuping. The incidence and the duration of hiccups are often greater in preterm babies.
Hiccups often come and go in infants and last for a few minutes. If hiccups continuously last for several hours or days, consult your doctor.
6. The duration of hiccups after surgery or anesthesia.
Hiccups are very common after surgical operations due to a variety of causes as (reference):
- Anesthetic medications alter the functions of muscles, nerves, and digestive system muscles.
- The use of Endotracheal tubes (ETT) during anesthesia irritates the nerves responsible for hiccups.
- Operations that affect the muscles and nerves responsible for hiccups (vagus nerve, phrenic nerve, the diaphragm, and the lung pleura). Any irritation or manipulation to these structures can trigger hiccups.
- Abdominal operations (manipulations of abdominal organs, especially the stomach).
- Electrolyte disturbances after operations (disturbances in the levels of Calcium, Potassium, Sodium, etc.).
The duration of hiccups after surgery or anesthesia is variable. However, hiccups usually last for an average of one to three days after anesthesia and surgery (reference).
7. The duration of Hiccups after Chemotherapy.
Various types of chemotherapy lead to hiccups. Unfortunately, no studies accurately assessed how long hiccups last after chemo treatment.
One case report found that hiccups lasted for about 30 hours after a dose of chemotherapy (reference). However, hiccups can be persistent and exhausting to the patients after chemotherapy.
The duration of hiccups after chemotherapy depends on various factors such as:
- The type of chemotherapeutic drug.
- The type of cancer (cancers of the stomach, mesothelioma, and the mediastinum are likely to trigger hiccups).
- The Dose and number of drug combinations.
Always consult your doctor, and work with your doctor to check for kidney function (kidney impairment with chemotherapy can be a potential cause of hiccups).
8. The longest duration of hiccups ever recorded (68 years of hiccups)
Charles Osborne (1892-1991) holds the world’s most extended duration of continuous hiccups. Charles started hiccuping after a hog collapsed on him in 1922.
He kept hiccuping continuously for 68 years (reference).