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Symptoms, Their Causes & Cures: Hiccups

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Hiccups

WHEN TO SEE YOUR DOCTOR

* Hiccups persist for more than one hour.

* You've been having bouts of hiccups several times a day or several days a week.

* You also have chest pain, heartburn or difficulty swallowing.

What Your Symptom Is Telling You

Boo!

Still have them, eh? Ah well, the old sneak-up-from-behind-and-scare-the-ever-lovin'-bejeebers-out-of-them trick never was a sure-fire remedy for the hiccups anyway.

And what is? For all the advances of medicine over the years and decades, science still has not found a sure cure for those annoying little spasms that temporarily make you sound like the town drunk.

A normal hiccup is just an audible tic. The phrenic nerve that excites the muscles of the diaphragm, for reasons unknown, lapses into uncontrollable spasms, says Ravinder K. Mittal, M.D., an associate professor of medicine in the Department of Internal Medicine at the University of Virginia in Charlottesville.

The esophagus also can be provoked into involuntary contractions, according to John Renner M.D., president of Consumer Health Information Research Institute in Kansas City, Missouri. An improper swallow or food stuck in your esophagus triggers a nerve spasm in the esophagus near where it meets the stomach.

Hiccups come and go innocently enough, but sometimes when they persist, they indicate a more serious medical problem, according to Monte Bobele, Ph.D., associate professor in the counseling psychology department of Our Lady of the Lake University in San Antonio. People recovering from gastric or back surgery often gasp their way through extended bouts of hiccups. Others get post-surgery hiccups in reaction to an anesthetic.

Developing kidney failure may bring on continual or recurring hiccups, Dr. Mittal says, as could a growing abscess or tumor in or near the chest, diaphragm or esophagus.

And some people develop hiccups for psychological reasons, Dr. Bobele says. In a reaction similar to the paralysis some soldiers suffer when they're afraid of combat, these people subconsciously give themselves hiccups as a way to avoid something disagreeable.

Symptom Relief

To cure hiccups you need to stop the spasm in the diaphragm or esophagus. You can do this by either distracting the person's attention from the affliction or making him or her gasp. That's usually all it takes.

"If hiccups don't go away, you're trying too hard to make them go away," Dr. Bobele says. "You're focusing on your chest and actually tightening your diaphragm. But tensing up and trying to suppress that next expected hiccup only worsens it." Here's how to do it right.

Swallow something bitter. Ingesting something with an overwhelming taste might jar you out of your spasm, Dr. Mittal says. Try sucking on a lemon or swallowing a teaspoon of vinegar.

Heed a gag order. Put your finger down your throat as if you're forcing yourself to throw up, Dr. Mittal says, although don't go so far as to actually vomit. A little gagging might be enough to disrupt the rhythm of your hiccups.

Drown them. Steadily drinking a large glass of water with regular, evenly paced swallows could disrupt the hiccups' rhythm, Dr. Renner says. It also will help wash away any food at the bottom of your throat that might be irritating the nerve down there.

Drink upside down. "Bottoms up" takes on a whole new meaning with this hiccup cure. Bend at the waist over a sink, Dr. Bobele says, and drink water from the side of the glass farthest from your body.

Attempt some scare fare. Startling the hiccup victim—by suddenly popping a bag or shouting boo provides a momentary jolt that can interrupt the spasm, Dr. Bobele says.

Leave 'em hanging by a thread. A popular cure for infant hiccups among Hispanics in southern Texas calls for placing a red thread or strip of red cloth in the middle of baby's forehead, near the bridge of the nose. "Maybe for the baby, crossing his eyes or diverting his attention is all that's needed to stop the hiccups," Dr. Bobele says.

Sweeten it. Sprinkle some sugar on the back of your tongue and swallow, Dr. Bobele says. Or mix a teaspoonful into a shot of bitters and gulp it down.

Pull on it. Open your mouth wide the next time you're under a hiccup attack, grasp your tongue, give it a gentle yank and hold on to it for several seconds. That's the cure that was preferred by President Kennedy's personal physician, Dr. Bobele says. (Attempting to pronounce "Ich bin ein hiccupper" with tongue in hand is optional.)

Put money on it. Finally, Dr. Bobele's favorite remedy for the average hiccup, which he says has yet to fail: The next time someone starts to hiccup, take out a $5 bill, place it on the table and bet the hiccupper that he or she can't hiccup again in the next minute. Without fail, the person can't release another real hiccup.

"Once you stop trying to make them go away, you bring a whole other set of muscles into play, and the spasms stop," Dr. Bobele says. "It works all the time. I haven't lost money yet."

Go for tests. If your hiccups are irritatingly frequent or the spells exceptionally long, your doctor probably will take x-rays after giving you some barium liquid to drink to highlight any obstruction in your esophagus, Dr. Renner says. To quell severely persistent hiccups not caused by some obstruction, your doctor may prescribe a medication depending on where he thinks the problem lies.

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