How do hiccups occur?
The hiccup reflex arc consists of three parts: sensory fibers of the vagus and phrenic nerves, a center in the brain stem and cervical spinal cord, and motor fibers going to the diaphragm. Irritation of any part of this chain triggers an attack. That is why hiccups can be caused by a distended stomach, inflammation in the chest, and processes in the brain. Contraction of the diaphragm occurs approximately 4–60 times per minute and does not depend on the will of the person.
- Episodic hiccups - up to several minutes
- Persistent - longer than 48 hours
- Untamed - longer than a month
- The attack is not subject to volitional control
- In fetuses and newborns, hiccups are a normal variant
Household reasons
Most episodes involve irritation of the stomach and esophagus. Overeating and carbonated drinks stretch the stomach, which puts pressure on the diaphragm from below. Very hot or very cold food, spicy foods, alcohol, smoking and chewing gum, which causes air to be swallowed, also provoke hiccups. Excitement, laughter and fast food on the run contribute to attacks. In these cases, it is enough to wait: the reflex fades away on its own within a few minutes.
- Overeating and eating on the run
- Carbonated drinks
- Alcohol
- Sudden change in food temperature
- Swallowing air when talking and chewing gum
- Excitement and laughter
When hiccups indicate illness
Persistent hiccups require a search for the cause along the reflex arc. From the abdominal side, this is gastroesophageal reflux disease, hiatal hernia, peptic ulcer, inflammation of the pancreas, subdiaphragmatic abscess. In the chest - pleurisy, pneumonia, enlarged lymph nodes, irritation of the phrenic nerve. From the nervous system - stroke, multiple sclerosis, brain stem tumors. Metabolic causes are considered separately: kidney failure, low sodium, as well as taking certain medications, including hormones and anesthesia.
- Reflux disease and hiatal hernia
- Peptic ulcer and pancreatitis
- Pleurisy and pneumonia
- Stroke and other brainstem lesions
- Renal failure and electrolyte disturbances
- Side effects of drugs and consequences of anesthesia
Home remedies to stop an attack
All simple techniques work due to two mechanisms: increasing the level of carbon dioxide in the blood and stimulating the vagus nerve. Therefore, holding your breath, slowly drinking water in small sips, swallowing a dry teaspoon of sugar, and inhaling with straining help. These methods are safe and often sufficient. You cannot scare a person, put pressure on the eyeballs, or use any techniques on infants - it is enough to give them a breast or a bottle, hold them in a column and do not overfeed.
- Hold your breath for 10–20 seconds
- Drink water in small sips
- Slowly swallow a teaspoon of sugar
- Breathe into folded palms for a short time
- Gently pull your knees towards your chest while sitting
- Hold the baby upright after feeding
Examination and treatment of persistent hiccups
If hiccups last longer than two days, the doctor finds out what is causing it, what medications the person is taking, and whether there have been any surgeries or injuries. Gastric endoscopy, abdominal ultrasound, chest x-ray and basic blood tests are usually ordered; for neurological signs, an MRI of the brain is added. Treatment is aimed at the cause: for reflux, proton pump inhibitors are prescribed and the diet is changed; for neurological causes, the neurologist selects special medications. You cannot select such funds yourself.
- EGD for evaluation of the esophagus and stomach
- Abdominal ultrasound
- Chest X-ray
- Blood biochemistry, sodium and creatinine
- MRI of the brain for neurological complaints
- Treatment of reflux and nutritional correction