One, and then another. A pause of a few minutes, then several back-to-back. Then they come in rapid succession, hiccups like machine-gun fire. None of the go-to methods for getting rid of them seem to work, and one is more ludicrous than the next. A certain number of sips of water? Holding your breath? A spoonful of sugar?  

"Hiccup" is a term used to describe an involuntary contraction or convulsion of a muscle, the thoracic diaphragm, that results in a sudden intake of air. The diaphragm sits horizontally below the lungs and rib cage – it assists in producing airflow for breathing, speaking, and it has other non-respiratory functions. The characteristic sound of a hiccup, or “hic” sound, happens when airflow is stopped at the trachea and the vocal folds.

Hiccups occur frequently and spontaneously under these conditions:

• overeating
• eating too quickly
• eating spicy or fatty foods
• swallowing too much air
• drinking (carbonated beverages and alcohol especially) too much or too quickly
• taking some medications
• changes in life circumstances that cause stress or excitement

Hiccups also could occur when the stomach experiences a sudden temperature change -- for example, after switching from a hot to cold beverage.


Hiccup Frequency and Diagnosis

Hiccups that may be diagnosed as persistent, often brought on by some sort of damage to the vagus or phrenic nerve (the nerve that allows for exhalation), last for more than two days but less than a month. Hiccups that continue for more than a month can be diagnosed as chronic, or intractable. Another issue of concern is the intensity or duration of each hiccup episode. Hiccups that interfere with daily functioning will lead to fatigue from loss of sleep and extreme weight fluctuations from disturbances in eating patterns.

Intervention is usually unnecessary with the everyday hiccup, and “folk remedies," like scaring the sufferer or taking a certain number of sips of water, are often enough to put the person hiccuping at ease. Medical treatment is often warranted when a case of chronic hiccups presents.

These are only a few of the many conditions related to chronic hiccups:

• brain lesions
• tumors
• liver or kidney disorders or uremic poisoning
• pleurisy of the diaphragm
• pneumonia
• alcoholism
• bowel diseases
• pancreatitis
• bladder irritation
• and other disorders of the intestine, the stomach or esophagus

Even if hiccups are thought to affect just about everyone, and that chronic hiccups are rare, when news got out of the success of a vagus stimulation treatment in 2004, the response was overwhelming, particularly for chronic sufferers, who have resorted to extreme treatments like taking Thorazine, ketamine and ephedrine. Surgery and even hypnosis also have been tried, according to the National Organization for Rare Disorders.

Patients will have tests conducted to assess the normal functioning of the central nervous system (CNS) and the “hiccup center,” where nerves affecting the diaphragm signal the cerebral cortex. Other tests will check for diseases or disorders of the lungs -- these may be the underlying problem in chronic hiccups.

Home Remedies for Hiccups

If you have an annoying but run-of-the-mill case of the hiccups, there are lots of home remedies you can try to get rid of them. Here are just a few:

• Holding breath
• Sucking a lemon
• Gulping water without taking a breath
• Using smelling salts
• Pulling hard on the tongue

However rare chronic hiccups may be, use good judgment and seek professional advice if you feel something is not quite right, if any ailment comes on suddenly or strongly, or begins to interfere with your quality of life.