Doctor's Notes on Hiccups
A hiccup is the term that refers to a sudden involuntary contraction of the diaphragm muscle. When this happens, the vocal cords snap shut and create the characteristic sound associated with hiccups. Most cases of hiccups go away on their own and are not associated with other symptoms and signs. Eating too rapidly or eating or drinking too much are the most common causes of hiccups.
Medical conditions can sometimes cause hiccups, but this is much less common. Medical conditions that might cause hiccups include stroke, brain tumors, or conditions or injuries that irritate the nerves that control the diaphragm. Sometimes, taking certain medications increases a person’s risk of having hiccups. These medications include, among others, levodopa, benzodiazepines, and medications to treat acid reflux.
Hiccups can be described as brief, irritable spasms of the diaphragm that can occur for a few seconds or minutes. They infrequently last longer in normal individuals without any underlying medical problem.
Diagnosis is based on physical evaluation. Laboratory testing is rarely necessary unless the hiccups are suspected to be a symptom of an associated medical condition. The tests to diagnose the associated medical condition will be done and tests will vary according to the associated condition.
Many conditions are associated with hiccups, but none has been shown to be the cause of hiccups.
- If a person eats too fast, he or she can swallow air along with food and end up with the hiccups.
- Smoking or chewing gum also can cause a person to swallow air and get hiccups.
- Any other practices that might irritate the diaphragm such as eating too much (especially fatty foods) or drinking too much (alcohol or carbonated drinks) can make a person prone to having hiccups.
- In these instances, the stomach, which sits underneath and adjacent to the diaphragm, is distended or stretched. As they occur in relation to eating and drinking, hiccups are sometimes thought to be a reflex to protect a person from choking.
- Strokes or brain tumors involving the brain stem, and some chronic medical disorders (such as renal failure) are reported to cause hiccups; trauma to the brain, meningitis, and encephalitis also may cause hiccups.
- Damage to the vagus or phrenic nerve may cause hiccups to last a long time.
- Problems with the liver, including swelling, infection, or masses can cause irritation of the diaphragm, which can cause hiccups.
- Some medications that can cause acid reflux may also have hiccups as a side effect. Most benzodiazepines, including diazepam (Valium), alprazolam (Xanax) and lorazepam (Ativan) can cause hiccups. In addition, medications such levodopa (Larodopa), nicotine, and ondansetron (Zofran) can cause hiccups. Other medications that can cause hiccups include levodopa, methyldopa (Aldomet), nicotine, ondansetron (Zofran), barbiturates, opioid pain relievers, corticosteroids, anesthesia, or chemotherapy medications.
- Noxious fumes can also trigger hiccup symptoms.
- A baby may hiccup after crying or coughing. This is common in babies in the first year. In some instances, babies with gastroesophageal reflux (GERD) could be more prone to hiccups.
- Anxiety and stress can induce both short and long-term hiccups
Oh no, not again! Another frozen treat, another brain freeze. “Ice cream headaches” happen when something cold touches nerves in the roof of the mouth, triggering blood vessels in the front of your head to swell. This rapid swelling causes the familiar, jabbing pain of a brain freeze. An easy solution? Try eating ice cream or other cold foods more slowly to avoid getting a headache.
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.