All About Hiccups

Hiccups are a common phenomenon in humans and many other animals. The sound and sensation we associate with the event occur when the diaphragm — a muscle separating the chest and abdomen, involved in the breathing process — contracts involuntarily, sometimes multiple times per minute. This diaphragmatic contraction is called a myoclonic jerk. Hiccups usually last only a short time, although there are cases of bouts of hiccups lasting much longer. The phenomenon is rarely problematic, though hiccups that begin to interfere regularly with sleeping or eating, or are accompanied by other symptoms, should prompt medical attention.

Signs and Symptoms of Hiccups

When someone hiccups, a jerk or tremor can be felt in the shoulder, abdomen, throat, or whole body. Often, the reaction produces an audible sound, such as a chirp, gasp, squeak, or “hupp” sound. Hiccups can be distracting and may be painful in certain circumstances. Though they usually go away after a few minutes, if they persist they can eventually cause exhaustion and even weight loss.

Physical Causes of Hiccups

Various physiological factors can result in hiccups. They may occur as a result of

• Swallowing excessive air
• Laughing
• Opioid use
• Acid reflux
• Hiatal hernia
• Eating too quickly
• Eating dry bread or spicy food
• Drinking alcohol or fizzy drinks

Conditions That Cause Hiccups

Additionally, some diseases, disorders, and conditions can cause chronic hiccups. Excessive or chronic hiccupping can be related to

• Diaphragm pleurisy
• Pneumonia
• Uremia
• Alcoholism
• Esophagus and stomach disorders
• Bowel disease
• Pancreatitis
• Bladder irritation
• Stroke
• Liver infection
• Meningitis
• Multiple Sclerosis
• Hepatitis
• Surgery, lesions, and tumors

Hiccuping can also occur more frequently during pregnancy.

Evolutionary Causes of Hiccups – Phylogeny Hypothesis

This theory of hiccupping is based on the idea that the hiccup can be traced back to our evolutionary lower vertebrate ancestors. It theorizes that hiccups stopped four-legged animals from choking when they swallowed food; their digestive tracts run parallel to the ground, and as such, they cannot rely on gravity to help food move through the system. Another theory speculates that hiccups developed alongside lung development in species that had used their gills to breathe in the past.

Evolutionary Causes of Hiccups – Clearing Air from the Stomach

Howes, in 2012, put forward the idea that hiccups may have evolved to get rid of the air in suckling infants, enabling them to consume more milk. The hiccup creates a burping action for the child. This theory is supported by the fact that infants hiccup much more than adults, and hiccuping lessens with age.

Medical Treatment for Chronic Hiccups

There is a lack of evidence around medical treatment for hiccups, although many medications have undergone tests of their efficacy when it comes to hiccups, including a muscle spasm medication, an antipsychotic, and a medication for seizures and neuropathic pain. Strong sedatives can effectively alleviate hiccups but can only be used for a short time due to their other effects. If hiccups are symptomatic, treatment of the primary disorder can alleviate the hiccups.

Folk Remedies for Hiccups

Drinking water upside down, standing on one’s head, drinking water while holding one’s breath, and having someone frighten the hiccuping person have all been put forward over the centuries as ways to alleviate hiccups. Diaphragmatic activity can be suppressed by increasing the pressure of CO2, so options such as holding the breath or breathing into a paper bag may offer relief.

World Records for Hiccups

Charles Osborne set the record for the longest bout of hiccups — the American hiccuped for 68 years, starting in 1922. In 2007, a Florida teenager hiccupped 50 times a minute for more than five weeks. A British man hiccupped every two seconds for just over two years due to a tumor. His hiccups stopped after the growth was removed.

Babies and Hiccuping

Infants, particularly those under one year, hiccup more than adults, and the action generally decreases with age. Fetuses even hiccup while inside the womb. Babies usually hiccup after feeding as they ingest air, and the diaphragm spasms to try to reduce the amount of air in the stomach. Parents should burp babies between feeds to reduce the amount they hiccup.

Animals and Hiccups

Many animals hiccup because they have similar breathing systems to humans. Cats and dogs tend to hiccup if they eat too fast. Horses have a particularly audible hiccup, and kittens usually hiccup without making any noise. Squirrels, porcupines, and otters have also been filmed hiccuping.