Are Hiccups a Sign of Something Serious?

If your hiccups are chronic, they may be more than a temporary annoyance. Find out about the underlying medical conditions that may be causing them.

Hiccups can be frustrating, especially if they occur for what seems like no apparent reason. They’re usually temporary, though, and resolve on their own in a few minutes. But, while we typically think of hiccups as annoying but not serious, that might not always be the case. Read on to learn more about hiccups, what you can do about them and when you should see a doctor. 

What happens when you hiccup? 

The physiological process of hiccupping is straightforward. It occurs when there is rapid contraction of your respiratory muscles such as your diaphragm, the muscle at the base of your lungs. This causes you to inhale quickly. When this happens, your vocal cords quickly close, which in turn causes the telltale “hic” sound. 

What causes hiccups? 

Involuntary spasms of the diaphragm can occur when we eat too quickly (or too much), drink alcohol or drink carbonated beverages. Other causes can include eating something hot or spicy, a bloated stomach, abdominal surgery, certain medications or even just feeling nervous. 

“For the average person, the cause is probably some type of gastric distension,” says Anisa Shaker, MD, a gastroenterologist with the USC Digestive Health Institute, part of Keck Medicine of USC.  

How to stop hiccups 

The first thing we usually turn to when it comes to alleviating hiccups are home remedies — and sometimes they actually do work! Special breathing exercises may provide some relief. Holding your breath or breathing into a paper bag, for instance, may help because it raises the content of carbon dioxide in the blood, and in doing so, quells hiccups.  

Anything that may stimulate the vagus nerve (which connects the brain to the stomach), such as sipping or gargling cold water, lightly pulling on your tongue or gently rubbing your eyes, may do the trick. 

While there’s no guaranteed way to prevent hiccups, you can take steps to reduce how often you get them. For those prone to hiccups, Dr. Shaker suggests avoiding known triggers, such as carbonated beverages, spicy foods, eating too fast or drinking too much alcohol. If your medications are causing the hiccups, your doctor can help recommend alternatives. 

Can hiccups be a sign of something serious? 

Most hiccups are harmless and self-limiting, meaning they resolve quickly on their own, but knowing when they might be a warning sign is important. Chronic hiccups, in particular, can signal an underlying medical condition.  

Thankfully, most hiccups typically resolve within minutes or a few hours at most. Hiccups that last longer than 48 hours are much rarer, Dr. Shaker notes. 

Chronic hiccups can impact your quality of life if they interrupt your sleeping and eating patterns. “You probably should not be having hiccups when you’re asleep,” Dr. Shaker says.  

In addition to causing weight loss, exhaustion and dehydration, chronic hiccups can cause other side effects including gastroesophageal reflux disease (also known as GERD), an irregular heartbeat, chest pain or difficulty breathing. 

Medical conditions associated with persistent hiccups 

More serious medical conditions can cause longer-term hiccups, Dr. Shaker explains. Chronic hiccups are associated with several underlying disorders, ranging from brain tumors and strokes to pneumonia and pleurisy.  

Brain and nerve problems: Strokes and resulting neurological damage (especially a condition called Wallenberg syndrome) can cause persistent hiccups by affecting the area of the nervous system that controls the hiccup reflex. 

Heart or lung conditions: Heart attacks and lung conditions like pneumonia can trigger hiccups. 

Cancer: Some studies show that a small percentage of cancer patients may experience hiccups due to tumors or a side effect of medications used in treatment. Your doctor can help manage these side effects. 

Digestive system issues: Pancreatitis, irritation, infection or a dilated esophagus can contribute to hiccups. 

When to see a doctor for hiccups 

Since chronic hiccup cases can persist for more than a month, it’s important to visit a doctor sooner rather than later. Persistent hiccups can be treated with medications such as chlorpromazine, a nerve blockade, or, in rare cases, surgery. 

If you do experience chronic hiccups, a visit to your doctor will help you get to the bottom of what’s causing them in the first place and find an appropriate treatment to make you feel more comfortable. 

Diagnosis

First, doctors will search for underlying causes by looking at your: 

• Medical and medication history 
• Physical examination 
• Basic blood tests  
• Imaging studies such as a chest X-ray 
• Additional testing such as an upper endoscopy 

“The first thing is to check all the basics,” Dr. Shaker says. The goal is to rule out serious conditions before focusing on treating symptoms.  

Treatment options

Treatment approaches depend on how long your hiccups last. For brief hiccups, Dr. Shaker recommends at-home remedies: 

• Holding your breath as long as you can 
• Performing the Valsalva maneuver (exhaling air or pushing air out while your nose and mouth are closed, such as during a bowel movement) 
• Drinking or gargling cold water 
• Biting on something sour like a lemon 

For persistent hiccups, your doctor may consider medications, although some medications may have side effects of their own.  

In severe cases — intractable hiccups that significantly impact your quality of life — more advanced options may be considered, including nerve blocks, a breathing machine called a continuous positive airway pressure (CPAP) device, electrical stimulation of the diaphragm or even surgery. 

When dealing with hiccups, trust your instincts, Dr. Shaker says. If your hiccups last longer than what’s normal for you, have your doctor check them out. This personal approach ensures that potentially serious conditions aren’t overlooked.  

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