DEAR DOCTOR K:
I’ve been hiccupping for days. Please help!
Most people have hiccups occasionally, and sometimes they can last for days. What are they, and what can you do to stop them?
At the bottom of your lungs, separating your chest from your abdomen, lies a flat, blanket-like muscle called the diaphragm. It moves down when you take a breath in, creating suction in your chest that helps pull air into your lungs. It moves up when you breathe out, helping push air out of your lungs.
A hiccup is caused by a sudden contraction or spasm of the diaphragm. It makes you inhale quickly and involuntarily. Then the space in your throat near your vocal cords snaps shut, producing the typical hiccup sound. Try making a hiccup sound: You’ll discover that you need to take in a quick breath, and you’ll feel something move in your throat.
Of the many purported ways to get rid of hiccups, here are a few that have some merit:
- Stimulate the uppermost region of your throat: Pull on your tongue; put a teaspoon of granulated sugar on the back of your tongue; gargle with water or sip ice water; drink from the far side of a glass; or bite on a lemon. (I’ve tried all of these, particularly the sugar trick, and they work for me.)
- Tap or rub the back of your neck.
- Gently poke the back of your throat with a long cotton swab.
- Stimulate the cone-like tissue that hangs from the very back of the top of your mouth (the uvula) by touching it with a cotton swab.
- Change your breathing pattern in various ways: Hold your breath; breathe into a paper bag; gasp in fright; or pull your knees up to your chest and lean forward.
- Distract yourself from the fact that you’re hiccupping.
Occasionally, hiccups just won’t go away. But even long-lasting hiccups don’t usually signal a medical problem.
In a small number of cases, though, persistent hiccups may be a sign of disease. The underlying issue is usually something that causes irritation of one of the nerves in the chest that send signals to the diaphragm telling it to move. Hiccups can also be triggered by excess alcohol use, kidney failure and infections, especially ear infections.
If you have long-lasting hiccups, see your doctor. He or she will look for problems that may be causing them and then try to fix that problem. Your doctor may also prescribe a medication that can help stop your hiccups. The ones most often used are chlorpromazine, haloperidol and metoclopramide. Or your doctor may tell you to stop taking a particular drug that may be causing your hiccups. Examples include midazolam, some types of chemotherapy and digoxin.
Surgery for persistent hiccups is another option, though it’s rarely used. One type of surgery is a “nerve block” that stops a signal telling the diaphragm to contract. Another option is implanting a pacemaker that makes the diaphragm contract more rhythmically.
Fortunately, the simple solutions I described earlier almost always solve the problem.