HICCUP

General Information

DEFINITION--Repeated, involuntary spasmodic contractions of the diaphragm. Hiccups are a symptom, not a disease. Hiccups involve the diaphragm (large, thin muscle which separates the chest from the abdomen) and phrenic nerve (nerve that connects the diaphragm to the brain). Almost everybody gets hiccups, even a fetus in a mother's womb.

BODY PARTS INVOLVED

• Diaphragm (big muscle which separates the chest from the abdomen).
• Phrenic nerve (nerve that connects the diaphragm to the brain).

SEX OR AGE MOST AFFECTED--Both sexes, but more common in men.

SIGNS & SYMPTOMS--A sharp, quick sound produced from the mouth by a spasm of the diaphragm. The spasm closes muscles in the back of the throat during inhalation.

CAUSES--

Irritation of nerves from the brain that control breathing muscles, especially the diaphragm. The cause of short hiccup episodes is usually unknown. Prolonged or recurrent hiccup episodes may be caused by:

• Swallowing hot or irritating substances.
• Diseases of the pleura (thin membrane layers that cover the lung).
• Pneumonia.
• Uremia.
• Alcoholism.
• Use of certain prescription or non-prescription drugs.
• Disorders of the stomach, esophagus, bowel or pancreas.
• Pregnancy.
• Bladder irritation.
• Hepatitis.
• Spread of cancer from another part of the body to the liver or part of the pleura.
• Recent surgery, especially abdominal surgery.
• Emotional causes.

RISK INCREASES WITH

• Illness that has diminished health.
• Recent abdominal surgery.
• Use of drugs, especially those that irritate the stomach.
• Full stomach.
• Laughter or intense emotions.
• Changes in temperature.
• Alcohol consumption.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor (sometimes).

APPROPRIATE HEALTH CARE

• Self-care.
• Doctor's treatment (prolonged hiccups).
• Surgery to cut phrenic nerve (severe, prolonged cases only).

POSSIBLE COMPLICATIONS--None unless hiccups are prolonged, which may indicate serious disease.

PROBABLE OUTCOME--Short hiccup episodes usually don't indicate disease. They will subside on their own or often with the treatment discussed below. Continued hiccups can be debilitating and require medical attention to determine the cause.

How To Treat

GENERAL MEASURES----These instructions are for short hiccup episodes. Prolonged hiccups require medical care. Try one or more methods to see which works best for you.

• Hold your breath and count to 10.
• Breathe into a paper bag and rebreathe air in the bag. Don't use a plastic bag because it may cling to nostrils.
• Insert your thumb between your teeth and upper lip; press the upper lip with your index finger just below the right nostril.
• Press a forefinger into each ear for about 20 seconds.
• Drink a glass of water rapidly.
• Swallow dry bread or crushed ice.
• Pull gently on the tongue.
• Close eyelids and apply gentle pressure to the eyeballs.
• Swallow a teaspoon of dry sugar.

MEDICATION--Usually no medications are needed for this disorder.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• Hiccups persist longer than 8 hours.
• You suspect a prescription drug may be causing hiccups.