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Hiccup, Causes, Diagnosis, Treatment, Prevention, Complications

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Hiccup, Causes, Diagnosis, Treatment, Prevention, Complications

Hiccups or singultus is a condition when a person makes a 'hic' sound involuntarily. Hiccups can last for a few seconds or minutes, up to more than 48 hours.

Hiccups are common in everyone, including babies and children. Apart from making a 'hic' sound, hiccups can also cause pressure in the chest, stomach, and throat.

Hiccups are generally harmless. However, hiccups that last a long time can be a symptom of a serious illness.

Causes of Hiccups


The muscle that separates the stomach and chest (diaphragm) has an important role in the human respiratory system. The diaphragm relaxes (contracts) when you breathe in, and rises back up (relaxes) when you exhale.

Hiccups occur when the diaphragm muscle contracts involuntarily and suddenly. This condition causes air to enter too quickly into the lungs so that the respiratory valves close and make a 'hic' sound.

In addition to adults, hiccups are also quite common in babies. However, hiccups in babies will generally go away on their own. Some studies even say that hiccups in babies are normal and part of the process of growth and development.

Sudden contractions of the diaphragm muscle, whether temporary or prolonged, can be triggered by various things. Temporary hiccups can be triggered by any of the following conditions:

  • Eat too much or too fast
  • Eating hot and spicy food
  • Consuming soft drinks or alcohol
  • Swallowing air when chewing or sucking candy
  • Swallowing too much air (aerophagia)
  • Experiencing a sudden change in temperature
  • Feeling nervous, overexcited, or stressed


While hiccups that last for more than 2 days can be triggered by:

  • Digestive system disorders, such as gastritis, peptic ulcers, pancreatitis, pancreatic cancer, stomach cancer, inflammatory bowel disease, intestinal obstruction, or hepatitis
  • Metabolic disorders, such as alcoholism, diabetes, or electrolyte disturbances
  • Kidney problems, such as chronic kidney failure
  • Nerve disorders, for example due to inflammation of the airways, or due to a tumor or cyst in the neck
  • Disorders of the brain, such as hemorrhagic stroke, inflammation and infection of the brain, brain tumors, multiple sclerosis, and hydrocephalus
  • Disorders in the chest cavity, for example pneumonia, bronchitis, tuberculosis, asthma, chest injuries, and pulmonary embolism
  • Heart problems, such as heart attacks and inflammation of the lining of the heart
  • Mental disorders, such as personality disorders, anxiety, and stress
  • History of surgery on the chest or abdomen


In addition to the medical conditions above, prolonged hiccups can also occur due to side effects of using drugs, including:

  • Steroids
  • Dope
  • Tranquilizers, such as diazepam and lorazepam
  • Chemotherapy drugs
  • Methyldopa
  • Dexamethasone


Symptoms of Hiccups


Hiccups are a symptom that can sometimes be accompanied by pressure in the chest, stomach, or throat. Hiccups usually last for a few minutes, but can last longer.

In certain conditions, hiccups can last for more than 2 days or even more than 1 month. This condition is called persistent hiccups. Although rare, this condition can make sufferers experience fatigue and stress.

When to go to the doctor

Check with your doctor if your hiccups last for more than 48 hours. Especially if the hiccups come repeatedly and interfere with your daily activities, such as eating, sleeping, or even breathing.

You are also advised to go to the hospital emergency room immediately if you experience hiccups accompanied by the following signs and symptoms:

  • Stomach ache
  • Fever
  • Vomit
  • Hard to breathe
  • Coughing up blood
  • Headache
  • Fatigue
  • Numb
  • Lost balance


Diagnosis of Hiccups


Hiccups that occur temporarily will go away on their own without further examination or treatment. Meanwhile, prolonged hiccups require further examination to find out the underlying cause.

First of all, the doctor will ask questions related to symptoms, medical history and history of drug use. The doctor will also perform a physical examination, especially neurological examination related to balance and coordination, muscle strength, reflexes, sensory nerves, and vision.

Next, the doctor will run several supporting tests to find out the cause of the hiccups, namely:

  • Blood tests, to look for signs of infection, liver and kidney function
  • Scans, to detect abnormalities that affect the nerves, namely X-rays, CT scans, or MRIs
  • Endoscopy, to see the condition of the esophagus or respiratory tract
  • Electrocardiography (ECG), to check the condition of the heart


Hiccup Treatment


Temporary hiccups can go away on their own without special treatment. However, there are several ways you can do to get rid of hiccups faster, such as:

  • Holding your breath
  • Take a deep breath
  • Gargle with ice water
  • Drink water fast
  • Drink cold water slowly
  • Drink warm water and honey
  • Breathe using a paper bag
  • Consume 1 teaspoon of sugar
  • Eating fresh ginger
  • Sucking lemon slices


Meanwhile, hiccups that last a long time or are caused by an illness require special treatment, one of which is by administering drugs to calm the diaphragm, namely:

  • Chlorpromazine
  • Diphenhydramine
  • Metoclopramide
  • Baclofen
  • Gabapentin
  • Nifedipine


If the above drugs have not been able to overcome the hiccups, the doctor will inject an anesthetic directly into the nerve that controls the contraction of the diaphragm. Meanwhile, if the hiccups are caused by disease, then the treatment is to overcome the disease.

Hiccup Complications


Prolonged hiccups can cause several complications in sufferers, such as:

  • Fatigue
  • Lack of sleep
  • Comfort disturbance
  • Difficulty in performing daily activities, such as eating or drinking
  • Dehydration
  • Nutritional deficiency
  • Weight loss
  • Surgical wound healing is hampered
  • Acid reflux disease (GERD)
  • Alkalosis


Hiccup Prevention


There is no specific proven way to prevent hiccups. However, there are steps you can take to avoid conditions that can trigger hiccups, including:

  • Avoid overeating and drinking or eating too fast.
  • Avoid drinking soft drinks.
  • Avoid consuming alcoholic beverages.
  • Protect yourself from sudden changes in temperature.
  • Stay calm and avoid conditions that can trigger emotional and physical reactions.
  • Carry out regular health checks so that you can get immediate treatment if you are diagnosed with an illness.

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