Hiccup#Folk remedies

Hiccups affect people of all ages, even being observed in utero. They become less frequent with advancing age. Intractable hiccups, lasting more than a month, are more common in adults. While males and females are affected equally often, men are more likely to develop protracted and intractable hiccups.{{cite web|last1=Wilkes|first1=Garry|title=Hiccups|url=http://www.emedicine.com/emerg/topic252.htm|website=eMedicine|publisher=WebMD|access-date=2023-06-29|archive-date=29 October 2008|archive-url=https://web.archive.org/web/20081029001013/http://www.emedicine.com/emerg/topic252.htm|url-status=bot: unknown}}

Along with humans, hiccups have been studied and observed in cats, rats, rabbits, dogs, and horses.{{cite journal |last1=Howes |first1=Daniel |title=Hiccups: A new explanation for the mysterious reflex |journal=BioEssays |date=2012 |volume=34 |issue=6 |pages=451–453 |doi=10.1002/bies.201100194 |pmid=22377831 |pmc=3504071 }}

{{listen

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File:Hiccup histogram.svg

A hiccup consists of a single or a series of breathing diaphragm spasms, of variable spacing and duration, and a brief (less than one half second), unexpected, shoulder, abdomen, throat, or full body tremor.

• Food stuck in the esophagus{{Cite web |last=Hoffmann |first=Herbert |date=June 1982 |title=Hiccups: An Occasional Sign of Esophageal Obstruction |url=https://www.gastrojournal.org/article/0016-5085(82)90081-6/pdf |url-status=live |archive-url=https://web.archive.org/web/20240808040704/https://www.gastrojournal.org/article/0016-5085(82)90081-6/pdf |archive-date=8 August 2024 |archive-format=PDF |access-date=8 August 2024 |website=Gastroenterology |format=PDF}}
• Swallowing air excessively{{cite web|url=http://www.webmd.com/digestive-disorders/tc/hiccups-topic-overview |title=Hiccups |publisher=WebMD |access-date=6 February 2014}}
• Gastroesophageal reflux{{cite encyclopedia|title=Gastroesophageal Reflux Disease |url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001311/ |encyclopedia=A.D.A.M Medical Encyclopedia |publisher=PubMed Health |access-date=18 July 2016 |url-status=dead |archive-url=https://web.archive.org/web/20140104160640/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001311/ |archive-date=4 January 2014}}
• Hiatal hernia{{cite journal|last1=Willis|first1=FM|title=Chronic hiccups|journal=Modern Drugs Discovery|date=2003|volume=6|issue=6|url=http://pubs.acs.org/subscribe/archive/mdd/v06/i06/toc/toc_i06.html|access-date=12 October 2016}}
• Rapid eating{{cite journal | last1 = Howes | first1 = D. | title = Hiccups: A new explanation for the mysterious reflex | journal = BioEssays | volume = 34 | issue = 6 | pages = 451–453| year = 2012 | pmid = 22377831| pmc = 3504071| doi = 10.1002/bies.201100194 }}
• Alcohol or carbonated beverages{{cite web | url=https://health.osu.edu/health/general-health/when-are-hiccups-serious | title=When are hiccups serious? | date=30 July 2024 | publisher=Ohio State University | access-date=18 August 2024 }}
• Spicy foods{{cite web|url=http://www.umm.edu/pediatrics/pdf/newsletter_win09.pdf |title=Hiccups Happen! |publisher=University of Maryland Hospital for Children |access-date=2 April 2012 |url-status=dead |archive-url=https://web.archive.org/web/20120110140402/http://www.umm.edu/pediatrics/pdf/newsletter_win09.pdf |archive-date=10 January 2012}}
• Opiate drug use{{cite journal|title=Hiccup and apparent myoclonus after hydrocodone: review of the opiate-related hiccup and myoclonus literature |journal=Clinical Neuropharmacology |volume=22 |issue=2 |pages= 87–92 |pmid=10202603 |year=1999|last1=Lauterbach|first1=E. C. |doi=10.1097/00002826-199903000-00004}}
• Laughing vigorously or for a long time{{cite web|url=http://www.livestrong.com/article/241185-causes-of-hiccups/|archive-url=https://web.archive.org/web/20101125122108/http://www.livestrong.com/article/241185-causes-of-hiccups/|archive-date=2010-11-25|title=Causes of Hiccups |last=Milano |first=Meadow |website=Livestrong |access-date=2 April 2012}}

Several human conditions can trigger hiccups. In rare cases, they can be a sign of serious medical problems such as myocardial infarction.{{cite journal |last1=Rueckert |first1=Kamiar Kersten |title=Case Report: From Irregular Hiccups to Acute Myocardial Infarction |journal=The Permanente Journal – Kaiser Permanente |date=January 2020 |volume=24 |issue=5 |page=1 |doi=10.7812/TPP/20.180 |pmid=33635776 |pmc=8817908 |s2cid=232066350 |url=http://www.thepermanentejournal.org/files/2020/tpj20180.pdf |access-date=31 December 2020 |archive-date=14 July 2021 |archive-url=https://web.archive.org/web/20210714180315/http://www.thepermanentejournal.org/files/2020/tpj20180.pdf |url-status=dead }}

• Kidney failure{{cite web|url=http://www.mayoclinic.com/health/hiccups/DS00975/DSECTION=causes |title=Hiccups: Causes |publisher=MayoClinic.com |date=2011-06-03 |access-date=2013-07-10}}

• Stroke
• Multiple sclerosis{{cite journal |vauthors=Witoonpanich R, Pirommai B, Tunlayadechanont S |title=Hiccups and multiple sclerosis |journal=Journal of the Medical Association of Thailand (Chotmaihet Thangphaet) |volume=87 |issue=10 |pages=1168–71 |year=2004 |pmid=15560692}}
• Meningitis

• Damage to the vagus nerve after surgery

• Although no clear pathophysiological mechanism has been described, hiccups is known to have been the initial symptom of Plasmodium vivax malaria in at least one documented case.{{Cite journal|last1=Guadarrama-Conzuelo|first1=F|last2=Saad Manzanera|first2=A D|date=2019-09-01|title=Singultus as an Unusual Debut of Plasmodium vivax Malaria|journal=Cureus|volume=11|issue=9|pages=e5548|doi=10.7759/cureus.5548|doi-access=free|pmid=31695971|pmc=6820320}}
• [https://pmc.ncbi.nlm.nih.gov/articles/PMC6509965/ Consumption or injection of corticosteroids], most commonly dexamethasone.

A leading hypothesis is that hiccups evolved to facilitate greater milk consumption in young mammals. The coordination of breathing and swallowing during suckling is complicated. Some air inevitably enters the stomach, occupying space that could otherwise be optimally used for calorie-rich milk.

The hypothesis suggests that the presence of an air bubble in the stomach stimulates the sensory (afferent) limb{{Explain|date=May 2025|reason=Not clear what limb means in this context.}} of the reflex through receptors in the stomach, esophagus, and along the underside of the diaphragm. This triggers the active part of the hiccup (efferent limb), sharply contracting the muscles of breathing and relaxing the muscles of the esophagus, then closing the vocal cords to prevent air from entering the lungs. This creates suction in the chest, pulling air from the stomach up into the esophagus. As the respiratory muscles relax, the air is expelled through the mouth, effectively "burping" the animal.{{Cite journal |last1=Steger |first1=M. |last2=Schneemann |first2=M. |last3=Fox |first3=M. |date=November 2015 |title=Systemic review: the pathogenesis and pharmacological treatment of hiccups |url=https://pubmed.ncbi.nlm.nih.gov/26307025/ |journal=Alimentary Pharmacology & Therapeutics |volume=42 |issue=9 |pages=1037–1050 |doi=10.1111/apt.13374 |issn=1365-2036 |pmid=26307025}}

There are a number of characteristics of hiccups that support this theory. The burping of a suckling infant may increase its capacity for milk by more than 15–25%, bringing a significant survival advantage. There is a strong tendency for infants to get hiccups, and although the reflex persists throughout life, it decreases in frequency with age. The location of the sensory nerves that trigger the reflex suggests it is a response to a condition in the stomach. The component of the reflex that suppresses peristalsis in the esophagus while the airway is being actively blocked suggests the esophagus is involved. Additionally, hiccups are only described in mammals, the group of animals that share the trait of suckling their young.{{fact|date=September 2022}}

An international respiratory research group composed of members from Canada, France, and Japan proposed that the hiccup is an evolutionary remnant of earlier amphibian respiration.{{cite journal |vauthors=Straus C, Vasilakos K, Wilson RJ, Oshima T, Zelter M, Derenne JP, Similowski T, Whitelaw WA | title = A phylogenetic hypothesis for the origin of hiccough | journal = BioEssays | volume = 25 | issue = 2 | pages = 182–188 | date = February 2003 | pmid = 12539245 | doi = 10.1002/bies.10224 | s2cid = 14200209 }} Amphibians such as tadpoles gulp air and water across their gills via a rather simple motor reflex akin to mammalian hiccuping. The motor pathways that enable hiccuping form early during fetal development, before the motor pathways that enable normal lung ventilation form. Thus, the hiccup is evolutionarily antecedent to modern lung respiration.

Additionally, this group (C. Straus et al.) points out that hiccups and amphibian gulping are inhibited by elevated CO₂ and may be stopped by GABA_B receptor agonists, illustrating a possible shared physiology and evolutionary heritage. These proposals may explain why premature infants spend 2.5% of their time hiccuping, possibly gulping like amphibians, as their lungs are not yet fully formed.{{cite journal | first1 = P | last1 = Kahrilas | first2 = G. | last2 = Shi | title = Why do we hiccup? | journal = Gut | volume = 41 | issue = 5 | pages = 712–713 | year = 1997 | pmc = 1891574 | pmid = 9414986 | doi=10.1136/gut.41.5.712}}

The phylogenetic hypothesis may explain hiccups as an evolutionary remnant, held over from our amphibious ancestors.{{cite news| url=http://news.bbc.co.uk/2/hi/health/2730251.stm | publisher=BBC News | title=Why we hiccup | date=6 February 2003}}

Episodes of hiccups usually last under 30 minutes. Prolonged attacks, while rare, can be serious. Root causes of prolonged hiccups episodes are difficult to diagnose.{{FV|date=June 2023}} Such attacks can cause significant morbidity and even death. An episode lasting more than a few minutes is termed a bout; a bout of over 48 hours is termed persistent or protracted. Hiccups lasting longer than a month are termed intractable. In many cases, only a single hemidiaphragm, usually the left one, is affected, although both may be involved.

Hiccups are normally waited out, as fits will usually pass quickly. Folk cures for hiccups are common and varied. Hiccups are treated medically only in severe and persistent (termed "intractable") cases.

Numerous medical remedies exist, but no particular treatment is known to be especially effective, generally because of a lack of high-quality evidence.{{Cite encyclopedia|title = Hiccups|encyclopedia = The Merck Manual Online|editor-last = Porter|editor-first = Robert S.|publisher = Merck Sharp & Dohme|year = 2011|url = http://www.merckmanuals.com/professional/gastrointestinal_disorders/approach_to_the_patient_with_upper_gi_complaints/hiccups.html|access-date = 7 October 2011|archive-date = 14 October 2013|archive-url = https://web.archive.org/web/20131014142136/http://www.merckmanuals.com/professional/gastrointestinal_disorders/approach_to_the_patient_with_upper_gi_complaints/hiccups.html|url-status = dead}}{{Cite journal|journal=Cochrane Database of Systematic Reviews|issue=1|pages=CD008768|last1=Moretto|first1=Emilia N|last2=Wee|first2=Bee|last3=Wiffen|first3=Philip J|last4=Murchison|first4=Andrew G|date=2013-01-31|doi=10.1002/14651858.cd008768.pub2|pmid=23440833|title=Interventions for treating persistent and intractable hiccups in adults|volume=2019|pmc=6452787}}

A vagus nerve stimulator has been used with an intractable case of hiccups. "It sends rhythmic bursts of electricity to the brain by way of the vagus nerve, which passes through the neck. The Food and Drug Administration approved the vagus nerve stimulator in 1997 as a way to control seizures in some patients with epilepsy."{{Cite news| last = Schaffer | first = Amanda | title = A Horrific Case of Hiccups, a Novel Treatment | work = The New York Times | date = 10 January 2006 | url = https://www.nytimes.com/2006/01/10/health/10hicc.html | access-date = 24 April 2008 }}

In one person, persistent digital rectal massage coincided with terminating intractable hiccups.{{cite journal |vauthors=Odeh M, Bassan H, Oliven A | title = Termination of intractable hiccups with digital rectal massage | journal = Journal of Internal Medicine | volume = 227 | issue = 2 | pages = 145–6 | date = February 1990 | pmid = 2299306 | doi = 10.1111/j.1365-2796.1990.tb00134.x | s2cid = 20742803 }}

There are many folk remedies for hiccups, including headstanding, drinking a glass of water upside-down, being frightened by someone, breathing into a bag, eating a large spoonful of peanut butter, and placing sugar on or under the tongue.{{cite journal |vauthors=Engleman EG, Lankton J, Lankton B | title = Granulated sugar as treatment for hiccups in conscious patients | journal = The New England Journal of Medicine | volume = 285 | issue = 26 | pages = 1489 | date = December 1971 | pmid = 5122907 | doi = 10.1056/nejm197112232852622 }}{{Cite news | title = MacGyver Tip: Cure hiccups with sugar | last = Boswell | first = Wendy | publisher = The People's Pharmacy (Lifehacker) | date = 25 March 2007 | url = http://lifehacker.com/246873/macgyver-tip-cure-hiccups-with-sugar | access-date = 30 November 2009 | archive-date = 2 December 2009 | archive-url = https://web.archive.org/web/20091202203628/http://lifehacker.com/246873/macgyver-tip-cure-hiccups-with-sugar | url-status = dead }}

Acupressure, either through actual function or placebo effect, may cure hiccups in some people. For example, one technique is to relax the chest and shoulders and find the deepest points of the indentations directly below the protrusions of the collarbones. The index or middle fingers are inserted into the indents and pressed firmly for sixty seconds, as long, deep breaths are taken.{{cite book |last1=Gach |first1=Michael Reed |title=Acupressure's Potent Points: A Guide to Self-Care for Common Ailments |date=1990 |publisher=Bantam Books |location=New York |isbn=0553349708 |page=272 |oclc=1035683945 |edition=1st |url=https://www.worldcat.org/oclc/1035683945}}

A simple treatment involves increasing the partial pressure of CO₂ and inhibiting diaphragm activity by holding one's breath or rebreathing into a paper bag.{{cite web|title=The Two Mechanisms That Make Hiccup Cures Actually Work|url=http://www.lifehacker.com.au/2014/01/the-two-mechanisms-that-make-hiccup-cures-actually-work/|first=Thorin|last=Klosowski|work=Lifehacker Australia|access-date=16 September 2016|date=30 January 2014}} Other potential remedies suggested by NHS Choices include pulling the knees up to the chest and leaning forward, sipping ice-cold water and swallowing some granulated sugar.{{cite web|access-date=2017-12-25|date=15 July 2017|title=Hiccups|url=https://www.nhs.uk/conditions/hiccups/|website=NHS Choices}}

A breathing exercise called supra-supramaximal inspiration (SSMI) has been shown to stop persistent hiccups. It combines the three principles of hypercapnia, diaphragm immobilization, and positive airway pressure. First, the subject must exhale completely, then take a deep breath. Then, they must hold their breath for ten seconds. After ten seconds, they must take another small breath without exhaling, then hold their breath for five seconds. Again, without exhaling, they must take another small breath and hold their breath for five seconds. Upon exhaling, the hiccups should be gone.{{Cite journal|url=https://www.jem-journal.com/article/S0736-4679(04)00352-X/fulltext|title=Errata|first1=Luc G.|last1=Morris|first2=Jennifer L.|last2=Marti|first3=David J.|last3=Ziff|date=1 January 2005|journal=Journal of Emergency Medicine|volume=28|issue=1|pages=117–118|via=www.jem-journal.com|doi=10.1016/j.jemermed.2004.11.013|doi-access=free}}

Drinking through a straw with the ears plugged is a folk remedy that can be successful. In 2021, a scientific tool with a similar basis was tested on 249 hiccups subjects; the results were published in the Journal of the American Medical Association (JAMA).{{cite journal|last1=Alvarez|first1=James|last2=Anderson|first2=Jane Margaret|last3=Snyder|first3=Patrick Larry|last4=Mirahmadizadeh|first4=Alireza|last5=Godoy|first5=Daniel Agustin|last6=Fox|first6=Mark|last7=Seifi|first7=Ali|title=Evaluation of the Forced Inspiratory Suction and Swallow Tool to Stop Hiccups|journal=JAMA Network Open|volume=4|issue=6|year=2021|pages=e2113933|issn=2574-3805|doi=10.1001/jamanetworkopen.2021.13933|pmid=34143196|pmc=8214157}}{{Cite web |title=Inventor Says His New Straw Will Cure Hiccups |last=Ellis |first=Ralph |website=Medscape |date=22 June 2021 |url= https://www.medscape.com/viewarticle/953553 }} This device is named FISST (Forced Inspiratory Suction and Swallow Tool) and branded as "HiccAway". This study supports the use of FISST as an option to stop transient hiccups, with more than 90% of participants reporting better results than home remedies. HiccAway stops hiccups by forceful suction that is being generated by diaphragm contraction (phrenic nerve activity), followed by swallowing the water, which requires epiglottis closure.Seifi A, inventor. Hiccup relieving apparatus. US patent application publ. US 2020/0188619 A1. 18 June 2020. US20200188619A1. https://patentimages.storage.googleapis.com/c1/fa/54/c983a34c045f36/US20200188619A1.pdf

The word hiccup itself was created through imitation. The alternative spelling of hiccough results from the association with the word cough.{{cite web|url=https://en.oxforddictionaries.com/definition/hiccup|archive-url=https://web.archive.org/web/20160925164544/https://en.oxforddictionaries.com/definition/hiccup|url-status=dead|archive-date=25 September 2016|title=Definition of hiccup in English|publisher=Oxford Dictionaries|access-date=8 February 2018}}

• American Charles Osborne (1894–1991) had hiccups for 68 years, from 1922 to 1990,{{Cite web |url=http://news.bbc.co.uk/2/shared/spl/hi/pop_ups/05/health_guinness_medical_record_breakers/html/2.stm |title=In pictures {{!}} Guinness medical record breakers {{!}} Longest attack of hiccups |work=BBC News |access-date=2 June 2013}} and was entered in the Guinness World Records as the man with the longest attack of hiccups, an estimated 430 million hiccups.{{Cite news| title = Survivor of 68-Year Hiccup Spell Dies | work = Omaha World-Herald | date = 5 May 1991 | edition = Sunrise |page=2.B }}
• In 2007, Florida teenager Jennifer Mee gained media fame for hiccuping around 50 times per minute for more than five weeks.{{Cite news| url = http://www.msnbc.msn.com/id/17643118 | archive-url = https://web.archive.org/web/20070318203922/http://www.msnbc.msn.com/id/17643118/ | url-status = dead | archive-date = 18 March 2007 | title = Florida girl hiccuping again after returning to school | date = 16 March 2007 | publisher = MSNBC }}{{Cite news|url=https://www.cbsnews.com/news/hiccup-girl-jennifer-mee-may-use-tourettes-defense-says-lawyer/ |title='Hiccup Girl' Jennifer Mee May Use Tourette's Defense, Says Lawyer |date=27 October 2010 |publisher=CBS News |url-status=live |archive-url=https://web.archive.org/web/20110101233346/http://www.cbsnews.com/8301-504083_162-20020853-504083.html |archive-date=1 January 2011 }}
• British singer Christopher Sands hiccupped an estimated 10 million times in 27 months from February 2007 to May 2009. His condition, which meant that he could hardly eat or sleep, was eventually discovered to be caused by a tumor on his brain stem pushing on nerves, causing him to hiccup every two seconds, 12 hours a day. His hiccups stopped in 2009 following surgery.{{Cite web|url=https://www.telegraph.co.uk/news/health/news/6966747/Singer-who-hiccupped-20-million-times-in-three-years-cured-after-brain-tumour-surgery.html |archive-url=https://ghostarchive.org/archive/20220112/https://www.telegraph.co.uk/news/health/news/6966747/Singer-who-hiccupped-20-million-times-in-three-years-cured-after-brain-tumour-surgery.html |archive-date=12 January 2022 |url-access=subscription |url-status=live|title=Singer who hiccupped 20 million times in three years cured after brain tumour surgery|first=Nick|last=Britten|date=11 January 2010|access-date=13 January 2020|work=The Daily Telegraph|location=London}}{{cbignore}}

In Baltic, German, Hungarian, Indian, Romanian, Slavic, Turkish, Greek and Albanian tradition, as well as among some tribes in Kenya, for example in the folklore of the Luo people, it is said that hiccups occur when the person experiencing them is being talked about by someone not present.{{cite web|url=http://ujszo.com/cimkek/fokuszban-luca-napja/2003/12/13/a-regi-babonak-napjainkban-is-elnek|language=hu|title=A régi babonák napjainkban is élnek|publisher=ujszo.com|access-date=3 December 2016|archive-url=https://web.archive.org/web/20161220035840/http://ujszo.com/cimkek/fokuszban-luca-napja/2003/12/13/a-regi-babonak-napjainkban-is-elnek|archive-date=20 December 2016|url-status=dead}}{{cite web|last1=Schersch|first1=Ursula|title=Schluckauf: Wer denkt an mich?|url=https://derstandard.at/1289607909005/Genauer-betrachtet-Schluckauf-Wer-denkt-an-mich|website=Der Standard|access-date=3 April 2018|language=de|date=17 November 2010}}

• Choking
• Cough
• Getting the wind knocked out of you
• Mr. Hiccup
• Sneeze
• Thumps, a more serious form of hiccups found in equines
• Vocal hiccup
• Yawn

{{Reflist}}

{{Refbegin}}

• Provine, Robert R. Curious Behavior: Yawning, Laughing, Hiccupping, and Beyond (Harvard University Press; 2012). 246 pages; examines the evolutionary context for humans.
• {{cite journal |last=Shubin |first=Neil |title=Fish Out of Water |journal=Natural History |pages=26–31 |volume=117 |issue=1 |date=February 2008 |id={{INIST|19986878}} }} Hiccup related to reflex in fish and amphibians.

{{Refend}}

{{Medical resources

| ICD10 = {{ICD10|R|06|6|r|00}}

| ICD9 = {{ICD9|786.8}}

| ICDO =

| OMIM =

| DiseasesDB = 5887

| MedlinePlus = 003068

| eMedicineSubj = emerg

| eMedicineTopic = 252

| MeshID = D006606

}}

{{Wiktionary}}

• [http://news.bbc.co.uk/2/hi/health/2730251.stm BBC News: Why we hiccup]
• {{Cite magazine |url=https://www.wired.com/wiredscience/2008/02/evolution-expla/ |title=Wired: The Best Cure for Hiccups: Remind Your Brain You're Not a Fish |archive-url=https://web.archive.org/web/20140722145942/http://www.wired.com/2008/02/evolution-expla/ |archive-date=2014-07-22 |date=Feb 25, 2008 |magazine=Wired}}
• {{cite journal | author = Cymet TC | title = Retrospective analysis of hiccups in patients at a community hospital from 1995–2000 | journal = J Natl Med Assoc | volume = 94 | issue = 6 | pages = 480–3 | date = June 2002 | pmid = 12078929 | pmc = 2594386 }}
• [http://www.webmd.com/digestive-disorders/tc/hiccups-topic-overview WebMD: Hiccups]
• {{Skeptoid | id=4914 | number=914 | date=12 December 2023 | title=Stopping Hiccups with Science}}

{{Circulatory and respiratory system symptoms and signs}}

{{Authority control}}

Category:Symptoms and signs: Respiratory system

Category:Reflexes