If you Bing “hiccups” you’ll find lots of supposed cures for this annoying, but usually fast-passing condition—one site lists 250 of them! You might find the story of a man in Iowa who had the hiccups for 60 years and couldn't shake them. One thing you won’t find, though, is a good explanation for why we hiccup. The truth is, after pondering the question for thousands of years, no one really knows. (Hippocrates, the Greek physician who lived in the fourth century B.C., thought liver inflammation was to blame. It’s not. But we still don’t know what is.)

Hiccupping is a more complex reflex than it might seem: A sudden contraction or spasm of the diaphragm and the muscles between the ribs makes you inhale quickly and involuntarily. It ends with “glottic closure”—the space in the throat near the vocal cords snaps shut, producing the typical hiccup sound. The technical term for hiccups—singultus—comes from a Latin word (singult) that means catching your breath while crying, which seems like a pretty good description of the sound of hiccupping.

Making hiccups go away

In most cases, hiccups seem to serve no purpose and go away on their own, usually after 30 or more hiccups. Any of the following may cause a short bout of hiccups:

  • An overly full stomach (due to too much food, too much alcohol or too much air in the stomach)
  • Sudden changes in temperature—either outside your body or internally
  • Smoking cigarettes
  • Excitement, stress or other heightened emotions

Of the many, many purported ways to get rid of hiccups, here are a few that you can do at home, and that are logical, considering the muscles and tissues involved in hiccuping:

  • Stimulating the nasopharynx, or the upper most region of the throat, by pulling on your tongue; swallowing granulated sugar; gargling with water; sipping ice water; drinking from the far side of a glass; or biting on a lemon.
  • Stimulating the skin that covers the spinal nerves near the neck by tapping or rubbing the back of the neck.
  • Stimulating the pharynx, or back of the throat, by gently poking it with a long cotton swab.
  • Stimulating the uvula, the cone-like tissue that hangs from the very back of the top of your mouth, again by touching it with a cotton swab.
  • Interrupting your normal respiratory cycle by holding your breath, breathing into a paper bag (which increases the amount of carbon dioxide you inhale), gasping in fright, or pulling your knees up to chest and leaning forward.
  • Distracting your mind from the fact that you’re hiccuping.

Treating persistent hiccups

Occasionally, hiccups just won’t go away. Imagine the annoying, interrupting gasp for air coming every few seconds for long periods of time, even days. Luckily, even long-lasting hiccups don’t usually signal a medical problem. In a very small number of cases, though, persistent hiccups may be a sign of disease, usually something that causes irritation of one of the nerves in the chest. Examples include laryngitis, goiters (enlargement of the thyroid gland), tumors in the neck, infections near the diaphragm and hiatus hernia (usually accompanied by heartburn). Hiccups can also be triggered by excess alcohol use, kidney failure and infections (especially ear infections). Rarer causes are aortic aneurysms and multiple sclerosis.

Persistent hiccups can also cause problems of their own. Think about it—hiccuping can make it difficult to eat, drink and sleep, all things you need to do to keep healthy. 

If you have hiccups that won’t go away on their own, your doctor will look for problems that may be causing them, and then try to fix that problem. Your doctor may also prescribe a medication—or tell you to stop taking a particular drug. Medications that have been shown to reduce hiccups are chlorpromazine, metoclopramide and baclofen. Medications that can cause hiccups include midazolam (a relative of ValiumR), some types of chemotherapy and digoxin (a heart medication). Stopping the medication (with your doctor’s guidance) may stop the hiccups.

Surgery for persistent hiccups is also an option, though one that’s exercised rarely. Two examples are a “nerve block” that stops the phrenic nerve (the major nerve supply for the diaphragm) from sending signals so that the diaphragm stops contracting, and implantation of a pacemaker to make the diaphragm contract in a more rhythmic pattern.

So, to review, we don’t know why we hiccup and we don’t know how to reliably get rid of them. They are as mysterious as they are universal. And it seems that just about everyone has a cure. Here’s my favorite: Wait a few minutes.

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