How many times have you seen this in the movies and on television: The “drunk,” slumped on his barstool, is telling his sad tale to the bartender or anyone else willing to listen. And every other word is punctuated with an involuntary spasm of the shoulders and a short, squeaking noise—a hiccup.

Ever wonder why we get the hiccups? Are they really associated with alcohol use? And to get rid of them, does frightening the “hiccupper” really work?

Hiccups in health

The reason we hiccup is unknown. The phenomenon is nearly universal and it can even be observed in a fetus, especially during the last trimester of pregnancy. The technical term for hiccups is singultus (from the Latin, singult, which describes catching your breath while crying). Hiccupping is a complex reflex: 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 sound. In most cases, only one of the two sides of the diaphragm is involved; it is left-sided in 80 percent of cases.

While much is uncertain, this much is clear: Most of the time hiccups are simply a normal part of the human condition and, as annoying as they may be, they rarely last long. While hiccups occasionally indicate illness (as described below), they rarely are cause to worry, and there should be no urgency to “cure” yourself when the hiccups will almost always go away soon regardless of what you do.

Why hiccups?

Most likely hiccups are a reflex. Nerves inside the chest send signals to the diaphragm and muscles between the ribs to spontaneously contract during normal breathing. This “hiccup reflex” may be set off by many triggers, including:

  • Emotional stress or excitement
  • Stretching of the stomach as may occur after overeating, drinking carbonated beverages, or swallowing air
  • Abrupt changes in the temperature (as with drinking a hot beverage)
  • Alcohol binging
  • Smoking

What is normal?

It is not easy to define “normal” hiccups. My medical dictionary describes them as “a spasmodic inhalation with closure of the glottis accompanied by a peculiar sound"—fair enough! But what if it goes on for an hour or more? At some point, everyone might agree that prolonged or particularly forceful or painful hiccups are not normal and warrant more than the usual “wait it out” strategy. Experts have set up these definitions for hiccups based on how long they last:

  • A bout of hiccupshaving hiccups on and off for up to 48 hours
  • Persistent hiccupshiccups that last more than 48 hours but less than one month
  • Intractable hiccupshiccups lasting two months or more

A standard definition of “abnormal” hiccups is important in order to study the phenomenon in illness and to determine effective treatment.