Got the Hiccups?

What causes hiccups? Is there a dependable, quick way to get rid of them?

– February 27, 2006

Hiccups are abrupt contractions in the diaphragm, followed by a sudden closure of the glottis (the opening between the vocal cords), which temporarily stop the inflow of air. Hiccups can be set off by stress, excitement, stomach irritation, toxins, temperature changes, barbiturates, and a variety of other triggers. If you eat too fast, you may swallow air along with your food – this can bring on hiccups. Drinking too much alcohol can also trigger hiccups.

Usually, hiccups go away within minutes, but they can go on – and on and on. The longest case on record was suffered by an Iowa pig farmer named Charles Osborne, who reportedly started hiccupping in 1922 when attempting to weigh a hog before slaughtering it. He continued hiccupping, first at the rate of 40 times a minute and then at the rate of 20 times a minute, until February 1990. He died the following year. Having suffered a 20-hour bout of hiccups in association with viral gastro-enteritis, I cannot imagine how Charles Osborne made it through all those years. It was one of the worst periods of my life.

For ordinary hiccups you can try any of the popular home remedies. Here are a few worth considering:

  • Breathe in and out of a paper bag held over the nose and the mouth. This raises the carbon dioxide level in the blood, calming the nerve and muscle irritability that causes hiccups. (Don’t use a plastic bag – it can cling to your nostrils.) Keep breathing into the paper bag until the hiccups stop, or you feel uncomfortable. This is my preferred method.
  • Swallow crushed ice or dry bread.
  • Drink a glass of water rapidly by repeatedly sipping and swallowing.
  • Add honey to ginger tea and then drink it over 10 minutes.
  • Put a teaspoon of sugar or honey on the back of your tongue and swallow it slowly.
  • A remedy I’ve never had a chance to try involves drinking from a glass of water with a spoon in it while touching the end of the spoon to one ear.
  • Ask someone to shout “boo” unexpectedly and scare you into breathing evenly.
  • Hold your breath; I often do this and then swallow my next hiccups until they go away.
  • Pull hard on your tongue.
  • Sniff smelling salts.

If your hiccups go on for more than three hours or interfere with your sleep, see your doctor who may prescribe medication to put an end to them. In very severe cases, surgery to disable the phrenic nerve that controls the diaphragm may be recommended. Fortunately, such cases are extremely rare.

Andrew Weil, M.D.

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