It’s hard to stop, annoying, noisy and hiccups eventually affects everyone. Regarding the causes and how to get rid of it there are many myths to dispel. Sometimes it goes away quickly and sometimes we resort to one of Grandma’s remedies, such as drinking small sips of water, holding our breath, inviting someone to frighten us, or trying to sneeze. So, what are hiccups? How does one get rid of them? And what happens if you keep getting hiccups?

We discussed this with Dr. Alessandro Repici, head of Digestive Endoscopy of Humanitas under the Gastroenterology Department headed by Prof. Alberto Malesci.

Why do we get hiccups?

“Hiccups are a phenomenon caused by contractions and involuntary repeated motions of the diaphragm. This is the muscle that contracts during inhale and relaxes as you exhale. The cause is the irritation of the phrenic nerve, which is responsible of precisely controlling the contractions of the diaphragm. If the phrenic nerve is irritated at any point, you can go wild with hiccups.

The typical “hic” sound, which is repeated rythmically, is due to the contraction of the diaphragm ending with an abrupt closure of the glottis. This is the valve that separates the respiratory tract from the digestive system.

In addition to the phrenic nerve, hiccups also involve parts of the nervous system. The centers that control breathing and the hypothalamus, a part of the brain thta can not be controlled by will. This is why hiccups suddenly occurs emerges”.


Is it more common in certain people or situations?

Often the reason that causes hiccups is unknown, ie you can not pinpoint the cause of the irritation of the phrenic nerve. However, it has been notices that there are some typical situations of everyday life that can more easily cause hiccups:

  • Dilation of the stomach, caused by rapid or excessive ingestion of food and drink.
  • Sudden changes in temperature, like going from hot to cold or drinking a hot or frozen beverage.
  • Excess intake of alcohol, which can damage the gastric mucosa (the lining of the stomach), causing inflammation and, indirectly irritating the diaphragm.
  • Episodes of emotion: when you are in great discomfort, you swallow a quantity of air that is higher than normal. This results to the irritation of the diaphragm and the appearance of hiccups”.


Can it be linked to a disease?

“Οccasional and transitional hiccups is not a cause for concern. However, situations in which you keep getting hiccups over longer period of time may occur. In these cases, hiccups can be determined by problems to internal organs, such as pericarditis, namely an inflammation of the pericardium (the sheath that surrounds the heart); digestive system disorders, such as gastro-oesophageal reflux (a problem for which the contents of the stomach tends to rise upwards) or gastritis (ie inflammation of the gastric mucosa that lines the internal walls of the stomach). Alterations of the nervous centers that control hiccups may also be present: an occluded blood vessel that feeds these centers is enough to cause the disorder”.


Is there a way to prevent hiccups?

“Useful measures to be taken to prevent the appearance of hiccups include: drink and eat slowly, chew well before swallowing, limit intake of alcohol and avoid food that is too hot or too cold.”


How long can it last?

“On average, an occasional hiccup episode has a duration ranging from a few seconds to a few minutes. In cases of persistent hiccups, related to diseases, it can last for hours, while in more severe cases it may have a duration of days “.


How can you get rid of it?

“More than 2000 years ago Hippocrates recommended a method which is still the most widely used. Breath in deeply, hold your breath and remain in apnea for 10-25 seconds, which relaxes the diaphragm.

There are also other remedies: ingesting water in small sips, favoring a sneeze, quickly swallow a spoonful of sugar, take a teaspoon of vinegar or pure lemon juice, compress an acupuncture point situated at the ear. ”


Are there serious cases that need treatment? What if I keep getting hiccups?

“There may be cases where hiccups is particularly persistent and does not occur due to cases mentioned above. If you keep getting hiccups it is advisable to consult your doctor and visit the emergency room to undergo assessment tests (chest X-ray, ultrasound, echocardiography, magnetic resonance imaging).

From a therapeutic point of view, in severe attacks you may be prescribed with powerful drugs such as antispasmodics, to relax and sedate.

In some cases it is necessary to resort to surgery to devitalize phrenic nerves”.


Strange fact: The longest lasting hiccup attack

The longest hiccup attack ever recorded belongs to the American Charles Osborne, who’s hiccups came in 1922. The hiccuping continued, first at a crazy pace (40 hiccups per minute) and then more slowly (“only” 20) until 1990. A total of 68 years of hiccups, almost a lifetime. It is estimated that he suffered a total of approximately 430 million “hics”. It remains a mystery as to why the hiccups stopped. We only know that one year after the last hiccup Mr. Osborne died at the age of 97. It would seem unbelievable were it not for the strict rules of the Guinness world reccord which document it.