What causes hiccups and how to get rid of hiccups

 

 

Hiccups, those annoying, involuntary, and often ill-timed spasms are a universal human experience. Medically known as singultus, a hiccup is a sudden, unprompted contraction of the diaphragm (the dome-shaped muscle beneath your lungs) that is immediately followed by the abrupt closure of your vocal cords. This closure is what creates the characteristic "hic" sound.

While usually harmless and short-lived, a persistent bout of hiccups can be frustrating. Understanding the science behind this reflex is the first step toward getting rid of them.

 

The Anatomy of a Hiccup: What is Happening?

The hiccup reflex is governed by a specific nerve pathway connecting the brain to the respiratory muscles.

1. The Diaphragm Spasm

The primary muscle involved is the diaphragm. It normally contracts downward when you breathe in and relaxes upward when you breathe out.

• Trigger: A stimulus (the trigger) irritates the nerve pathway.
• Action: This causes the diaphragm to contract suddenly and erratically.

 

2. The Vocal Cord Closure

The signal doesn't stop at the diaphragm. It also causes the glottis (the opening between the vocal cords in the larynx) to snap shut about a fifth of a second after the diaphragm contracts. The rapid, involuntary intake of air hitting the closed glottis produces the distinctive "hic" sound.

The Nerve Pathway: The Vagus and Phrenic Nerves

The entire process is controlled by the vagus nerve and the phrenic nerve. Irritation along these nerves, which travel from the brainstem to the abdominal cavity and diaphragm, is what initiates the hiccup reflex.

Common Causes: Why Does the Nerve Get Irritated?

Most hiccups are caused by temporary irritation or distension (stretching) of the stomach, which in turn stimulates the vagus or phrenic nerves.

A. Dietary and Consumption Triggers

These are the most common reasons for a brief bout of hiccups:

• Eating Too Fast: Swallowing large amounts of air along with your food (aerophagia), which distends the stomach.
• Overeating: A very full stomach presses on the diaphragm, irritating the phrenic nerve.
• Carbonated Beverages: The gas released in the stomach quickly stretches it.
• Alcohol: Excessive consumption, especially of carbonated alcoholic drinks.
• Spicy or Hot Foods: Can irritate the lining of the esophagus and stomach, stimulating the nerves.
• Sudden Temperature Change: Ingesting very hot or very cold liquids.

B. Emotional and Physical Triggers

• Sudden Excitement or Stress: Emotional intensity can cause us to swallow air or change our breathing patterns quickly.
• Sudden Changes in Air Temperature: Being suddenly exposed to cold air.
• Gastroesophageal Reflux Disease (GERD): Acid backing up into the esophagus can irritate the vagus nerve.

 

How to Get Rid of Hiccups:

The most effective, scientifically supported remedies aim to interrupt the hiccup reflex arc by either distracting the nervous system or modifying the blood gas balance.

1. Modifying Blood Gas (Increasing )

Increasing the concentration of carbon dioxide () in your blood can sometimes "reset" the respiratory reflex and calm the diaphragm.

• Holding Your Breath: Inhale deeply, hold your breath for 10–20 seconds, and exhale slowly. The buildup of signals the brain to focus on controlling respiration, overriding the hiccup reflex.
• Breathing into a Paper Bag: Gently breathe into a small paper bag for a short period. This causes you to re-breathe , achieving the same buildup effect. (Caution: Do not use a plastic bag and stop if you feel dizzy.)

2. Physical and Sensory Stimulation

These methods aim to stimulate the vagus nerve to interrupt the involuntary spasm.

• The Valsalva Maneuver: Close your mouth and nose, then try to forcefully exhale (like bearing down). This increases pressure in the chest and abdomen, stimulating the vagus nerve.
• Drinking Cold Water: Quickly drinking a glass of ice water or gargling with ice water can stimulate the vagus nerve in the esophagus.
• Pulling on the Tongue: Grasp your tongue with your fingers and gently pull it forward. This stimulates nerves in the throat.
• Swallowing Granulated Sugar: Place a teaspoon of granulated sugar on the back of your tongue and swallow. The intense stimulation may disrupt the nerve signal.

Scientific Principle: Methods that increase chest/abdominal pressure (Valsalva) or stimulate the vagus nerve (drinking, sugar) are highly effective because they directly counteract the errant signal causing the hiccup.

 

When to See a Doctor: Persistent Hiccups

Most hiccups resolve on their own within a few minutes or hours. However, if hiccups last for more than 48 hours (persistent hiccups) or more than one month (intractable hiccups), they may indicate a serious underlying medical condition and require a doctor's evaluation.

Potential medical causes of persistent hiccups can include:

• Nerve Damage: Damage or irritation to the vagus or phrenic nerves (e.g., from tumors, goiters, or reflux).
• Central Nervous System Disorders: Conditions affecting the brainstem, such as stroke or multiple sclerosis.
• Metabolic Disorders: Kidney failure or diabetes.
• Medications: Certain tranquilizers or steroids.

For persistent cases, doctors may prescribe muscle relaxants or other medications like chlorpromazine to block the reflex arc.

Summary (Conclusion)

The article effectively explains that hiccups are a harmless but annoying reflex caused by the sudden, involuntary contraction of the diaphragm and the rapid closure of the vocal cords, triggered by irritation to the vagus and phrenic nerves. Common causes range from simply eating or drinking too quickly (distending the stomach) to sudden stress or temperature changes.

The most effective, science-backed methods for stopping hiccups are based on two principles: increasing blood concentration (e.g., holding breath) or stimulating the vagus nerve (e.g., the Valsalva maneuver or sensory input like cold water/sugar) to interrupt the errant nerve signal. While most hiccups are transient, those lasting longer than 48 hours (persistent) warrant medical attention as they may signal a more serious underlying health issue.