What are your hiccups telling you?
By Dr Timothy Pfanner
Most of the time hiccups are harmless but, if they last more than 48 hours, they may be a sign of serious health problems …
A case of the hiccups
Do you remember the Grey's Anatomy episode in which Meredith's step-mom checks into the hospital for a case of hiccups that wouldn't go away?
The diagnosis wasn't pretty and it may have caused viewers to panic every time they hiccupped. Everyone gets hiccups in their life. The majority of the time they are completely harmless but, if you experience hiccups that last more than 48 hours, it could signal potentially serious health complications.
"You should seek advice from your healthcare provider if your hiccups progress from happening every once in a while to becoming persistent or intractable," said Timothy Pfanner, M.D., assistant professor of medicine at the Texas A&M Health Science Center College of Medicine.
What causes hiccups?
Hiccups happen when the diaphragm and respiratory organs experience a sudden, involuntary spasm. This spasm is usually followed by the closure of the glottis (the slit-like opening between the vocal cords and larynx) and a characteristic sound like that of a cough.
Persistent hiccups are hiccups that last more than 48 hours but less than 30 days, while intractable hiccups are classified as hiccups that last more than 30 days.
Pfanner added that hiccups are normally seen in smokers and people who consume large amounts of alcohol.
"Anything that causes your stomach to become distended can cause hiccups," he said. "Smokers are prone because they are constantly swallowing air. Drinking alcohol can induce hiccups because it irritates the esophagus and may result in a flare-up of acid reflux."
Acid reflux disease is a common culprit behind hiccups, and surprisingly, ear infections may cause them as well. When the tympanic membrane (the membrane in the ear that vibrates in response to sound waves) becomes irritated this can result in hiccups.
"This membrane can become irritated due to infection - especially if a hair makes its way into the ear and sits next to the membrane," Pfanner said. "This is a very common cause for hiccups that don't subside."
When to seek medical help
If your hiccups last more than two days, talk to your health practitioner.
"Generally, when someone is diagnosed with intractable hiccups, we start worrying that something more serious is going on internally," Pfanner said. "However, since intractable hiccups is also a symptom of acid reflux disease it's always important to discuss your symptoms with your physician."
Cancer is not a word to be thrown around lightly, and according to Pfanner, intractable hiccups could be a symptom of certain cancers. "Sometimes we see intractable hiccups in patients diagnosed with cancers of the brain, lymph nodes or stomach cancer," he said. "They can also indicate stroke. It's still unclear why many of these incidents occur."
Since hiccups convulse the muscles that control the diaphragm, patients who experience persistent or intractable hiccups can suffer nerve damage in the nerve that controls these muscles. "This may also point to a tumor in the neck or goiter," Pfanner said.
Pesky hiccups that refuse to subside may even be symptoms of heart muscle damage or a heart attack. "Persistent or intractable hiccups can indicate inflammation around the heart or a pending heart attack," Pfanner said. "That's why we always want patients who are experiencing this type of hiccups to immediately consult their healthcare provider."
Don't panic
While the hiccups can be a tell-tale sign of serious health complications, common hiccups are more of a nuisance than a health risk.
To quickly ease your occasional hiccup woes, Pfanner recommends a few different methods.
"You can hold your breath (for a short period of time) or breathe into a bag to ease hiccups," he said. "Other methods include putting a cotton swab in the back of the throat to induce a gag reflex, gargling with ice water, swallowing granulated sugar, biting a lemon or pulling your knees to the chest to compress it. Pressing lightly on the eyeballs will also activate your vagus nerve and result in a reflex that hinders the spasm of hiccups."
"You should seek advice from your healthcare provider if your hiccups progress from happening every once in a while to becoming persistent or intractable." - Dr Timothy Pfan