About hiccups, persistent

What is hiccups, persistent?

A hiccup is an involuntary spasmodic contraction of the muscle at the base of the lungs (diaphragm) followed by the rapid closure of the vocal cords. Usually, hiccups last for a few hours or, occasionally, a day or two. However, chronic hiccups are ones that continue for an extended period of time. Episodes that last for more than two days and less than a month are sometimes called persistent hiccups. On rare occasions, hiccups persist even longer than a month or recur frequently over an extended period of time. The longest recorded episode of these chronic hiccups lasted 60 years.

Sometimes, although not always, hiccups that persist may indicate the presence of another medical problem. Some illnesses for which continuing hiccups may be a symptom include: pleurisy of the diaphragm, pneumonia, uremia, alcoholism, disorders of the stomach or esophagus, and bowel diseases. Hiccups may also be associated with pancreatitis, pregnancy, bladder irritation, liver cancer or hepatitis. Surgery, tumors, and lesions may also cause persistent hiccups.

What are the symptoms for hiccups, persistent?

Hiccupping is a symptom. It may sometimes be accompanied by a slight tightening sensation in your chest, abdomen or throat.

When to see a doctor

Make an appointment to see your doctor if your hiccups last more than 48 hours or if they are so severe that they cause problems with eating, sleeping or breathing.

What are the causes for hiccups, persistent?

The most common triggers for hiccups that last less than 48 hours include:

  • Drinking carbonated beverages
  • Drinking too much alcohol
  • Eating too much
  • Excitement or emotional stress
  • Sudden temperature changes
  • Swallowing air with chewing gum or sucking on candy

Hiccups that last more than 48 hours may be caused by a variety of factors, which can be grouped into the following categories.

Nerve damage or irritation

A cause of long-term hiccups is damage to or irritation of the vagus nerves or phrenic nerves, which serve the diaphragm muscle. Factors that may cause damage or irritation to these nerves include:

  • A hair or something else in your ear touching your eardrum
  • A tumor, cyst or goiter in your neck
  • Gastroesophageal reflux
  • Sore throat or laryngitis

Central nervous system disorders

A tumor or infection in your central nervous system or damage to your central nervous system as a result of trauma can disrupt your body's normal control of the hiccup reflex. Examples include:

  • Encephalitis
  • Meningitis
  • Multiple sclerosis
  • Stroke
  • Traumatic brain injury
  • Tumors

Metabolic disorders and drugs

Long-term hiccups can be triggered by:

  • Alcoholism
  • Anesthesia
  • Barbiturates
  • Diabetes
  • Electrolyte imbalance
  • Kidney disease
  • Steroids
  • Tranquilizers

What are the treatments for hiccups, persistent?

Most cases of hiccups go away on their own without medical treatment. If an underlying medical condition is causing your hiccups, treatment of that illness may eliminate the hiccups. The following treatments may be considered for hiccups that have lasted longer than two days.

Medications

Drugs that may be used to treat long-term hiccups include:

  • Baclofen
  • Chlorpromazine
  • Metoclopramide

Surgical and other procedures

If less invasive treatments aren't effective, your doctor may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups.

Another option is to surgically implant a battery-operated device to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but it has also helped control persistent hiccups.

What are the risk factors for hiccups, persistent?

Men are much more likely to develop long-term hiccups than are women. Other factors that may increase your risk of hiccups include:

  • Mental or emotional issues. Anxiety, stress and excitement have been associated with some cases of short-term and long-term hiccups.
  • Surgery. Some people develop hiccups after undergoing general anesthesia or after procedures that involve abdominal organs.

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