How to Get Rid of Hiccups

We've all suffered from hiccups at some point in our lives and are familiar with them. Just the same, it's a reflex that's very difficult to control. Keep reading to learn how to get rid of them.

Written and verified by el biólogo Samuel Antonio Sánchez Amador.

Last update: 02 April, 2024

The human body has been studied extensively throughout history, but there are still physiological events in our bodies that aren’t easy to explain. Hiccups are one of them: Despite the fact that their biological function has been hypothesized countless times, to this day, experts have yet to discover the clear function of this reflex. Just the same, we’ve all had hiccups at some time or another, and we’ve wondered how to get rid of them effectively.

Keep reading, because in the following article, we’ll tell you everything you need to know about this involuntary contraction.

What are hiccups?

The Royal Spanish Academy of Language (RAE) defines hiccups as “a convulsive movement of the diaphragm, which produces interrupted and violent breathing and causes some noise.” On a physiological level, they’re conceived as spasmodic, involuntary, and repetitive contractions of the intercostal and diaphragmatic muscles, causing a sudden inspiration.

It’s important to emphasize the involuntary nature of hiccups. Therefore, they fall into the category of reflexes and follow a specific neural arc. These are its main components:

1. The afferent end, which includes the phrenic, vagus, and sympathetic nerves to transmit somatic and visceral sensory signals.
2. The central processing unit, which is located in the midbrain. The exact point at which the hiccup signal is processed isn’t yet known, as it could involve the functionality of structures between the brainstem and the spinal column.
3. The efferent end. The signal travels in motor fibers from the phrenic nerves to the diaphragm and accessory nerves to the intercostal muscles, respectively.

The route of action of hiccups isn’t exactly known. Still, research has shown that the neurotransmitters dopamine and gamma-aminobutyric acid (GABA) are involved in its processing. This knowledge has allowed the use of some specific drugs to eliminate their chronic forms, as we’ll see below.

Be that as it may, the signals emitted cause a diaphragmatic contraction to occur during hiccups, followed by a closure of the glottis that involves the vocal cords, which generates the characteristic hic sound. The time interval from the contractile movement to the emission of the hic is about 35 milliseconds.

The evolutionary sense of hiccups

Hiccups are a ubiquitous reflex experienced by all human beings, but a biological sense to explain them has yet to be found. Even so, there are multiple theories of great interest that try to explain their purpose.

For example, it has been postulated that this reflex action is a vestigial trait in human beings. That is, it was significant for our ancestors but no longer is for us. Amphibians use a very similar movement to swallow air and water through their gills, something that could have been inherited in mammals due to the presence of a common ancestor.

According to this postulation, the hiccups would be the remnant of basic respiration that has been supplanted by the pulmonary variant that we all know. This idea is supported when we consult human fetal development, as the nervous pathways of hiccups appear in fetuses before the mechanisms that allow pulmonary ventilation.

As professional sources indicate, hiccups are present in many mammals beyond our species. This reflex has been studied in cats, rats, rabbits, dogs, and even horses. To explain this “coincidence”, it has also been proposed that it could be a mechanism to expel air in the stomach of lactating animals.

Types of hiccups and causes

Hiccups can be divided into several subcategories according to their duration. We’ll show them to you in the following lines.

Acute hiccups

This variant is also thought of as acute or self-limited hiccups. They’re the most common type of hiccups of all and have a maximum duration of 48 hours, although most episodes are isolated and don’t last for more than a few minutes. Due to their low clinical significance, they’re seldom characterized in primary care settings or in the emergency room.

Some of the most common causes of acute hiccups, according to the Mayo Clinic, are the following:

1. Drinking carbonated liquids, such as beer, soda, or soda. The bubbles from these foods cause the stomach to swell, which stimulates the phrenic nerve and diaphragmatic contraction to expel excess stored air.
2. Drinking too much alcohol. It’s suggested that alcohol irritates the digestive system and stimulates diaphragmatic contraction. The cartoonish stereotype of alcoholics with red noses and constant hiccups makes some physiological sense.
3. Eating too much and in a hurry. Anxiety at mealtime can cause a person to swallow air, causing their stomach to increase in volume quickly. Again, this would stimulate the nerve pathway in charge of triggering the hiccups. Chewing gum can also promote this reflex for the same reason.
4. Stress and excitement. Although it’s considered a mostly digestive gesture, professional sources suggest that acute hiccups may arise as a response to an emotional process.

Once an episode of acute hiccups begins, the person may experience 4 to 60 reflexes of this type per minute. The frequency remains more or less constant in each individual, but it can be modified by various factors. In any case, it’s not considered a medical emergency in almost any case.

Persistent hiccups

The duration of the episode is greater than 48 hours but less than one month. If the person experiencing it doesn’t present other warning signs, it’s advisable to go to the doctor after 2-3 days of hiccups. Some of the causes (which are pathological) that trigger this event are the following:

1. Gastroesophageal reflux: In this condition, part of the stomach acids travel in the opposite direction towards the esophagus, irritating this tissue and other adjacent ones. Hiccups are accompanied by other symptoms, such as a burning sensation in the chest and an unpleasant taste at the oral level.
2. Hiatal hernia: Hiatal hernia is a condition in which the upper part of the stomach bulges through an opening in the diaphragm. In addition to hiccups (especially after eating), this condition causes regurgitation, stitches in the pit of the stomach, and bad breath, among other things.
3. Addiction or use of drugs of an opiate nature: Although their use isn’t chronic, the ingestion of opiate drugs (even as anesthetics) can cause continued hiccups.
4. Cancer: Although rare, a malignant tumor pressing on the diaphragmatic area can cause persistent hiccups. A neoplastic brain process could also modify the route of this reflex and cause it to occur unnecessarily and constantly.

On the other hand, some persistent episodes can be caused by irritation or injury to the phrenic or vagus nerves, which promote diaphragmatic contraction. It’s also possible for damage to the central nervous system from an exogenous cause to cause the neuronal pathways in charge to fail. In these cases, meningitis, multiple sclerosis, and effusions are suspect.

Intractable hiccups

Intractable hiccups are those that last more than 2 months. The presentation of this picture is serious, as it affects the life of the patient in every way (from talking to eating and drinking water). Despite its name suggesting otherwise, there are some drugs that are used to alleviate the condition underlying the reflex. Baclofen, gabapentin, metoclopramide, and chlorpromazine are some.

Intractable hiccups are often caused by already debilitating chronic conditions, such as cardiovascular disorders (aortic aneurysms, atrial fibrillation, myocardial infarction, and more) and neurological diseases (encephalitis, meningitis, and other triggers already mentioned). Intrathoracic disorders, such as asthma and bronchitis, are also common suspects.

How to get rid of the hiccups?

As you can see, the duration of the hiccups marks the severity of the condition in all cases (unless the patient has other warning signs in short time intervals). Here, we’ll show you how to get rid of this annoying reflex, but we’ll divide the solutions according to the severity on a clinical level. Keep reading!

Home remedies to get rid of the hiccups

First of all, it should be noted that there’s no foolproof method to end hiccups in a home environment. Just the same, you can try any of the approaches that we’ll show you in the following list. You’re sure to find the one that helps you the most in a short time:

• Hold your breath and swallow three times, always with your head down to prevent even more air from entering the gastric environment. It’s believed that this could regulate the diaphragmatic imbalances that caused the contraction in the first place.
• Breathe in a paper bag until your ventilatory cycle regulates. Don’t extend this practice for a long time, as the little amount of oxygen that the bag will offer after a few seconds can make you dizzy.
• Drink a glass of water very quickly. Especially if it’s a little cold, the water can reduce discomfort in the diaphragmatic environment.
• Gargle with water. The mechanism of action is similar to those already mentioned.
• Stimulate the vagus nerve. As indicated by the MSD Manuals medical portal, stimulating this nerve ending can help stop hiccups. This can be accomplished by gently rubbing the eyes, ingesting dry bread or granulated sugar, or lightly pulling the tongue out. It’s also achieved by inducing nausea, but we never recommend using such an extreme method.

Although all these solutions are very simple to carry out, it’s necessary to emphasize that they don’t have any medical support. Almost all focus on restoring normal respiratory and diaphragmatic rhythm, but there’s no clinical evidence to support their efficacy. Take all this information with reservations and never substitute it for a medical consultation.

Medical treatments to get rid of hiccups

As we’ve mentioned above, if the hiccups last more than 48 hours, you have to go to the doctor without hesitation. The clinical approaches to stop this reflex are much more specific and reliable than the ones we’ve shown you in the previous list. Some of them are the following:

• Medications: Baclofen, gabapentin, metoclopramide, and chlorpromazine are used to stop persistent and intractable hiccups. Clinical research has shown that these drugs are excellent at causing symptomatic relief in patients with these variants.
• Anesthetic injections: If the patient comes to the emergency room for constant and prolonged hiccups, the administration of anesthetics may be necessary to stop stimulation of the phrenic nerve.
• Surgical implantation: In the most drastic cases, a mechanism that provides mild stimulation to the vagus nerve can be implanted through a surgical procedure. Unfortunately, clinical trials have shown that this approach doesn’t always work.

In addition to treating the hiccups itself, it’ll also be necessary to address the clinical picture underlying the reflex. Gastroesophageal reflux, gastric cancer, or any other trigger should be solved even if the hiccups stop with any of the aforementioned medications or approaches.

What to do to avoid this reflection

We’ve all had hiccups at some point in our lives. It’s normal for a baby to spend a large part of their time performing this reflex (due to the nursing theory already mentioned), but it’s not normal for an adult to hiccup every day (however slight).

In the case that you experience isolated and annoying episodes of hiccups, we recommend that you follow the advice that we’ll show you below:

1. Eat calmly and slowly. This will minimize the entry of air into the gastric environment.
2. Reduce or cut back on carbonated beverages, such as soda and soft drinks. You won’t only avoid hiccups but also the unnecessary intake of processed sugars.
3. Don’t drink alcohol or smoke excessively.
4. Avoid constant consumption of gum. If you’re worried about your breath, you can resort to using mouthwashes and sanitizing solutions.
5. Avoid eating very heavy or spicy foods.
6. Get a good night’s sleep, avoid constant stress, relax when you can, and seek psychological help if you suffer from anxiety or another related disorder.

If all else fails, go to the doctor and suggest a general check-up of your body. Most likely, nothing serious will happen to you, but prevention is always the best medicine.

The mysteries behind the hiccups

As you may have seen while reading this paragraph, the hiccups continue to be a great mystery for humans. We all suffer from them at some point in our lives, but it’s very difficult to attribute a nervous path or a specific biological cause to them. Most professionals agree that the reflex is a vestigial trait, although we’re still a long way from being able to affirm it.

Most episodes of hiccups are considered natural, but in some cases, these conditions can become chronic and manifest an underlying pathology. If the hiccups last for more than 48 hours, it’s imperative that you see a doctor.