Hiccup

Hiccup
Specialty	Otorhinolaryngology

A hiccup or hiccough (generally pronounced "HICK-up" (IPA: /ˈhɪ.kəp/) independent of the spelling) is an involuntary spasm of the diaphragm; typically this repeats several times a minute. The sudden rush of air into the lungs causes the glottis to close, creating the "hic" noise. A bout of hiccups generally resolves by itself, although many home remedies are in circulation to shorten the duration, and medication is occasionally necessary. By extension, the term "hiccup" is also used to describe a small and unrepeated aberration in an otherwise consistent pattern. The medical term is singultus.

While many cases develop spontaneously, hiccups are known to develop often in specific situations, such as eating too quickly, taking a cold drink while eating a hot meal, eating very hot or spicy food, laughing vigorously or coughing, or drinking an excess of an alcoholic beverage. Hiccups may be caused by pressure to the phrenic nerve by other anatomical structures, or rarely by tumors.

It is still unclear to scientists exactly why hiccups occur, particularly because it doesn't seem to give us any specific benefit. Some speculation exists that hiccups are a remnant of a bodily function that has been phased out by evolution, such as the move from aquatic gilled creatures to land animals. More research is required to ascertain their true nature, origins, and purpose, if any.

Home remedies

The following are some commonly suggested home remedies. While numerous remedies are offered, they mostly fall into a few broad categories. These categories include purely psychosomatic cures centered around relaxation and distraction, cures involving swallowing and eating (with the rationale generally that this would remove irritants or reset mechanisms in the affected region), and cures involving controlled/altered breathing.

The science behind many of these methods is unfounded, however most people have their own particular remedy that they are convinced is the solution. Such methods are often complex tasks involving drinking in awkward positions, or breathing in certain patterns. The common factor amongst all these methods is that the person attempting such remedies is usually concentrating on their preferred task and not the hiccups. Hence many remedies can actually be considered a psychosomatic distraction technique of one form or another.

Psychosomatic

• Distraction from one's hiccup (e.g. being startled or asked a perplexing question)
• Concentration on one's hiccup
• Another distraction based technique is to count in reverse, eg. from 100 down, which requires concentration.
• The least embarrassing way to control hiccups is using a psychosomatic method involving 'waiting' for the next hiccup. The key is to attempt to anticipate the hiccup by counting it aloud just prior to it taking place, the aim is to be saying 'one' just as the hiccup occurs. Practice with this method leads to the situation where one can simply decide not to hiccup anymore.

Swallowing

• Swallowing three times (or more) while holding one's breath
• Eating particular foods, such as peanut butter, Fluffernutter sandwich, chocolate, sugar or honey, Lingonberry jam, wasabi, vinegar
• Eating a spoonful of granulated table sugar (slowly letting it dissolve in mouth)
• Drinking a glass of water through a napkin placed over the glass
• Drinking a glass of water in several small sips
• Drinking a glass of water "from the wrong side of the glass", i.e. bending over a sink so one's head is upside-down when drinking
• Drinking a glass of water with another's palms against one's ears
• Drinking a glass of a carbonated beverage (with salt)
• Gulping down a glass of water while holding one's breath
• Drinking a glass of water while raising the right or left hand.
• Drinking several glasses of water.
• Eating an ice cube
• Drinking a glass of water with a spoon touching one's temple.
• Fill a large glass with water, and take in a mouthful of the water, but hold the water in your mouth. Do not swallow yet. Tip your head all the way back, stretching your throat in the process, then open your mouth as wide as you can and use your throat muscles to swallow the water. Drink the whole glass of water using this method. This will not work as effectively if your stomach is very full.

Respiratory

• Breathing slowly and deeply in while thinking 'breathing out' and breathing slowly and fully out while thinking 'breathing in'.
• Breathing slowly and deeply in and out through the mouth.
• Holding one's breath while optionally squeezing one's stomach.
• Breathing deeply through the nose, then exhaling slowly through the mouth.
• Exhaling all the air from one's lungs and holding one's breath while swallowing water or saliva.
• Blowing up a balloon.
• Inducing sneezing.
• Breathing into a paper bag or other sealed container. Only attempt this in severe cases of hiccups that have persisted despite other attempts at cures. Perform this sitting or laying down, and with someone at your side to ensure safety. Stop as soon as you begin to feel lightheaded.
• Belching.

Other

• For babies, hiccups are usually immediately stopped by the suckling reflex, either by breastfeeding or simply by insertion of a finger or bottle teat into the baby's mouth.
• For some, vomiting the contents in one's stomach.

Medical treatment

Referred to as singultus, hiccups are treated medically only in severe and persistent (termed "intractable") cases. Haloperidol (Haldol, an anti-psychotic and sedative), metoclopramide (Reglan, a GI stimulant), and chlorpromazine (Thorazine, an anti-psychotic with strong sedative effects) are used in cases of intractable hiccups. In severe or resistant cases, baclofen (an anti-spasmodic) is sometimes required to suppress hiccups. Effective treatment with sedatives often requires a dose that either renders the person unconscious or highly lethargic. Hence, medicating singultus is done short-term and is not a situation where the affected individual could continue with normal life activities while taking the medication.

The New York Times reports that Dr. Bryan R. Payne, a neurosurgeon at the Louisiana State University Health Sciences Center in New Orleans, has had some success with an experimental new procedure in which a vagus nerve stimulator is implanted in the upper chest of patients with an intractable case of hiccups. "It sends rhythmic bursts of electricity to the brain by way of the vagus nerve, which passes through the neck. The Food and Drug Administration approved the vagus nerve stimulator in 1997 as a way to control seizures in some patients with epilepsy. Last year, the agency endorsed the use of the stimulator as a treatment of last resort for people with severe depression" [1].

World record

The world record for the longest continuous bout of hiccups goes to Charles Osborne (1894–1991) from Anthon, Iowa. The hiccups started in 1922 at a rate of 40 times per minute, slowing to 20 and eventually stopping in February 1990 – a total of 68 years. [2]

References

• C. Straus, K. Vasilakos, RJA Wilson, et al., A phylogentic hypothesis for the origin of hiccoughs, In: Bioessays, Vol.25, 2003, S.182-188, Abstract
• Launois et al., Hiccup in adults:an overview, In: European Respiratory Journal, 1993, S.563-575, Abstract
• Davis J. Newsom, An experimental study of hiccup, In: Brain, 1970, Vol.93, S.851-72

External links

• Hiccups (WebMD)
• The Straight Dope: What are hiccups and why do we get them?
• Hiccups Causes and Home Remedies to Get Rid of Hiccups
• Cures for Hiccups
• Guinness World Record- Longest Hiccup
• BBC News:Why we hiccup