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Hiccups can be annoying. I've heard about ways to stop them including breath holding, drinking warm water, and breathing really quickly, but these don’t seem to be consistently effective. What sorts of interventions can be helpful for mitigating or even stopping hiccups?

Susan
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Unihedron
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  • Burp. My hiccups are caused by air bubbles that are trapped in the throat. Therefore burping the trapped air bubbles upwards cures the hiccups. – Mats Granvik Jun 14 '19 at 13:25

2 Answers2

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I summarized the mechanism of hiccups in a question on biology.SE a few months ago. That may be useful background information for the answer to this question about what interventions work.

Regarding the available data, as usual a Cochrane Review provides the best meta-analysis, and as usual they conclude that there is insufficient evidence for anything. However, in practicality there are decent observational data available.

Because hiccups stem from a reflex arc involving the vagal nerve, physical maneuvers that stimulate the vagus often abort hiccups.

These may include:

  • Breath holding
  • Valsalva maneuver (exhaling against a closed glottis)
  • Stimulating the nasopharynx or glottis (e.g. gargling cold water; upside down is often (reasonably) recommended to route water up into the nasopharynx where is is more likely to cause vagal stimulation)

If none of these is successful, medications are occasionally used. The oldest and most well-established treatment is chlorpromazine (a.k.a. Thorazine), a first-generation antipsychotic. Although it is approved by the U.S. FDA for treatment of hiccups, even that has only been studied in small case series, mostly in patients with hiccups due to cancer. Other medications that are sometimes used off-label include metoclopramide (a.k.a. Reglan) and baclofen. Although the studies of these medications are small, they do appear to be effective.

Most often, hiccups are benign, often triggered by gastric distention from over-eating or carbonated beverages. However, particularly intractable hiccups have been associated with serious conditions including intracranial problems such as stroke or encephalitis as well as many different kinds of cancer. If hiccups are occurring very frequently or are difficult to resolve, you should consult with a doctor.

References
1. Guelaud C, Similowski T, Bizec JL, Cabane J, Whitelaw WA, Derenne JP. Baclofen therapy for chronic hiccup. Eur Respir J. 1995 Feb;8(2):235-7.
2. Friedgood CE et al. Chlorpromazine (thorazine) in the treatment of intractable hiccups. J Am Med Assoc. 1955 Jan 22;157(4):309-10.
3. Friedman NL. Hiccups: a treatment review. Pharmacotherapy. 1996 Nov-Dec;16(6):986-95. 4. Kolodzik PW, Eilers MA. Hiccups (singultus): review and approach to management. Ann Emerg Med. 1991 May;20(5):565-73.
5. Moretto EN, Wee B, Wiffen PJ, Murchison AG. Interventions for treating persistent and intractable hiccups in adults. Cochrane Database Syst Rev. 2013 Jan 31;1.
6. Wang T, Wang D. Metoclopramide for patients with intractable hiccups: a multicentre, randomised, controlled pilot study. Intern Med J. 2014 Dec;44(12a):1205-9.

Community
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Susan
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I have found a particular combination of actions has worked for me every time, and for all but one of the friends and acquaintances I recommended it to.

  1. Get a glass of water (lukewarm is best)
  2. Hyperventilate a little (this is so you can hold your breath longer)
  3. Take a very deep breath and hold it
  4. Start taking very small swallows of water (not large swallows!)
  5. Keep doing this for (almost) as long as you can hold your breath
  6. Let your breath out in an easy, relaxed flow (if you let it out all at once you can re-start your hiccups)

After using it for so many years I can now simulate the underlying physical mechanism without the aids. To me it feels like with each swallow you are pushing down on that muscle between your stomach and esophagus, making it clench and at some point it just gives up and stops clenching. I can just visualize this happening (though I still have to hold my breath) and I can feel the exact moment when the hiccups stop.

Interestingly, after reading @Susan's answer I think it might be the glottis that I feel like I'm putting pressure on. The combination of breath holding and swallowing cause the glottal pressure.

Francine DeGrood Taylor
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    Hi, Francine, and welcome to the site. Do you have a good source for your answer? The SE model favors answers with sources that others can read if interested. Including them would make this a more valuable answer. As it is, it could possibly be closed for lack of references. If you would like more information, you can see this meta post – JohnP Jun 01 '15 at 22:16
  • Hi JohnP. Perhaps I'm confused as to the purpose of the site. Is this site for medical academia? Who visits the site? I had been assuming it was "people with a medical condition who want advice on what to do for it". I suppose if this was a clear-cut case of "there's a definite cure and here it is" references would be available but as far as I can tell in my research there are a few common cures (holding your breath is one) but mostly everybody has their own method. Hiccup cures that work for one person may not work for others. And it risks nothing to try different things :) – Francine DeGrood Taylor Jun 02 '15 at 22:45
  • I'm not meaning to be argumentative, I just thought that my answer might be useful to someone who was looking for a good cure to a recurring problem. – Francine DeGrood Taylor Jun 02 '15 at 22:47