Formula Medical Group
Apple Valley, CA

James Krider, MD

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Hiccup - Singultus

Almost all cases of hiccups have no medical significance. They usually occur for unknown reasons and disappear quickly, in less than half an hour. A variety of circumstances can provoke hiccups. Noxious fumes, smoking, or inhaling the smoke of others can cause hiccups in some people. Other people may experience hiccups after eating spicy foods; excessive alcohol consumption also can cause hiccups. Sobbing, especially in a child, can cause hiccups.

In a few rare instances, hiccups can become chronic, interfering with normal activities. And in some cases, hiccups may be a symptom of a serious disorder.

Causes of hiccups

Brain tumor
Hiccups are sometimes caused by a tumor's encroachment on the "hiccup center" in the brain. Thus, persistent hiccups may be a sign of brain cancer or a benign tumor that is crowding normal brain tissue. Other symptoms may include personality changes, numbness, headaches, visual changes, and paralysis.

This is a serious disease in which a virus infects and inflames the brain. It is contagious and may occasionally be a complication of other diseases, most commonly flu, measles, chickenpox, whooping cough, or meningitis. It occurs more often in epidemics than as an isolated case. In infants, the disease strikes suddenly with a high fever, usually accompanied by convulsions. In older children and adults, there is also fever, with a severe, pounding, relentless headache. It is common to feel drowsy or be in a stupor. In more severe cases, persistent hiccups, weakness of the eyes and muscles, excessive salivation, delirium, convulsions, and coma may occur. Stiff neck and vomiting, characteristic symptoms of brain disease, may also be present. The treatment for most forms is supportive therapy, except for the type that is caused by the herpes simplex type I virus, for which there is specific, antivirus drug therapy.

Hiatus hernia
A hiatus hernia is the protrusion (hernia) of a small part of the stomach through an opening (the hiatus) in the diaphragmatic

A good home remedy is a teaspoon of peanut butter.

muscle at the point where the esophagus and the stomach join. Pain ranging from mild heartburn to a deep ache may be felt behind the lower end of the breastbone and may radiate to the left shoulder and arm, as if it were a sign of a heart attack. The pain of hiatus hernia occurs immediately after meals, especially when reclining or bending over. Hiccups are also an occasional symptom.

Lung disorders
Pneumonia or an inflammation of lung tissue, usually due to a viral or bacterial infection, can cause irritation of the diaphragm, resulting in hiccups. Other symptoms include fever, weakness, shortness of breath, a sharp pain when breathing deeply, and coughing up thick, often foul-smelling phlegm. In severe cases, some lung tissue may die, a condition called pulmonary infarction. .

Peritonitis is an inflammation of the peritoneum, the membrane that lines the abdominal cavity and covers the organs within it. It is usually caused by an injury or an infection that is due to a ruptured appendix, perforated ulcer, diverticulitis, or, in women, pelvic inflammator
y disease. A person with peritonitis is usually in severe, prostrating pain, and tends to lie motionless with the legs drawn up. The abdominal area is distended and there is acute nausea with vomiting. There also may be diarrhea and hiccups.

This is an inflammation of the pleura, the thin membranes that surround the lungs. The predominant symptom is a sharp pain when breathing in or coughing; other symptoms may include hiccups.

Many women experience repeated bouts of hiccups during pregnancy, especially during the last trimester. In this instance, the hiccups are due to pressure the growing fetus exerts on the diaphragm. The problem, which disappears with delivery, often can be relieved by eating small meals and avoiding bending over or other movements that put added pressure on the diaphragm, especially after eating.

Advice about hiccups

  • It is natural for a baby to hiccup. Do not try to stop the hiccuping. If it lasts more than a few minutes, seek medical advice.
  • Simple hiccups with no other symptoms are nothing to be concerned about. Some people hiccup when they are emotionally upset, and children hiccup when crying. This is normal and has no adverse effects.
  • There are many folk remedies for stopping hiccups. Some of the more popular include drinking a glass of ice water, startling the hiccuping person, breathing into a paper bag, holding your breath, or eating a spoonful of sugar. Some of these methods can cause more problems than they cure. The best method for getting rid of hiccups is to ignore them, and they will go away on their own.
  • Persistent hiccups may require a doctor's treatment. A number of drugs, including chlorpromazine (a drug used to treat psychosis), metoclopramide (an anti­nausea drug), or scopolamine (used to treat motion sickness), may be pre­ scribed for hiccups. Non-drug treatments, such as hypnosis, also may be helpful. Surgery to sever the nerve involved in hiccups is considered a treatment of last resort.
This article was last reviewed October 28, 2005 by Dr. James Krider.
Reproduced in part with permission of Home Health Handbook.
Brain cancer
Hiatus hernia
Lung tissue death
Pleural effusion
Pregnancy and diet
Pregnancy and exercise
Viral encephalitis

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