Hiccups

What is it?

Hiccups (singultus) result from involuntary diaphragmatic spasms followed by sudden glottal closure. Acute hiccups lasting under 48 hours are almost always benign and triggered by eating too quickly, carbonated drinks, alcohol, sudden temperature changes, or excitement. Persistent hiccups (2–30 days) and intractable hiccups (>30 days) are pathological and require investigation for GI, CNS, metabolic, or thoracic causes. Chlorpromazine is the only FDA-approved treatment for intractable hiccups; baclofen and metoclopramide are commonly used off-label.

Common causes

When to see a doctor

• 1Hiccups lasting more than 48 hours
• 2Hiccups severe enough to interfere with eating, drinking, sleeping, or breathing
• 3Hiccups with chest pain, difficulty swallowing, or weight loss
• 4Hiccups in the context of a new neurological symptom (stroke evaluation)
• 5Hiccups following surgery that are worsening rather than resolving

What you can do

• ✓Hold your breath for 10–20 seconds or breathe into a paper bag — raises CO2 and suppresses diaphragm spasm
• ✓Swallow a teaspoon of sugar or drink ice-cold water quickly
• ✓Swallow repeatedly — clears the esophagus and may interrupt the hiccup reflex
• ✓Eat slowly, avoid carbonated drinks and alcohol — most benign hiccups are preventable

Conditions that cause this symptom

Medications that may help

Treatment depends on the underlying cause. Always consult your provider before starting any medication.

Frequently asked questions