Hiccups Won't Go Away: Why and What to Do

For most people, hiccups are not a problem, just perhaps a disturbance or an embarrassment when it is least needed. In general, hiccups tend to resolve on their own within a couple of minutes. However, in certain cases, hiccups tend to become persistent, lasting for more than 48 hours, causing a real discomfort and frightening the affected person. 

My Hiccups Won’t Go Away, Why?

As mentioned, hiccups stop on their own within a couple of minutes, sometimes even hours. However, in certain cases, hiccups tend to last for more than 48 hours, known also as persistent hiccups. If your hiccups don’t go away even after 48 hours, seek medical help as they can be a sign of a medical problem.

For hiccups which last less than 48 hours, common triggers include:

  • Too much eating
  • Too much alcohol drinking
  • Drinking too many carbonated beverages
  • Emotional stress
  • Excitement
  • Sudden changes of temperature
  • Air swallowing especially when sucking a candy or chewing gum, etc.

If hiccups won’t go away even after 48 hours, causes can be grouped into the following categories:

1. Nerve Damage

A damage or irritation of the vagus nerve and especially of the phrenic nerve leads to long lasting hiccups. Factors that can lead to a damage or irritation of these two nerves include:

  • Gastroesophageal reflux
  • Laryngitis
  • A sore throat
  • Something touching your eardrum
  • A cyst located in the neck
  • Goiter
  • A tumor of the neck

2. Metabolic Disorders and Drugs

Hiccups won't go away? These metabolic disorders can trigger hiccups lasting longer than 48 hours:

  • Diabetes
  • Kidney failure
  • Electrolyte imbalance
  • Alcoholism
  • Anesthesia
  • Steroids
  • Barbiturates
  • Tranquilizers

3. Central Nervous System Disorders

The following central nervous system disorders can lead to persistent hiccups:

  • Brain injuries
  • Meningitis
  • Encephalitis
  • Stroke
  • Multiple sclerosis
  • Tumors

How to Stop the Hiccups

The following tips and home remedies recommended by the CDC and NHS can help stop the hiccups:

1. Breathing and Posture

  • Breathe in a paper bag.
  • Lean forward so you gently compress your chest.
  • Bring the knees to the chest, hug them and remain in that position for about 2 minutes.
  • Breathe in and hold your breath for about 10 seconds. Slowly breathe the air out. Repeat this process 2 or 3 times. If the hiccups still don't stop, you can repeat this process every 20 minutes, along with all the other tips mentioned above.

2. Eating and Drinking

  • A couple drops of vinegar in your mouth can help stop the hiccups.
  • Drink slowly one glass of warm water, without breathing.
  • Suck one slice of lemon after you have placed it on the tongue.
  • Gargle with ice water.
  • Granulated sugar might help stop the hiccups. Once the sugar has melted in your mouth, swallow it.
  • Drink a very cold water slowly.

3. Pressure Points

  • Gently press your nose while swallowing.
  • Gently press the diaphragm.
  • Pull the tongue, hold it with your fingers and tug. This will help stimulate the vagus nerve.

What If the Hiccups Won't Go Away After 48 Hours?

Any underlying cause of the hiccups should be treated. In certain cases, medications are needed in order to stop these persistent hiccups lasting longer than 48 hours. Various medications used for the treatment of hiccups include:

  • Haloperidol or chlorpromazine works by relaxing the diaphragm muscle and its nerve supply, stopping this way persistent hiccups.
  • Anti-acid medicines such as ranitidine, omeprazole, etc., are used in cases when there are stomach problems such as acid reflux, or a distended stomach.
  • Metoclopramide works by emptying the stomach faster than normal. Metoclopramide, when given as an intravenous injection, stops the hiccup's occurring after anesthesia.
  • Baclofen works by relaxing the muscles, including the diaphragm muscles.
  • Gabapentin works by relaxing the nerve supply of the diaphragm.
  • Ketamine, which is an intravenous anesthetic, might be helpful in stopping hiccups that won't go away, especially if other treatment methods have failed to stop the hiccups.
  • Midazolam is recommended as treatment options for terminally ill patients who are dealing with persistent hiccups as well. Midazolam is a sedative and tends to reduce and eliminate stress.

Alternative treatment options such as acupuncture, hypnotherapy, or even a placement of a device similar to heart pacemaker, can help stop persistent hiccups.

If the hiccups continue regardless all the treatment options mentioned above, a phrenic nerve block is necessary. A local anesthetic is injected near the nerve in order to interrupt its work. However, this is a high-risk procedure as the phrenic nerve is very important for the normal functioning of the diaphragm and breathing.

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