The characteristic sound of a hiccup, sometimes preceded by a slight tightening sensation in your chest, abdomen or throat, are the only signs and symptoms associated with hiccups. The number of hiccups a minute typically ranges between four and 60.

When to see a doctor
Make an appointment to see your doctor if your hiccups last more than 48 hours or if they are so severe that they cause problems with eating or breathing.

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The most common triggers for short-term hiccups include:

• Eating too much
• Drinking carbonated beverages
• Excessive consumption of alcohol
• Sudden temperature changes
• Excitement or emotional stress

Hiccups that last more than 48 hours may be caused by a variety of factors, which are generally grouped into the following categories:

Nerve damage or irritation
The most common cause of long-term hiccups is damage or irritation of the vagus nerves or phrenic nerves, which serve the diaphragm muscle. Factors that may cause damage or irritation to these nerves include:

• A hair or something else in your ear touching your eardrum
• Sore throat or laryngitis
• A tumor, cyst or goiter in your neck
• Gastroesophageal reflux

Central nervous system disorders
A tumor or infection in your central nervous system or damage to your central nervous system as a result of trauma can disrupt your body's normal control of the hiccup reflex. Examples include:

• Stroke
• Multiple sclerosis
• Tumors
• Meningitis
• Encephalitis
• Traumatic brain injury

Metabolic disorders and drugs

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

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Sex
Men are much more likely to develop long-term hiccups than are women.

Surgery
Several factors related to surgical procedures appear to increase your risk of developing long-term hiccups. They include:

• General anesthesia
• Intubation, in which a tube is placed down your throat to help you breathe
• Neck extension, which is necessary during intubation
• Abdominal distension, which is common after endoscopic procedures performed through small incisions
• Organ manipulation

Mental or emotional issues
Anxiety, stress and excitement have been associated with some cases of short-term and long-term hiccups.

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Prolonged hiccups may interfere with:

• Speech
• Eating
• Sleeping
• Post-surgical wound healing

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

While you may initially consult your family physician about your persistent hiccups, he or she may refer you to a doctor who specializes in neurological or gastrointestinal disorders.

What you can do
You may want to write a list that includes:

• Detailed descriptions of your symptoms
• Information about medical problems you've had
• Information about the medical problems of your parents or siblings
• All the medications and dietary supplements you take
• Questions you want to ask the doctor

What to expect from your doctor
In addition to performing a physical exam, your doctor may ask:

• When did your hiccups start?
• How often do they occur?
• Is there anything that worsens or alleviates them?
• What medications are you taking?
• Have you had a sore throat or earache?

He or she may also perform a neurological exam, to check your:

• Reflexes
• Muscle strength
• Muscle tone
• Senses of touch and sight
• Coordination
• Balance

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

If your doctor suspects an underlying medical condition may be causing your hiccups, he or she may recommend one or more of the following tests:

Laboratory tests
Samples of your blood may be checked for signs of:

• Infection
• Diabetes
• Kidney disease

Imaging tests
These types of tests may be able to detect anatomical abnormalities that may be affecting the vagus nerve, phrenic nerve or diaphragm. Imaging tests may include:

• Chest X-ray
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI)

Endoscopic tests
These procedures utilize a thin, flexible tube containing a tiny camera, which is passed down your throat to check for problems in your esophagus or windpipe.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Most cases of hiccups go away on their own, without medical treatment. If an underlying medical condition is causing your hiccups, treatment of that illness may eliminate the hiccups. The following treatments may be considered for hiccups that have lasted longer than two days.

Medications
Drugs most commonly used to treat long-term hiccups include:

• Chlorpromazine, a powerful antipsychotic
• Metoclopramide (Reglan), an anti-nausea drug
• Baclofen (Lioresal), a muscle relaxant

Surgical and other procedures

• Nasogastric (NG) tube. If your stomach is distended, a thin, flexible tube inserted through your nose and into your stomach (nasogastric tube) may stop hiccups.
• Nerve block. If less invasive treatments aren't effective, your doctor may recommend an injection of an anesthetic to block your phrenic nerve to stop hiccups.
• Vagus nerve stimulation. A battery-operated device that's surgically implanted into your chest can be programmed to deliver mild electrical stimulation to your vagus nerve. This procedure is most commonly used to treat epilepsy, but has also helped control persistent hiccups.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

Although there's no surefire way to stop hiccups, if you have a bout of hiccups that lasts longer than a few minutes, the following home remedies may provide relief:

• Swallow a teaspoon of sugar
• Breathe into a paper bag
• Gargle with ice water
• Hold your breath

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When long-term hiccups don't respond to other remedies, alternative treatments, such as hypnosis and acupuncture, may be helpful.

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.

You may be able to decrease your frequency of short-term hiccups by avoiding common hiccup triggers, such as:

• Eating large meals
• Drinking carbonated beverages or alcohol
• Sudden changes in temperature

©1998-2009 Mayo Foundation for Medical Education and Research (MFMER). Terms of use.