A hiccup is a sudden contraction of the muscles (diaphragm) that help a person to breathe in, that repeats several times per minute. During a hiccup, the muscle contraction causes the person to take in a quick breath. This breath in is then interrupted by the epiglottis closing over the windpipe and causing a “hic” sound. Short hiccup spells are commonly experienced by healthy children and adults. Adult males are more likely to experience episodes of hiccups (Lee et al., 2016).
Guidelines
Good practice points
- Home remedies such as holding the breath for a couple of seconds, doing the Valsalva manoeuvre for a short time, sipping ice-cold water, swallowing some granulated sugar, biting into a lemon or tasting vinegar may be effective and may be attempted.
- The use of gripe water is not recommended.
- A person with hiccups should seek medical advice if hiccups last longer than 48 hours or if they have other symptoms in combination with hiccups, such as Chest pain, weakness in their limbs or face, Headache or trouble keeping balance.
Chain of survival behaviours
Prevent and prepare
- Giving babies a break from feeding and burping them may reduce the amount of air in their stomach and could help prevent hiccups.
- Eating slowly and avoiding alcohol may help reduce the likelihood of hiccups.
Early recognition
- A person with hiccups will take a short breath inward followed by a “hic” sound. This can occur between 2 and 60 times per minute.
First aid steps
- Comfort the person and reassure them that hiccups usually pass after a few minutes.
- If they can, encourage them to perform the Valsalva manoeuvre (take a deep breath in, close the nose and mouth and gently blow out) for a short time.
There are other methods to stop hiccups which may be more suited to some contexts.
- Drink a glass of ice-cold water.
- Suck a sugar cube or an ice cube.
- Bite into a lemon.
- Hold your breath for a couple of seconds.
Access help
- Generally, hiccups pass within a few minutes. Seek medical advice if the hiccups last longer than 48 hours or if the person has other symptoms in combination with hiccups, such as Chest pain, weakness in their limbs or face, Headache or trouble keeping balance.
Education considerations
Learner considerations
- This topic may be useful for some audiences such as school nurses, new parents or other people who care for children.
Facilitation tips
- Define what a hiccup is and how it happens and discuss different safe home remedies.
Scientific foundation
Systematic reviews
The Centre for Evidence-Based Practice (CEBaP) developed an evidence summary concerning techniques to stop hiccups, but no studies could be identified.
Non-systematic reviews
Hiccups are classified based on their duration. Short hiccup spells are commonly experienced by healthy children and adults. Hiccups resolve spontaneously or maybe with simple home remedies and do not require medical attention. Short hiccup bouts are mostly associated with gastric distention, like drinking carbonated beverages or ingestion of spicy, very hot or very cold food, or alcohol intake. In the foetus, hiccups are normally present after the eighth week of gestation during behavioural active phases and tend to persist after birth in babies (Launois et al., 1993).
Babies often get hiccups when feeding. Hiccups do not normally harm a baby and will go away once the baby is one year old. Usually, a baby will have the hiccups for only a few minutes. Taking a break from feeding, to burp the baby, may reduce the amount of air in their stomach – can and prevent hiccups. No scientific evidence has been found for the use of gripe water (a mixture of herbs and water traditionally used to treat colic and other stomach problems). It is not recommended for babies (Adhisivam, 2012).
The purpose of some home-remedies is the attempt to interrupt the reflex arc thought to maintain repetitive diaphragmatic contractions. This is most often attempted by breath-holding, the Valsalva manoeuvre (a particular way of breathing that increases pressure in the chest) or breathing into a paper bag. Other home remedies to stop hiccups on a short term include sucking an ice cube, sucking a sugar cube with vinegar, chewing a piece of lemon, stop breathing and scaring someone with hiccups. These home-remedies are in general not harmful and may be effective only in shortening acute hiccups and not in the treatment of persistent or recurrent hiccups (Brañuelas Quiroga et al., 2016; Goldstein, 1999).
Prolonged hiccups are rare in healthy people. However, hiccups lasting more than 48 hours are not uncommon in people with advanced disease. They are disabling and may induce depression, weight loss and sleep deprivation. A wide variety of pathological conditions can cause chronic hiccups including myocardial infarction, brain tumour, renal failure, prostate cancer and abdominal surgery (Brañuelas Quiroga, 2016; Juan Rey, 2010). Any hiccup episode lasting longer than 48 hours is described as chronic and needs medical attention (Petroianu, 2005).
References
Systematic reviews
Centre for Evidence-Based Practice, Belgian Red Cross-Flanders, (2020). Evidence summary Hiccup – Techniques to stop hiccups. Available from: https://www.cebap.org/knowledge-dissemination/first-aid-evidence-summaries/
Non-systematic reviews
Adhisivam, B. (2012). Is gripe water baby-friendly? J Pharmacol Pharmacother, 3, 207-08.
Brañuelas Quiroga J., Urbano García J., & Bolaños Guedes J. (2016). Hiccups: a common problem with some unusual causes and cures. The British journal of general practice: the Journal of the Royal College of General Practitioners, 366(652), 584–586.
Chang FY, & Lu CL (2012). Hiccup: mystery, nature and treatment. J Neurogastroenterol Motil, 2 123-30.
Goldstein, R. (1999). Practice tips. Simple method for curing hiccups. Canadian Family Physician, (45), 1459.
Juan Rey R., & Solari L.A. (2010). El paciente con hipo. [The patient with hiccups]. Lo cotidiano, loagudo, locomplejo, 1 (7) 18–19.
Launois S., Bizec, J.L., Whitelaw, W.A., Cabane, J., & Derenne, J.P. (1993). Hiccup in adults: an overview. European Respiratory Journal, 6, 563-575.
Lee, G. W., Kim, R. B., Go, S. I., Cho, H. S., Lee, S. J., Hui, D., … & Kang, J. H. (2016). Gender differences in hiccup patients: analysis of published case reports and case-control studies. Journal of pain and symptom management, 51(2), 278-283.
Petroianu, G. (2005). Hiccups. In Rakel, R.E., & Bope, E.T. (eds.), Conn’s Current Therapy, 12-16.
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