Hiccup

A hiccup or hiccough (generally pronounced "HICK-up" (IPA: /ˈhɪ.kəp/) independent of the spelling) is an involuntary spasm of the diaphragm; typically this repeats several times a minute. The sudden rush of air into the lungs causes the glottis to close, creating the "hic" noise. A bout of hiccups generally resolves by itself, although many home remedies are in circulation to shorten the duration, and medication is occasionally necessary. By extension, the term "hiccup" is also used to describe a small and unrepeated aberration in an otherwise consistent pattern. The medical term is singultus. The term singultus is becoming more popular as this condition is being recognized as a significant performance issue in the 21st century, with an increased emphasis on human communications.

While many cases develop spontaneously, hiccups are known to develop often in specific situations, such as eating too quickly, taking a cold drink while eating a hot meal, eating very hot or spicy food, laughing vigorously or coughing, or drinking an excess of an alcoholic beverage. Hiccups may be caused by pressure to the phrenic nerve by other anatomical structures, or rarely by tumors and certain kidney disease. It is reported that 30% of chemotherapy patients suffer singultus as a side effect to treatment. (American Cancer Society)

It is still unclear to scientists exactly why hiccups occur, particularly because it doesn't seem to give us any specific benefit. Some speculation exists that hiccups are a remnant of a bodily function that has been phased out by evolution, such as the move from aquatic gilled creatures to land animals. Ultrasounds have also shown that unborn fetuses experience hiccups. Some suggested hypotheses include hiccups as a possible muscle exercise for the child's respiratory system prior to birth or as a preventive measure to keep amniotic fluid from entering the lungs^*. More research is required to ascertain their true nature, origins, and purpose, if any. Plus, its out-of-the-ordinary and complex remedies also make it harder for any scientists to find out the cause.

Home remedies

The following are some commonly suggested home remedies. While numerous remedies are offered, they mostly fall into a few broad categories. These categories include purely psychosomatic cures centered around relaxation and distraction, cures involving swallowing and eating (with the rationale generally that this would remove irritants or reset mechanisms in the affected region), and cures involving controlled/altered breathing.

The science behind many of these methods is unfounded, however most people have their own particular remedy that they are convinced is the solution. Such methods are often complex tasks involving drinking in awkward positions, or breathing in certain patterns. The common factor amongst all these methods is that the person attempting such remedies is usually concentrating on their preferred task and not the hiccups. Hence many remedies can actually be considered a psychosomatic distraction technique of one form or another.

Psychosomatic

Distraction from one's hiccup (e.g. being startled or asked a perplexing question)
Concentration on one's hiccup (e.g. The least embarrassing way to control hiccups is using a psychosomatic method involving 'waiting' for the next hiccup. The key is to attempt to anticipate the hiccup by counting it aloud just prior to it taking place, the aim is to be saying 'one' just as the hiccup occurs. Practice with this method leads to the situation where one can simply decide not to hiccup anymore.)

Another distraction based technique is to count in reverse, eg. from 100 down, which requires concentration.

Swallowing

Swallowing three times (or more) while holding one's breath
Eating particular foods, such as peanut butter, Fluffernutter sandwich, chocolate, sugar or honey, Lingonberry jam, wasabi, or vinegar
Eating a spoonful of granulated table sugar (slowly letting it dissolve in mouth)
Drinking a glass of water through a napkin placed over the glass
Drinking a glass of water in several small sips
Drinking a glass of water "from the far side of the glass", i.e. bending over a sink so one's head is upside-down when drinking
Drinking a glass of water with another's palms against one's ears
Keep a sip of water in the mouth, one finger in each ear and count to ten, and then swallow.
Drinking a glass of a carbonated beverage (with salt)
Gulping down a glass of water while holding one's breath
Drinking a glass of water while raising the right or left hand
Drinking several glasses of water
Eating an ice cube
Drinking a glass of water with a spoon touching one's temple
Filling a large glass with water and, taking in a mouthful of the water, while holding the water in one's mouth (without swallowing) tipping one's head all the way back, stretching the throat in the process, then opening the mouth as wide as possible and using the throat muscles to swallow the water, repeating until the entire glass of water is drunk using this method. This will not work as effectively if one's stomach is very full.

Respiratory

Breathing slowly and deeply in while thinking 'breathing out' and breathing slowly and fully out while thinking 'breathing in'.
Breathing slowly and deeply in and out through the mouth.
Holding one's breath while optionally squeezing one's stomach.
Breathing deeply through the nose, then exhaling slowly through the mouth.
Breathing deeply and instead of exhaling completely, leave air in the lungs.
Exhaling all the air from one's lungs and holding one's breath while swallowing water or saliva.
Blowing up a balloon.
Inducing sneezing.
Breathing into a paper bag or other sealed container. Only attempt this in severe cases of hiccups that have persisted despite other attempts at cures. Perform this sitting or laying down, and with someone at your side to ensure safety. Stop as soon as you begin to feel lightheaded.
Belching.
Sneezing

Other

For babies, hiccups are usually immediately stopped by the suckling reflex, either by breastfeeding or simply by insertion of a finger or bottle teat into the baby's mouth.
For some, vomiting is a direct albeit messy solution.
Burping is also a good method for some, and usually ends the hiccups immediately.
Saying the ABC's and taking a sip of water for every letter in the alphabet.
By simply waiting until the hiccups subside.

Medical treatment

Referred to as singultus, hiccups are treated medically only in severe and persistent (termed "intractable") cases. Haloperidol (Haldol, an anti-psychotic and sedative), metoclopramide (Reglan, a gastrointestinal stimulant), and chlorpromazine (Thorazine, an anti-psychotic with strong sedative effects) are used in cases of intractable hiccups. In severe or resistant cases, baclofen (an anti-spasmodic) is sometimes required to suppress hiccups. Effective treatment with sedatives often requires a dose that either renders the person unconscious or highly lethargic. Hence, medicating singultus is done short-term and is not a situation where the affected individual could continue with normal life activities while taking the medication.

The New York Times reports that Dr. Bryan R. Payne, a neurosurgeon at the Louisiana State University Health Sciences Center in New Orleans, has had some success with an experimental new procedure in which a vagus nerve stimulator is implanted in the upper chest of patients with an intractable case of hiccups. "It sends rhythmic bursts of electricity to the brain by way of the vagus nerve, which passes through the neck. The Food and Drug Administration approved the vagus nerve stimulator in 1997 as a way to control seizures in some patients with epilepsy. Last year, the agency endorsed the use of the stimulator as a treatment of last resort for people with severe depression" ^*.

On June 13, 2006, Philip C. Ehlinger of Doylestown, Pennsylvania, was awarded a U.S.Patent (#7062320 B2) for the first medication free medical treatment for singultus (see: http://www.freshpatents.com). The patent is for "a device for the treatment of hiccups, and more specifically, to a method and apparatus for the treatment of hiccups involving galvanic stimulation of the Superficial Phrenetic and Vagus nerves using an electric current." This is an improvement over the vagus nerve stimulator used by Dr. Payne (above) in that it can be employed by any person sufferring with problem hiccups as a self-help method in a non-medical environment. Rather being a last resort, this bio-electric stimulator can be used at anytime, anywhere, safely, pain-free, and without risk of side effects or dangerous drug interactions. The device works quickly, is low-cost, easily cleaned and sterilized, portable, and requires no outside electrical source. It is presumably the world's first reliable hiccup cure for the general public.

The sub-sensory bio-electric therapy is administered by the device using natural galvanic action. According to the unique features of the invention, a cup-like vessel that is constructed of a carbon based metal with a specific electrochemical potential (stainless steel)which serves as the first electrode. The second electrode is a copper alloy material(brass) which has a dissimilar electrochemical property than the carbon based metal of the vessel body. The first electrode is electrically insulated from the second electrode except for when the vessel is filled with an electrically conductive liquid such as tap water. During use, both electrodes are partially immersed in the liquid, and one electrode is also in contact with the lips and mouth, and the second electrode is in contact with the temple or cheek region of the face. Thus a flow of Ions is created by the electrochemical potentials of the dissimilar metal electrodes and is conducted through the body tissues sufficiently to interrupt the Hiccup Reflexive Arc. The new innovation, "The Hic-Cup" is reported to become available to the public sometime in 2006.

World record

The world record for the longest continuous bout of hiccups goes to Charles Osborne (1894–1991) from Anthon, Iowa. The hiccups started in 1922 at a rate of 40 times per minute, slowing to 20 and eventually stopping in February 1990 – a total of 68 years. ^*

References

C. Straus, K. Vasilakos, RJA Wilson, et al., A phylogentic hypothesis for the origin of hiccoughs, In: Bioessays, Vol.25, 2003, S.182-188, Abstract
Launois et al., Hiccup in adults:an overview, In: European Respiratory Journal, 1993, S.563-575, Abstract
Davis J. Newsom, An experimental study of hiccup, In: Brain, 1970, Vol.93, S.851-72

External links

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