What should you know about bad hiccups?

A hiccup is a sudden involuntary contraction of the diaphragm followed by closure at the top of the airway. Common triggers include eating quickly, a very full stomach, fizzy drinks, alcohol, sudden temperature changes or strong emotion. Reflux and gastritis can irritate nearby tissues and may accompany stubborn hiccups. Less commonly, persistent hiccups can be linked with a medicine or a problem affecting the chest, abdomen or nervous system, so duration and associated symptoms are useful clues.

Pause eating and sip cool water slowly. Breathe calmly and avoid gulping, fizzy drinks, alcohol and large meals while the episode continues. Sitting upright may help if you also have burning or regurgitation. Avoid risky tricks such as frightening someone, swallowing objects or breathing into a bag. If reflux symptoms repeat, record triggers and ask whether acid reflux medication is appropriate rather than treating repeatedly on your own.

Arrange medical advice when hiccups continue for a prolonged period, repeatedly return, prevent sleep, or make eating, drinking or speaking difficult. Seek urgent care if they occur with severe chest or abdominal pain, breathing trouble, confusion, weakness, severe headache, repeated vomiting, blood in vomit or black stools. A clinician may review medicines and look for reflux, gastritis or another cause.

Mention when the hiccups began, what preceded them, whether they stop during sleep, and any reflux, pain, vomiting or neurological symptoms. Ask whether a medicine or underlying digestive irritation could be contributing and what treatment is suitable.