Daily hiccups: what to know

A hiccup is an involuntary spasm of the breathing muscle followed by sudden closure of the voice box. Eating a large meal, fizzy drinks, alcohol, sudden excitement, laughing or a rapid change in temperature can stimulate the reflex. Reflux or inflammation in the upper digestive tract can also irritate nearby nerves and contribute to repeated hiccups.

Most brief episodes settle without treatment. Hiccups that continue or recur daily can interfere with eating, drinking, sleep and conversation. The duration, triggers and accompanying symptoms help a clinician decide whether reflux, gastritis, medication effects or another problem needs attention.

Eat slowly, take smaller mouthfuls and avoid gulping air. Sip water, reduce fizzy drinks and notice whether alcohol, very hot or cold foods, or large meals trigger an episode. Sit upright after eating if reflux symptoms occur. Avoid frightening remedies or holding your breath for a long time, particularly if you have heart or breathing problems.

Arrange a routine appointment if hiccups return every day, last long enough to disturb sleep or meals, or continue despite simple changes. Bring a list of medicines and describe any heartburn, upper-abdominal discomfort, cough, swallowing difficulty or recent illness.

Seek urgent help if hiccups occur with difficulty breathing, inability to swallow fluids, repeated vomiting, severe chest or abdominal pain, confusion, weakness or a severe headache. Prompt review is also needed when they begin after a significant injury or prevent you from drinking enough.

Do not use frequent doses of acid-reducing medicine simply to suppress hiccups without checking the cause. A clinician can assess the pattern and decide whether treatment for reflux or another condition is appropriate.

Ask whether reflux, gastritis, a medicine or another trigger could explain your hiccups; whether you need an examination or tests; and which symptoms should prompt urgent care. Ask how to manage meals and sleep while the cause is being assessed.