Extreme hiccups: what you should know

A hiccup is an involuntary spasm of the diaphragm followed by a sudden closure of the voice box. Short episodes can follow a large meal, fizzy drinks, alcohol, sudden temperature changes, or strong emotion. Hiccups that continue may be related to irritation around the diaphragm, the stomach, or the nerves controlling breathing. Stomach conditions such as [Acid Reflux](/conditions/acid-reflux/) and [Gastritis](/conditions/gastritis/) are possible contributors, but the hiccups themselves do not identify one cause.

Sit upright, take small sips of cool water, and eat slowly when the episode settles. Avoid alcohol, fizzy drinks, very large meals, and foods that clearly trigger symptoms. Keep a note of when the hiccups began, what you ate or drank, and whether you have heartburn, abdominal pain, cough, or medication changes. Avoid frightening yourself or using methods that restrict breathing. If reflux symptoms are present, a clinician can advise whether [Acid Reflux Medication](/treatments/medical-management/acid-reflux-medication/) is suitable.

Arrange medical advice when hiccups keep returning, last long enough to disturb sleep, or make eating and drinking difficult. Seek urgent care for severe chest or abdominal pain, trouble breathing, repeated vomiting, fainting, new weakness, confusion, or inability to swallow. A clinician may examine your chest and abdomen, review medicines, and decide whether tests are needed.

Ask whether reflux or stomach irritation could explain the pattern, which medicines might trigger hiccups, whether dehydration is a concern, and what treatment is appropriate if they return.