Hiccups not stopping: what to know

The diaphragm normally moves with breathing. A hiccup is a sudden involuntary contraction followed by closure at the voice box. Repeated spasms can be encouraged by a stretched stomach, swallowed air, fizzy drinks, alcohol, emotional excitement or abrupt temperature changes. Ongoing irritation in the upper digestive tract is another possibility. Acid Reflux can present with hiccups, and may also cause burning, sour taste or fluid coming back up. Gastritis can present with hiccups when stomach irritation is accompanied by nausea or discomfort in the upper abdomen.

A stop-start pattern can be useful information rather than reassurance that the cause is harmless. Write down how long each spell lasts, how often it returns and whether meals or lying down affect it. A clinician may review medicines and decide whether an examination is appropriate.

Eat slowly, take smaller portions and sip still water rather than gulping. Avoid carbonated drinks and alcohol while you are tracking the pattern. Remain upright after meals, especially if lying down brings on sour fluid or burning. Keep a list of prescription medicines, supplements and recent procedures. Do not deliberately frighten yourself, swallow dry food or use forceful breathing manoeuvres. If the episodes continue, book a primary-care review so treatment can address a possible trigger instead of only suppressing the sound.

Go to urgent care for chest pain, difficulty breathing, fainting, new confusion, new weakness, severe headache, persistent vomiting or inability to drink enough. Contact a clinician promptly when recurrent hiccups disturb sleep, prevent meals or follow surgery or a new medicine. The associated symptom, rather than the hiccup alone, helps determine urgency.

Do my timing and accompanying symptoms suggest reflux, stomach irritation or a medicine effect? Is any examination needed? What should I change while waiting? Which symptoms mean I should seek urgent help rather than wait for the appointment?