What should you know about permanent hiccups?

A hiccup is an involuntary spasm of the diaphragm followed by sudden closure of the vocal cords. Short episodes may follow a large meal, fizzy drinks, alcohol, a sudden temperature change, laughing or emotional excitement. Persistent episodes can irritate the nerves or diaphragm and may occur with acid reflux or gastritis; medicines and other health problems can also contribute.

Long-lasting hiccups may make it hard to eat, drink, sleep, speak or breathe comfortably. Note when they began, how often they occur, what you ate or drank beforehand, and whether there is heartburn, abdominal pain, vomiting or swallowing difficulty.

For a brief episode, take small sips of water, breathe slowly and avoid rushing meals, fizzy drinks and alcohol. Do not use frightening or forceful tricks, swallow objects or deliberately restrict breathing for a long time. If reflux symptoms accompany the hiccups, smaller meals and remaining upright after eating may reduce irritation.

When episodes persist, a clinician can review medicines, examine you and choose treatment for the cause. Acid reflux medication may be appropriate for some people, but do not start or stop prescription treatment without advice.

Arrange medical care when hiccups continue, repeatedly disrupt sleep or make eating and drinking difficult. Seek urgent help for severe breathing trouble, chest pain, confusion, weakness, repeated vomiting, inability to swallow fluids or signs of dehydration.

Ask whether reflux, gastritis, a medicine or another condition could be involved; which details to track; whether you need tests; and what treatment is safe if hiccups are affecting sleep, nutrition or breathing.