Hiccups-amusing when other people have them but annoying when you get them-are a common enough affliction that most people have a favorite way to cure them. But for some people, persistent hiccups lasting more than 48 hours or intractable hiccups that last more than a month constitute a serious health problem and require medical intervention. Hiccups result from an uncontrolled spasm of the diaphragm, the muscle that separates the chest from the abdomen, and the treatments attempt to reset the normal rhythmic contraction of the diaphragm.
Home Remedies
Almost always, hiccups stop on their own. But some common home remedies to speed the end of a bout include breathing into a paper bag, deep breathing, holding the breath, drinking or gargling cold water and swallowing a small amount of granulated sugar or crushed ice. By varying your breathing pattern, you consciously control the movement of the diaphragm, which can reset its involuntary control by the vagus and phrenic nerves, ending the spasms. Swallowing sugar or cold things can irritate the pharynx, stimulating the vagus nerve to reset itself, says the Merck Manual.
Medical Condition
An underlying medical condition can sometimes cause persistent or intractable hiccups. Conditions associated with hiccups include diabetes, kidney failure, stroke, brain tumor, encephalitis, meningitis and multiple sclerosis. In those cases, treating the underlying condition often resolves the hiccups, according to the Mayo Clinic. Some medications can cause hiccups, including barbiturates, steroids and tranquilizers. In those cases, switching drugs might stop the hiccups.
Medications
For persistent hiccups that interfere with someone's ability to speak, eat or sleep, a doctor might prescribe medication. Baclofen, a muscle relaxant, can stop the diaphragm spasms. Metoclopramide, an anti-nausea drug with effects on the stomach, esophagus and central nervous system, can quiet hiccups. The anti-psychotic chlorpromazine is labeled for use on intractable hiccups, although it is not clear how it works, according to the Merck Manual.
Surgery
In very rare cases of intractable hiccups that cannot be controlled any other way, surgery might be an option. If gastric distension is the suspected culprit, a nasogastric tube passed through the nose and into the stomach can relieve the pressure on the diaphragm and stop the hiccups. The Merck Manual suggests that a solution of procaine, injected into the phrenic nerve, can anesthetize it to stop hiccups. Alternatively, a surgeon could implant a battery-powered device in the chest to artificially stimulate the vagus nerve and control diaphragm contractions.
