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A hiccup (scientific name singultus, from Latin for "sob, hiccup"; also spelled hiccough) is an spasm (myoclonic jerk) of the diaphragm that may repeat several times per minute. The hiccup is an involuntary action involving a reflex arc. Once triggered, the reflex causes a strong contraction of the diaphragm followed about a quarter of a second later by closure of the epiglottis, a structure inside of the throat, which results in the "hic" sound.
Hiccups may occur individually or in bouts. The rhythm of the hiccup, or the time between hiccups, tends to be relatively constant. A bout of hiccups generally resolves itself without intervention, although many home remedy are often used to attempt to shorten the duration. Medical treatment is occasionally necessary in cases of chronic hiccups.
Along with humans, hiccups have been studied and observed in cats, rats, rabbits, dogs, and horses.
Several human conditions can trigger hiccups. In rare cases, they can be a sign of serious medical problems such as myocardial infarction.
The hypothesis suggests that the presence of an air bubble in the stomach stimulates the sensory (afferent) limb of the reflex through receptors in the stomach, esophagus, and along the underside of the diaphragm. This triggers the active part of the hiccup (efferent limb), sharply contracting the muscles of breathing and relaxing the muscles of the esophagus, then closing the vocal cords to prevent air from entering the lungs. This creates suction in the chest, pulling air from the stomach up into the esophagus. As the respiratory muscles relax, the air is expelled through the mouth, effectively "burping" the animal.
There are a number of characteristics of hiccups that support this theory. The burping of a suckling infant may increase its capacity for milk by more than 15–25%, bringing a significant survival advantage. There is a strong tendency for infants to get hiccups, and although the reflex persists throughout life, it decreases in frequency with age. The location of the sensory nerves that trigger the reflex suggests it is a response to a condition in the stomach. The component of the reflex that suppresses peristalsis in the esophagus while the airway is being actively blocked suggests the esophagus is involved. Additionally, hiccups are only described in mammals, the group of animals that share the trait of suckling their young.
Additionally, this group (C. Straus et al.) points out that hiccups and amphibian gulping are inhibited by elevated CO2 and may be stopped by GABAB Sensory receptor , illustrating a possible shared physiology and heritage. These proposals may explain why premature birth spend 2.5% of their time hiccuping, possibly gulping like , as their are not yet fully formed.
The phylogenetic hypothesis may explain hiccups as an evolutionary remnant, held over from our amphibious ancestors.
Numerous medical remedies exist, but no particular treatment is known to be especially effective, generally because of a lack of high-quality evidence.
A vagus nerve stimulator has been used with an intractable case of hiccups. "It sends rhythmic bursts of electricity to the brain by way of the vagus nerve, which passes through the neck. The Food and Drug Administration approved the vagus nerve stimulator in 1997 as a way to control seizures in some patients with epilepsy."
In one person, persistent digital rectal massage coincided with terminating intractable hiccups.
Acupressure, either through actual function or placebo effect, may cure hiccups in some people. For example, one technique is to relax the chest and shoulders and find the deepest points of the indentations directly below the protrusions of the collarbones. The index or middle fingers are inserted into the indents and pressed firmly for sixty seconds, as long, deep breaths are taken. (1990). 9780553349702, Bantam Books. ISBN 9780553349702
A simple treatment involves increasing the partial pressure of CO2 and inhibiting diaphragm activity by holding one's breath or rebreathing into a paper bag. Other potential remedies suggested by NHS Choices include pulling the knees up to the chest and leaning forward, sipping ice-cold water and swallowing some granulated sugar.
A breathing exercise called supra-supramaximal inspiration (SSMI) has been shown to stop persistent hiccups. It combines the three principles of hypercapnia, diaphragm immobilization, and positive airway pressure. First, the subject must exhale completely, then take a deep breath. Then, they must hold their breath for ten seconds. After ten seconds, they must take another small breath without exhaling, then hold their breath for five seconds. Again, without exhaling, they must take another small breath and hold their breath for five seconds. Upon exhaling, the hiccups should be gone.
Drinking through a straw with the ears plugged is a folk remedy that can be successful. In 2021, a scientific tool with a similar basis was tested on 249 hiccups subjects; the results were published in the Journal of the American Medical Association (JAMA). This device is named FISST (Forced Inspiratory Suction and Swallow Tool) and branded as " HiccAway"
In Balts, Germans, Hungarians, , Romanians, Slavs, Turkish people, Greeks and Albanians tradition, as well as among some in Kenya, for example in the folklore of the Luo people, it is said that hiccups occur when the person experiencing them is being talked about by someone not present.
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Society and culture
The word hiccup itself was created through Onomatopoeia. The alternative spelling of hiccough results from the association with the word cough.
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