Hiccups are involuntary muscular spasms originating in the diaphragm. Most hiccups appear without any apparent reason and disappear on their own within a few minutes. But when they continue for more than two days but less than a month, the condition is referred to as persistent hiccups. However, in rare cases, they might continue for over one month or recur at frequent intervals over a longer span of time, they’re called chronic hiccups.

Certain incidences of persistent hiccups may be more than a harmless case of repetitive muscular spasms of the diaphragm. They may be the underlying cause of certain other medical conditions or lifestyle habits, which we will discuss later in the article.

Chronic hiccups are unintentional spasmodic contractions of the diaphragm, immediately succeeded by rapid closure of the vocal cords. This condition continues for a prolonged period of more than 2 months.

Hiccups are a symptom that is rarely mistaken for anything else. In the case of chronic hiccups, they can affect the appetite and sleep of an individual, causing many other symptoms.

The possible symptoms accompanying this medical condition are:

• Dehydration
• Fatigue and exhaustion
• Weight loss
• Disrupted sleep or sleeplessness
• Disruption of normal eating patterns
• Irregular heartbeats
• Gastroesophageal reflux (GERD)

Causes of Chronic Hiccups

The underlying cause of this medical condition is unclear. It is believed that the following medical conditions and lifestyle disorders may result in chronic hiccups:

• Pneumonia
• Pleurisy and other disorders associated with irritation of the diaphragm
• Kidney diseases
• Gastrointestinal disorders related to small or large intestine, stomach, and esophagus
• Liver diseases
• Brain conditions like infections, injuries, tumours, stroke, etc.
• Disorders of the central nervous system (CNS)
• Metabolic disorders
• Uremia
• Diseases associated with bowel movements
• Psychological abnormalities like personality disorders, hysteria, fear, shock, etc.
• Alcoholism
• Certain surgeries

The diagnostic procedure for the medical condition usually follows a combination of physical examination, questions about the medical history, followed by medical tests.

Let’s take a closer look at the procedure:

Physical examination

The doctor will conduct a thorough check of the diaphragm and the nearby organs. They may use a stethoscope to analyze the presence of abnormalities in breathing movements, esophagus, and the surrounding organs.

Investigation of medical history

The doctor is likely to investigate your personal medical history to find out the cause of chronic hiccups.

The doctor may also take a closer look at the medications that you are taking or have taken. Make sure to carry all your medical documents that record the history of your personal medical conditions and drug intake.

Tell your doctor all of your medications, like non-prescription or OTC (over-the-counter) medications, herbals, vitamins, and supplements. This is important for the doctor to evaluate whether your symptoms may be due to drug interactions.

Treatment of Chronic Hiccups

Treatment of this medical condition is generally determined by the underlying cause of the condition, its severity, types of other symptoms, etc. The available treatment options are:

Medications

Tranquilisers like chlorpromazine, metoclopramide, and haloperidol is one of the most prescribed drug therapies for chronic hiccups. Muscle relaxants or pain relievers are another line of treatment.

Anticonvulsant agents including phenytoin, valproic acid, and carbamazepine. At other times, sedatives and stimulants are also possible treatment options.

Alternative treatments

Acupuncture and hypnosis are alternative therapies that may be recommended.

Surgery

This is kept as the last treatment option since medications mostly work effectively in treating incidences of chronic hiccups.

Surgery involves blocking the phrenic nerve permanently or temporarily through the administration of an injection. This nerve controls the diaphragm. There is another surgical procedure that involves cutting off the nerve from the neck.