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Genetic and Rare Diseases Information Center (GARD)

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Chronic hiccups

Other Names for this Disease
  • Hiccups, intractable
  • Intractable hiccups
  • Intractable singultus
  • Persistent hiccups
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What are chronic hiccups?

What causes chronic hiccups?

How might chronic hiccups be treated?

What are chronic hiccups?

Chronic hiccups are hiccups that persist for a long period of time or recur frequently over an extended period of time.[1][2] A hiccup is an unintentional movement (spasm) of the diaphragm, the muscle at the base of the lungs. The spasm is followed by the rapid closure of the vocal cords, which produces a distinctive sound.[3][1] Hiccups often start for no apparent reason and usually disappear after a few minutes.[3] Hiccups that last for more than two days and less than a month are sometimes called persistent or protracted hiccups. On rare occasions, hiccups persist even longer than a month or recur frequently over an extended period of time, and are called intractable hiccups.[1][2] Intractable hiccups are difficult to treat and often indicate the presence of another medical problem.[1][4][5]
Last updated: 6/21/2013

What causes chronic hiccups?

Hiccups occur when the diaphragm becomes irritated. Some things that irritate the diaphragm are eating too quickly or too much, an irritation in the stomach or the throat, or feeling nervous or excited.[5] In many cases, there is no obvious cause (idiopathic).[3][2]

Some additional causes include:[3][2]
  • Abdominal surgery
  • Any disease or disorder that irritates the nerves that control the diaphragm (such as pleurisy or pneumonia)
  • Hot and spicy foods or liquids
  • Noxious fumes
  • Stroke or tumor affecting the 'hiccup center' in the brain
  • Use of alcohol and/or tobacco in excess

There are many known causes of chronic hiccups, among which the most prominent is esophagitis due to gastroesophageal reflux (GERD).[4][6] Other cases occur in association with central nervous system problems or result from serious pathophysiological processes affecting a component of the hiccup reflex mechanism.[4][2][6] A full systemic inquiry, surgical history, and comprehensive drug history may reveal one of the many causes.[2]

You can click on the links below to access comprehensive listings of the causes of chronic hiccups.
Last updated: 2/20/2012

How might chronic hiccups be treated?

The treatment of chronic hiccups depends on the cause. Hiccups associated with gastroesophageal reflux may be treated with antacids and omeprazole. Those found in association with central nervous system problems may be treated with Baclofen.[4] Other medications which may be used include chlorpromazine, gabapentin, valproate, and lidocaine bolus.[7] Very rarely, medical methods fail to treat persistent hiccups. Further treatment may include a phrenic nerve block. The phrenic nerve controls the diaphragm.[3]
Last updated: 2/20/2012

  1. Hiccups, Chronic. National Organization for Rare Disorders (NORD). 2005; Accessed 11/28/2011.
  2. Wilkes G. Hiccups. eMedicine. July 2010; Accessed 11/28/2011.
  3. Vorvick L. Hiccups. MedlinePlus. January 2011; Accessed 11/28/2011.
  4. Cabane J. Chronic hiccup. Orphanet. 2004; Accessed 11/28/2011.
  5. What Causes Hiccups?. KidsHealth from Nemours. October 2011; Accessed 11/28/2011.
  6. Cabane J. Chronic hiccup. Orphanet . July 2004; Accessed 11/28/2011.
  7. Lierz P, Felleiter P. Anesthesia as Therapy for Persistent Hiccups. Anestesia & Analgesia. 2002; Accessed 11/28/2011.