Chronic hiccups

Title

Other Names:

Intractable singultus; Intractable hiccups; Persistent hiccups; Intractable singultus; Intractable hiccups; Persistent hiccups; Hiccups, intractable See More

Categories:

Digestive Diseases; Nervous System Diseases

Summary Summary

Chronic hiccups are unintentional movements (spasms) of the diaphragm followed by rapid closure of the vocal cords that persist for an extended period of time. Hiccups often develop for no apparent reason and typically go away on their own after a couple minutes. However, chronic hiccups last over two days and in rare cases, may continue for over a month. Hiccups that recur over long periods of time are also considered "chronic." Depending on how long the hiccups last, affected people may become exhausted, dehydrated and/or lose weight due to interruptions in sleep and normal eating patterns. Other complications may include irregular heart beat and gastroesophageal reflux.^[1] The exact underlying cause is often unknown; some cases may be caused by surgery, certain medications and/or a variety of health problems such as central nervous system (brain and spinal cord) abnormalities, psychological problems, conditions that irritate the diaphragm, and metabolic diseases. Treatment of chronic hiccups varies but may include medications and/or surgery.^[2]

Last updated: 12/23/2014

Symptoms Symptoms

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms	Other Names	Learn More: HPO ID
80%-99% of people have these symptoms
Recurrent singultus	Recurrent hiccup	0100247
30%-79% of people have these symptoms
Abnormal eating behavior		0100738
Abnormality of the diaphragm	Diaphragm issues Diaphragmatic defect [ more ]	0000775
Dehydration		0001944
Depressivity	Depression	0000716
Malnutrition		0004395
Sleep disturbance	Difficulty sleeping Trouble sleeping [ more ]	0002360
Weight loss		0001824

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Last updated: 3/1/2019

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Cause Cause

Although the exact underlying cause of chronic hiccups is often unknown, many factors can contribute to the development of hiccups. For example, common triggers for hiccups include hot or spicy foods and liquids; harmful fumes; surgery; and/or certain medications.^[3] Chronic hiccups can also be associated with a variety of health problems including:^[1]^[2]

Pneumonia, pleurisy and other conditions that irritate the diaphragm
Brain abnormalities (i.e. strokes, tumors, injuries, infections)
Metabolic disorders
Gastrointestinal (esophagus, stomach, small/large intestines) diseases
Psychological problems such as hysteria, shock, fear, and personality disorders
Liver abnormalities
Kidney disorders

For a comprehensive listings of factors that can cause chronic hiccups, please click here.

Last updated: 12/23/2014

Inheritance Inheritance

Chronic hiccups are not thought to be inherited. Most cases occur sporadically in people with no family history of the condition.^[2]

Last updated: 8/24/2015

Diagnosis Diagnosis

A diagnosis of chronic hiccups is usually obvious based on symptoms. However, a complete physical exam with various laboratory tests and imaging studies (i.e. chest X-ray, CT scan, MRI scan, and/or fluoroscopy of the diaphragm) may be performed to determine the underlying cause.^[1]^[2]

For more information about the workup and diagnosis of chronic hiccups, please click here.

Last updated: 12/24/2014

Treatment Treatment

Treatment for chronic hiccups often varies based on the underlying cause. In many cases, medications can be prescribed to treat chronic hiccups. These may include:^[1]^[2]

Tranquilizers such as chlorpromazine and haloperidol
Muscle relaxants
Anticonvulsant agents including phenytoin, valproic acid, and carbamazepine
Sedatives
Pain medications
Stimulants

Rarely, medications may not be effective in the treatment of chronic hiccups. In these cases, surgery to temporarily or permanently block the phrenic nerve may be performed. The phrenic nerve controls the diaphragm.^[2]

Last updated: 12/24/2014

Prognosis Prognosis

The long-term outlook (prognosis) for people with chronic hiccups depends on the cause. Chronic hiccups are often associated with underlying medical conditions that vary in severity.^[2]

Depending on how long the hiccups last, affected people may experience the following complications regardless of the underlying cause:^[1]^[2]

Irregular heartbeat
Gastroesophageal reflux
Exhaustion
Dehydration
Weight loss

Last updated: 12/24/2014

Related Diseases Related Diseases

Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
Hiccups are extremely specific and can rarely be mistaken for another condition. Visit the Orphanet disease page for more information.

Research Research

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

Orphanet lists European clinical trials, research studies, and patient registries enrolling people with this condition.

Learn More Learn More

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
The Merck Manual provides information on this condition for patients and caregivers.
The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
The Merck Manual for health care professionals provides information on Chronic hiccups.
The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
PubMed is a searchable database of medical literature and lists journal articles that discuss Chronic hiccups. Click on the link to view a sample search on this topic.

Selected Full-Text Journal Articles

Kohse EK, Hollmann MW, Bardenheuer HJ, Kessler, J. Chronic Hiccups: An Underestimated Problem. Anesthesia & Analgesia: 2017 Oct;125(4):1169-1183.

GARD Answers GARD Answers

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

My friend has chronic hiccups. His doctors have discovered tumors near his phrenic nerve and suspect that this may be the cause. They have recommended a number of different drug therapies, but nothing has worked. Has there been others with cases like his? See answer
I have experienced several bouts of hiccups that go on for several weeks to months with no relief. I have had all of the normal tests to determine a cause, but no cause has been identified. I also have other stomach problems. What causes intractable hiccups? What tests may be conducted to determine the underlying cause of intractable hiccups? Can intractable hiccups be related to other stomach problems? How might intractable hiccups be treated? See answer

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