Curing Hiccups

Curing hiccups has been a concern of medicine for thousands of years. A passage in the Dialogs of the Greek philosopher Plato records “When Pausainis came to pause, Aristodemus said that the turn of Aristophanes was next, but either he had eaten too much or from some other cause he had the hiccup, and was obliged to change with Eryximachus, the physician, who was reclining on the couch below him. ‘Eryximachus,’ he said, ‘you ought either to stop my hiccup or to speak in my turn until I am better.’ ‘I will do both,’ said Eryximachus, ‘I will speak in your place and do you speak in mine; and while I am speaking, let me recommend that you hold your breath, and if this fails, gargle with a little water; and if the hiccup still continues, tickle your nose with something and sneeze, and if you sneeze once or twice, even the most violent hiccup is sure to go. In the meantime, I will take your turn and you shall take mine.’”

In the twenty-first century, friends continue to help each other control hiccups. Among the more colorful approaches to curing the malady are jumping out of a plane, drinking a glass of water while someone presses the ears closed, counting sheep (and its variation, counting people), tickling the rib cage, kissing, having someone deliver a swift punch to the abdomen (not recommended), swallowing a teaspoon of vinegar and sugar together in one gulp, eating pickled habañero peppers, and smoking marijuana, catnip, and/or fennel (also not recommended). Many traditional remedies for hiccups, however, have a scientific basis and some have even been scientifically tested.

Holding your breath while bearing down on the abdominal muscles opens the stomach slowly and allows gas to escape slowly, circumventing a hiccup. Attempting to imitate a belch will have the same effect.

Angostura Bitters are made from the herb gentian, a plant so bitter that 1 part of gentian in 58,000 parts of water has a disagreeably bitter taste. Their intense bitter taste causes a reflex action by the vagus nerve to secrete fluids into the stomach, altering stomach pressure.

Hiccups sometimes result from hyponatremia, low sodium levels caused by a deficiency of salt in the diet. In the United States, low sodium levels are rare, but taking a pinch of salt in a cup of warm water sometimes help.

Breathing in and out of a paper bag (never use plastic) increases the carbon dioxide (CO2) content of inhaled air. Receptors in the blood vessels respond to changes in CO2 levels by increasing the rate of respiration, interrupting the hiccups cycle.

Stimulating the soft palate activates a cranial nerve controlling the glottis, the “gate” through which hiccups pass. Rubbing the soft palate, letting a spoonful of sugar dissolve in the mouth, or drinking cold water shuts the gate.
Sudden loud sounds are a favorite home remedy for hiccups. Research shows that sounds of an intensity between 70 and 125 decibels, at least as loud as a lawn mower but not quite as loud as sitting in the front row at a rock concert, and a low pitch, about 1000 Hz, are the most likely to break a contraction cycle in the long muscles of the diaphragm that cause hiccups.

Popping a paper bag into which a hiccups sufferer has been breathing in and out interrupts the hiccups cycle in two different ways. The loud, low sound stimulates a new rhythm in the diaphragm, and the sudden movement of air into the lungs resets the vagus nerve.