Persistent hiccups

Category: Lungs & Breathing · All lungs & breathing symptoms

What it can feel like

Hiccups are sudden, involuntary contractions of the diaphragm followed by a snap shut of the vocal cords — the familiar 'hic'. Most attacks pass in minutes. Hiccups lasting more than 48 hours, or returning frequently, are unusual enough to deserve a medical look.

Possible causes

A symptom can have many causes, and most are not serious. The lists below group conditions this symptom can be associated with — common causes first. They are possibilities to discuss with a clinician, not a diagnosis.

Common causes

Short attacks can be associated with eating quickly, fizzy drinks, alcohol, excitement and a very full stomach. Longer bouts can follow stomach distension or reflux irritation of the diaphragm's nerves.

Other possible causes

Persistent hiccups can be associated with irritation of the vagus or phrenic nerves by conditions of the chest, neck or abdomen, with some medicines, with metabolic disturbances such as kidney failure, and occasionally with conditions affecting the brainstem.

Red flags — when to seek help promptly

Hiccups lasting more than 48 hours
Hiccups with vomiting, weight loss or difficulty swallowing
Hiccups that prevent sleeping or eating
Hiccups together with weakness, numbness or other new neurological symptoms

What a clinician may do

A clinician will ask about duration, triggers, reflux, medicines and alcohol, and examine your ears, neck, chest and abdomen. Blood tests check salts and kidney function, and a chest X-ray or further imaging follows if no simple cause emerges.

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Frequently asked questions

Why do hiccups happen at all?

Hiccups are a reflex arc: sensors in the chest and abdomen send signals along the vagus and phrenic nerves to the brainstem, which fires the diaphragm. Anything irritating that loop — a stretched stomach is the classic — can set it off.

Do home remedies work?

Breath-holding, cold water and other remedies aim to interrupt the reflex and sometimes work for short attacks. Hiccups beyond 48 hours have usually outlasted home remedies and deserve a proper assessment for an underlying cause.

Related symptoms — Lungs & Breathing

Breathlessness Bringing up phlegm Chest infections that keep coming back Cough Coughing up blood Noisy breathing

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Please note: This page is educational information about a symptom. A symptom alone cannot diagnose any condition, and the causes listed here are possibilities, not a diagnosis. If you are worried about a symptom — especially one that is new, severe, getting worse or not going away — please see your own clinician, who can examine you and arrange tests. In an emergency, call your local emergency number.