In Depth
Health
The medical mystery that is the hiccups
Last Updated March 2007
By Steve Morales, CBC News
Jennifer Mee, 15, right, and her mother, Rachel Robidoux, wait to appear on a Florida TV show. Her hiccups finally stopped after five weeks. (Carrie Pratt/St. Petersburg Times)
Over time, everyone gets the hiccups. They come and go and, while they can be somewhat annoying, they're not really a big problem.
Usually.
But try telling that to Jennifer Mee, the 15-year-old Florida girl who made headlines last month after appearing on NBC's Today Show with a three-week-long case of the hiccups.
Mee had been hiccupping since Jan. 23 at a rate of nearly 50 per minute. They only stopped when she slept or was talking. She visited an infectious disease specialist, a neurologist and a chiropractor. She tried hypnotism and acupuncture. She even drank a glass of pickle juice.
Nothing worked.
Theories abound about the cause of hiccups. Spicy food, stress, laughter and drunkenness are just a few of the suspected culprits. Some suggest they are symptoms of more severe medical conditions, ranging from an electrolyte imbalance to kidney disease. A significant number of chemotherapy patients experience them as a side effect.
But Mee was just sitting in science class when they started. She has no medical problems.
So what causes hiccups?
An involuntary spasm
Dr. John Fisher, a professor of respiratory physiology at Queen's University in Kingston, Ont., says no one really knows.
"Some people have hiccups for inordinate lengths of time and what makes them initiate and what makes them stop is not entirely clear," he admits.
The good news, though, is that what happens during a hiccup, at least, is well understood.
When you hiccup, a spasm contracts the diaphragm, causing an intake of breath that is suddenly stopped by the closure of the glottis, that part of the larynx where the vocal chords are located. This closure produces that old familiar sound.
"Hic!"
Cures?
There's no shortage of suggested cures. Try typing "hiccup cures" into an internet search engine, and you'll quickly find hundreds of recommended treatments. A random sample reveals a great range of cures from the tame to the ridiculous. Some sources will suggest the following:
- Quickly drink a glass of water (plugged ears optional).
- Swallow a spoonful of sugar.
- Take two quick swallows of white vinegar straight out of the bottle.
- Hold your breath, hyperventilate, swallow air or belch.
- A punch in the stomach.
- Hold your breath and think of four animals that begin with the letter F.
- A dose of the anti-psychotic drug Thorazine.
- Slide a well-greased length of thin, flexible rubber tubing through one nostril to the point where it just barely touches the back of the throat.
In desperation, Mee eventually tried some of the more stomach-churning cures, including a mouthful of mustard, vinegar and the pickle juice, to no avail.
There are some commercial gadgets that promise a cure as well. They include the Hic-Cup and the VNS Pulse Duo, a device that stimulates the vagus nerve, the one that starts in the brain stem and extends down through the jugular to the stomach.
Dr. Fisher says drinking water is one of your better bets, but it's hardly a guarantee.
"If you think about water, regardless of whether it works particularly well or not, at least you can come up with a hypothesis about why it might work," he says. "The water approach would result in the inhibition of the inspiratory muscles so might result in the resetting of the respiratory controller in a way that allows the upper airway and the lower airway to be coordinated and to suppress the hiccups."
In fact, most cures that involve water or breathing are logical, if not medically proven.
"Holding your breath, putting your face in water and a few other things associated with diving reflexes could work," he says.
"But they're all pretty much old wives' tales."
Some people maintain that a good scare will shock you out of your hiccups, but make sure to keep the scare tactics reasonable. In January 2006, a Colombian man tried to scare his nephew by threatening him with a handgun. The gun went off, killing the young man. Distraught, his uncle then shot himself.
Combination therapies
On Feb. 28, 2007, Jennifer Mee's hiccups finally stopped. Typical of their mysterious origin, she doesn't know why they stopped, although she attributed it to a combination of acupuncture, chiropractic work, hypnotism and a Hic-Cup machine.
She was by no means the longest case on record. As of March 1, 2007, Jaime Molisee of Jacksonville, Fla., had been hiccupping for eight months, pretty much straight.
Herman Long of Sacramento, Calif. has suffered hiccupping spells since the late 1990s, some severe enough to land him in hospital. While rare, doctors have reported cases that have gone on for decades.
Thankfully, most people will never endure such marathon hiccupping or even need to go to the length Mee did to cure hers. But her efforts nonetheless hold a valuable lesson for others: Don't drink the pickle juice. It doesn't work and it tastes pretty awful.
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