Sunday 28 September 2014

Hiccups - and their cure

This post is a re-publication of an article I posted on my website many years ago.  I have used the cure below successfully many times on many people. I am yet to find a case of hiccups this will not cure.

Health Warning - I am no medical expert, please consult one if you need assistance. If you have good cause to enlighten me, please comment below.  I will gladly consider warranted corrections.

There is quite a mystery about hiccups. Medical knowledge seems to be rather limited about their causes, and cures. So it is not surprising that many home remedies remain popular, even if they blatantly don't work.

Have you ever been shocked out of your hiccups? If so, please comment below.

Conventional wisdom on hiccups
According to the NHS, hiccups "don't seem to have a useful purpose". This can be translated as "we haven't a clue what they're for".

According to the Phylogenetic hypothesis, hiccups are an evolutionary remnant of earlier amphibian respiration. That's only 250 million years out of date then.

Short term verses persistent hiccups
As far as I know we all get short term hiccups. These are sometimes humorous, sometimes irritating. This page deals with short term hiccups.

However there is a rare but more sinister version which is not humorous at all. Persistent hiccups are those which continue for longer than 48 hours and these usually result from an underlying medical cause. They can be positively debilitating and can prevent the sufferer from working, sleeping, eating and performing many ordinary functions of life. If you have hiccups which last for longer than 48 hours, please seek medical advice without further delay.

My Hypothesis
Mammals appear to be unique among vertebrates in that we can breath while we feed.  This is essential for infants suckling, and has the nutritional advantage that we can take time to chew our food. Reptiles and birds can do neither of these, and must swallow chunks of food whole, which means that their food takes longer to digest.  However, breathing while we feed does not come without added complexity.

Hiccups seem to be associated with the phasing of swallowing and breathing in mammals. Swallowing is a complex process which involves four different neurological mechanisms which must be correctly coordinated to enable a bolus to pass from the mouth to the oesophagus without entering the trachea. If we fail to close the trachea we risk aspirating part of the bolus into the trachea which we know as "going down the wrong way" and produces a powerful cough reflex to clear the airway. In extreme cases, a piece of food can block the trachea which causes choking.

Normally we unconsciously time our swallow to occur at the moment when we have fully inhaled, and momentarily hold our breath while the epiglottis closes our airway and the bolus passes cleanly into the oesophagus. This allows us to remain fully oxygenated during swallowing, and prevents us from aspirating which may happen if we inhaled as we swallowed. It also ensures we have a lungful of air in case we get it wrong and need a good strong cough.

My hypothesis is that failing to synchronise swallowing with inhaled breath-holding risks causing spasms, which present as hiccups, and that re-synchronising swallowing with inhaled breath-holding can cure hiccups.

Supporting Evidence
Many causes of hiccups are given in the usual references. A great many of them are associated with mis-phasing our swallowing and breathing. Let's examine some of the commonly cited causes of hiccups. All of these involve a disruption in the ordered synchronisation to our swallowing and breathing. It is important to remember that we swallow not only when we eat or drink, but regularly swallow saliva unconsciously.

Commonly Cited Cause My Explanation
Eating or drinking quickly If we eat too quickly we swallow too soon rather than at peak inhalation.
Alcohol Alcohol produces a general loss of coordination which is required to synchronise swallowing with breathing.
Sudden excitement or shock Excitement or shock can cause an involuntary inhalation which can interrupt our synchronisation.
A sudden change in temperature This can cause a shock induced inhalation.
Spicy food Surprising food taste or temperature can also cause a shock induced inhalation.
Carbonated (fizzy) drinks Fizzy drinks commonly cause regurgitated air (burping) which interrupts both swallowing and breathing functions.
Swallowing air Swallowing air also causes regurgitation (burping).
Smoking Smokers often exhale while drawing smoke into their mouth. Tobacco smoke promotes salivation and if the smoker swallows immediately prior to inhaling the smoke then the swallow will occur during full exhalation. This is exactly opposite to our normal synchronisation.
The other major piece of supporting evidence is the success of the cure as described below which aims to resynchronise swallowing and breathing functions.

None of the above qualifies as scientific evidence. The first is is hypothetical narrative; the second is anecdote. I would be most interested in supporting any proposed scientific evaluation of my cure.

Billy's Hiccup Cure
Billy's cure simply involves relaxing and resynchronising breathing and swallowing. It's a simple step-by-step process which I've found to work with many people, particularly children.
  1. Sit somewhere quiet and calm.
  2. Breath in SLOWLY until your chest is full.
  3. Breath out SLOWLY until your chest is empty.
  4. Breath in SLOWLY until your chest is full and hold your breath.
  5. Swallow three times.
  6. Breath out SLOWLY until your chest is empty.
  7. Gently breath again normally.
  8. If you still hiccup, repeat the process once more.

Does this work for you? If so then pass it on. If it doesn't, then do please let me know by commenting, telling me what happened and what worked in the end.