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Hiccups comprise a series of body reactions which end in a flap of flesh, called the epiglottis, clicking shut. Usually harmless, prolonged hiccups can be a sign of a serious underlying condition. APRIL CHONG reports
 Everyone has had embarrassing encounters with hiccups, sometimes at the most inopportune moments. While hiccups usually last a few minutes, in rare cases, they can go on for days, months and even years.
This little inconvenience that strikes without warning is a sudden, forceful contraction of the diaphragm that forces air into the lungs, causing the flap, called the epiglottis, at the upper end of the trachea to click shut.
That is what makes the “hic" sound. The diaphragm is the muscle that separates the chest from the abdomen. The epiglottis is a flap of tissue that sits at the upper end of the trachea (or windpipe) to keep food from entering the trachea when a person is swallowing.
Hiccups can be caused by the irritation of the phrenic and vagus nerves that serve the diaphragm, or by metabolic imbalances, said Dr Ong Kian Chung, a
consultant respiratory physician at eMenders Specialist Medical Care.
Common actions like laughing too hard, eating too fast or the consumption of too much spicy food, alcohol and carbonated drinks can irritate the diaphragm and trigger hiccups.
While they usually go away on their own after a while, some people swear by various home remedies.
Dr Reuben Wong, a consultant at the National University Hospital’s gastroenterology and hepatology department, said he stops his hiccups by drinking water while pinching his nose. He does this until the hiccups go away.
Dr Ong said it is best to breathe in very deeply, then take in a few extra breaths – until one can take in no more – before exhaling completely.
However, these remedies work only for normal hiccups.
Prolonged hiccups are usually linked to medical problems, including renal failure, tumours of the chest or central nervous system and metabolic disorders such as low sodium levels, said Dr Wong.
For example, if a tumour is persistently irritating the diaphragm, the hiccups can go on, either intermittently or
continuously, for a very long time. This can continue until the tumour is removed.
Dr Ong has also observed long bouts of hiccups in cancer patients undergoing chemotherapy. The corticosteroids that control nausea and some chemotherapy drugs are believed to be the culprit.
While the hiccups themselves pose no danger, they can be distressing and disruptive to rest and activities, said Dr Wong.
However, what is more important is to determine the cause of prolonged hiccups, as it can sometimes indicate a serious underlying condition, he added.
The hiccups can be controlled either with medication or physical intervention, such as electrical stimulation of the phrenic nerve via a surgical procedure.
If your hiccups persist for more than a day or two, or is disrupting daily life, see a doctor.
The longest bout of hiccups
American farmer Charles Osborne was well-known for having the longest bout of hiccups.
According to BCC News, his hiccups started in 1922, when he was 28 years old, and continued for a staggering 68 years until 1990.
His doctor believed that a fall had injured a part of his brain resulting in the hiccup response.
It is estimated that Osborne hiccupped 430 million times during those 68 years. However, he still managed to lead a normal life – he got married and had eight children.
He died in 1991 at the age of 97, shortly after his hiccups ceased.
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