Hiccups that will not stop: what causes them and what helps

MedlinePlus describes a hiccup as an unintentional movement, a spasm, of the diaphragm. The diaphragm is the sheet of muscle at the base of your lungs that drives your breathing.

The muscle contracts suddenly. Your vocal cords snap shut right after. That closure is what makes the noise.

Once a day at dinner, this is a joke. Once every few seconds for two days, it stops being funny. It interferes with eating, with talking and with sleep, and people going through cancer treatment have limited reserves for that kind of interruption.

The triggers MedlinePlus lists are a mixed bag:

• Hot and spicy foods or liquids
• Abdominal surgery
• Nerve irritation, from conditions such as pneumonia or pleurisy
• Harmful fumes
• Stroke or brain tumors
• Often, no cause that anyone can identify

Three of those overlap with a cancer journey in obvious ways. Abdominal surgery is on the list. So is nerve irritation from lung inflammation. So are brain tumors.

Worth being straight about: the MedlinePlus page does not name chemotherapy drugs or steroid medicines as causes of hiccups. Plenty of people in treatment report them, and your own oncology team may well have seen a pattern with a specific drug. But we are not going to put a claim in writing that our source does not make. Ask your team directly, because they know your regimen.

MedlinePlus lists four self-help approaches that may bring relief:

• Breathing into a paper bag
• Drinking cold water
• Swallowing a teaspoon of sugar
• Holding your breath

There is no ranking, and no promise attached. They are cheap and quick, which is most of their appeal. If one works for you, use it.

If you are on a fluid restriction, a modified diet, or recovering from surgery on your mouth, throat or abdomen, check with your team before swallowing sugar or gulping cold water. What is harmless for most people is not automatically harmless for you right now.

MedlinePlus draws the line clearly: contact a healthcare provider if hiccups go on for more than a few days.

That is a reasonable trigger to phone in. Hiccups that have run for days are wearing you down, and they may also be pointing at something worth investigating, given that nerve irritation and other conditions are on the cause list.

For hiccups that will not quit, MedlinePlus lists several options providers may turn to:

• Gastric lavage, which means washing out the stomach
• Carotid sinus massage, which is done only by a provider and never by you at home
• Medications
• Nasogastric intubation, a thin tube passed through the nose into the stomach
• A phrenic nerve block, used in rare cases

That last one targets the nerve that runs the diaphragm. It is at the far end of the list for a reason.

The useful takeaway is that persistent hiccups are treatable. People sometimes suffer through them for weeks because they assume nothing can be done, or because it feels like too trivial a thing to raise when your team is dealing with your cancer. It is not trivial if it is stopping you eating and sleeping, and there are things to try.

Note when they started, roughly how long each bout lasts, whether anything makes them better or worse, and what they are costing you. If they are keeping you from finishing meals or from sleeping through the night, say so in those words. That is the detail that moves hiccups from a footnote to something your team acts on.