Image Credit: Nadine Shaabana / Unsplash. This image has been modified

How to Treat Hiccups

Nearly everyone has experienced hiccups, but what exactly are they? It used to be thought that a hiccup is just a simple muscle spasm of the diaphragm, but that was apparently disproven more than 40 years ago. Instead, hiccups involve a complex, orchestrated pattern of muscle contractions. But, why?

Hiccups might be a leftover from the womb. During fetal life, “hiccups are universally present, their incidence peaking in the third trimester…[This] suggest[s] that hiccups might represent a necessary and vital primitive reflex” that would permit in-the-womb training of the breathing muscles without choking on amniotic fluid.

In adulthood, nearly anything can trigger hiccups. Case in point: A 19-year-old woman presented with persistent hiccups. Her physical exam was normal except for an ant crawling on her eardrum. Once the ant was removed, her hiccups stopped.

There appear to be as many cures for hiccups as there are causes, as I discuss in my video How to Stop Hiccups. As the famous Dr. Mayo put it, the less we know about something, the more treatments we seem to have for it—and perhaps “there is no disease which has had more forms of treatments…than has persistent hiccups.”

There are drugs, of course. There are always lots of drugs, from thorazine to apomorphine, but there are also a whole slew of non-pharmacological approaches—from breathing into a paper bag and drinking from the far side of a glass to smearing mustard on your tummy (as you can see at 1:24 in my video). “Many of these ‘remedies’ have not been tested and some appear to have been invented ‘purely for the amusement of the patient’s friends’.” One method, “forcible traction of the tongue” (which means pulling on someone’s tongue) was attributed to the great Dr. Osler, the first Chief Physician at Johns Hopkins Hospital, but the “therapy, however, is much older and (perhaps not surprisingly) of French origin.”

Another trick that might work to cure hiccups is “a modified Heimlich maneuver,” consisting of just three thrusts and moderate pressure. In one instance, it was so successful the patient’s “hiccups ceased immediately.” In general, however, “[t]reatment is notably disappointing, as is evidenced by the hundreds of remedies have been tried, none of which have been regularly curative.” You know doctors are starting to get desperate when they suggest things like chilling the ear lobe, and you know they are really getting desperate when they have to add prayer to the end of a miscellaneous hiccup cures list.

“Use of vinegar to relieve persistent hiccups in an advanced cancer patient” was the paper that started me down the hiccup rabbit hole. I was reviewing the latest research on vinegar and stumbled across a case where, “[a]fter the failure of common treatments for hiccups, the patient was given a sip of vinegar and his hiccups abated”—stopped after just a single sip. Evidently, sour tastes, such as vinegar and lemon, have been used to treat hiccups since the 1930s, but “nonpharmacological remedies such as vinegar…fell out of favor with the widespread use of pharmacotherapy,” that is, drugs. After all, how much can you charge for a sip of vinegar?

If worse comes to worst, there is the “phrenic nerve crush” surgery, which is as bad as it sounds. Before going that route, though, you may find it “surprising how many patients with hiccups respond to digital compression of the eyeballs.” Yes, we’re talking about digit as in finger, as in pushing your finger into someone’s eyes as a counter-irritation measure. That will get their mind off their hiccups!

If a finger in the eye somehow doesn’t distract them enough, doctors can try “digital rectal massage.” A 27-year-old man presented to the ER with “intractable hiccups.” Emergency staff tried massaging other places and even tried the digital eyeball compression, but nothing seemed to do it. So, bend over. “Digital rectal massage was then attempted using a slow circumferential motion”—and it worked! So, before giving patients drugs, maybe we would give them a massage. It’s “easy to perform” and may be less dangerous than sticking your fingers into people’s eye sockets, which, if you’re in medical school and have to memorize all these ridiculous names, is known as the Dagnini-Aschner Maneuver. (Medicine loves its eponyms.)

Speaking of maneuvers, how’s this for a pick-up line? “Hello. (Hic!) Want to help me (hic!) cure my hiccups?” In one case, on the fourth day of continuous hiccuping, the patient’s hiccups finally “suddenly and completely ceased,” with some spousal help, at the point of climax. “It is unclear,” the doctor wrote, “whether orgasm in women leads to a similar resolution, an issue that could be investigated further.” 

And it was, back in 1845. An infamous, disturbing case report that amounted to effectively bragging about sexual assault was published in what was to be become the New England Journal of Medicine. A young, religious woman with intractable hiccups fell into the hands of a Dr. George Dexter. He first attempted the best modern medicine could offer—bloodletting—but she continued to hiccup, until he pressed his hand on her genitals for a few minutes and that apparently worked. This went on for month after month, with the doctor frequently calling in his colleagues to show them this “singular phenomena.”

Who was this guy? “Although his interaction with the young female patient would not meet today’s ethical standards”—you could say that again!—“his medical observation was valid…” Even though rectal massage and sexual stimulation may help, “this kind of recommendation is reserved for carefully selected patients!”


DO NOT drink vinegar straight. In this blog, I talked about taking a tiny sip, not full-on drinking it. If you do drink instead of sip, you can make the problem worse, as I discuss in my video Vinegar Mechanisms and Side Effects. Vinegar can be great stuff, though. Check out my video series to find out why I include it in my own family’s daily diet:

There’s another way to treat hiccups—one that I’ve used myself since I was a kid. Since then, I’ve never had more than one or two hiccups because I can stop them in their tracks. Learn my trick in my video How to Strengthen the Mind-Body Connection.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Discuss

Michael Greger M.D., FACLM

Michael Greger, M.D. FACLM, is a physician, New York Times bestselling author, and internationally recognized professional speaker on a number of important public health issues. Dr. Greger has lectured at the Conference on World Affairs, the National Institutes of Health, and the International Bird Flu Summit, testified before Congress, appeared on The Dr. Oz Show and The Colbert Report, and was invited as an expert witness in defense of Oprah Winfrey at the infamous "meat defamation" trial.


62 responses to “How to Treat Hiccups

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  1. You mean they have drugs for these things? It figures. The BOO! effect used to work on me. An other option was simply holding my breath until I slowly counted to ten. Or touching my toes while thinking of something other than hiccoughs. Haven’t had them for many a year, though. Yikes, it must be awful to have them for a long time.

    The gal in the pic has really long fingers. I wish I could read palms. :-)

    https://www.realsimple.com/work-life/life-strategies/palm-reading-guide

    1. I taught high school for 34 years and frequently would have students with observable hiccups asked to be excused to get a drink of water. I would say “I don’t think you have hiccups. Show me! Come on hiccup for me.” When they consciously tried to hiccup, the couldn’t and would exclaim “how did you do that?”
      This is purely anecdotal, but, perhaps since hiccuping seems to be a spontaneous, autonomic response to a stimulus, focusing the conscious mind on eliciting a hiccup, breaks the circuit much as other stimuli Dr. Gregor cites.

      1. Michael G Cassidy,

        I’ve had a similar experience: when I have hiccups (which is rare), I focus on them, trying to figure out exactly which muscles are involved. Within a short period of time, they are gone. And I haven’t been able to figure out which muscles are involved.

    2. All you have to do is swallow water just before and during the next hiccup. Hiccups usually have a rhythm to them. Get some water and start drinking even little sips will do it. The point is to be swallowing as the hiccup tries to get through. I take little amounts as as fast as I can. It works the first time every time.

      1. Little sips of water from the opposite side of the glass by leaning over. Best over a sink to avoid spillage, but it works every time.

      2. Many years ago when I was visiting an aunt and uncle I had hiccups. Uncle Tony told me to put some warm water in a glass and take three sips, but do not inhale or exhale between swallows. Work like a charm every time I had hiccups in the future. Have not had them in a very long time.

    3. YR, regarding your comment: “The gal in the pic has really long fingers. I wish I could read palms. :-)”

      I tried reading the palm of the lady in the picture and all her hand lines say is that this lady probably has the hiccups ;-)

    4. Another bartender’s trick is several dashes of bitters on a wedge of lime. I never seen it fail to stop them. And I’ve seen a lot of hiccups!

  2. As a person who suffered more often I liked with hiccups, I figured out years ago that when I was sleeping I never got them, or they went away. So my solution, which has worked every time and with every person I’ve ever told about it, has been to “fool” them by pretending I’m going to sleep! Lying on a bed is one way, but this can be done in a pinch by lying on the floor or even slumping in my chair, closing my eyes, and relaxing. Works for me!

    1. Eat a big scoop of peanut butter whe. You get them and they instantly go away. Simple, safe, easy. I’ve never seen it not work in my 55 years.

  3. Holding one’s breath whilst doing a few sit-ups works every time for me. I told my kids it worked for me and now it works for them too. No idea why ‍♀️.

    1. Kim,

      We always did the holding our breath thing, too. Not doing the sit-ups, but even without the sit-ups, holding one’s breath as long as possible a few times seemed to help.

  4. For hiccups i take a huge intake of air, when I think it’s enough, I take another gulp-inhale and hold my breath for as long as possible. Only a couple of times have I had to do this twice. This air intake and hold method always works for me.

    1. Works for me too! Was going to write the comment myself, as this absolutely always works for me. I just take a deep breath, hold it for as long as I can, and when I finally have to breathe out, it’s gone! Without a fail!

    2. Yes, that has worked for me too. But I have observed that I only get the hiccups when I’m not taking my magnesium regularly. Magnesium helps relax muscles and we tend to get muscle spasms when low in magnesium (but also potassium).

  5. Hiccups is a “Salt deficiency”

    (This is a bit strange, one website I have been to said “nobody knows what courses hiccups”, but when I give anybody my following story, there is proof people enjoy the warmth of their head in the sand)

    For many years I have often suffered from hiccups from time to time, now I know the reason it is because we are often told salt causes high blood pressure, so I have always had none or reduced salt whenever I can as opposed to shoving on heaps of salt, like I see some people do without even tasting their meal, for them salt goes on first.

    A few years ago (2017) I got a mineral & heavy metal test just to check up heavy metals that can contribute to Alzheimer and my very boring diet, mainly mixed vegetables in the morning & mixed fruit at lunch with rolled oats, to carry me through to the next day breakfast. B.T.W. It has been said if you can not go a few hours without food, you are a sugar burner, but if you can go a lot longer than a few hours without meals, your body is a fat burner.

    It was the worse report I have ever seen, The results was reasonably good, as some of the results tied in with results from other tests. But what they assumed in the report was rubbish. Like they accused me of having too much processed “toxic” refined table salt and suggested healthy salt, I never go near toxic salt and try and stay away from food loaded with salt (it has been said there is only one place for processed salt, and that is in the rubbish bin), As I had both the Sodium & Iodine was in the OK high border range. I get my Iodine from a packet a day of “Dried seaweed” It has been said that no salt in the diet gives high blood pressure, but that could be more “Isolated Systolic Hypertension” that is the 40 mmHg gap difference between the diastolic and the systolic reading is higher than 40. when it should always be 40, while too much processed salt gives high blood pressure as well. I have been told that a overdose in healthy salt is safe and would not cause high blood pressure, however I think with everything moderation should always be a good rule to use.

    Towards the end of last year (2018) I decided to try another mineral & heavy metal test just for results, and see if there was much reduction in heavy metals. So I cut back on a little salt just to see how the sodium results would be, but still had my dried seaweed. That would prove there report is wrong when the iodine is still much the same but a reduced sodium result.
    A few weeks later before I had the repeat mineral & heavy metal test, I had the worse hiccup attack I have ever had in my life, just about the whole warm spring-summer afternoon I had hiccups, as soon as it stopped half a hour later it started again, as I quickly rushed off to catch public transport I thought “its like something is missing from my diet”, later on that night when I had more time to think, I thought the only difference between my diet now and a month or so before I reduced my salt intake, so I added more salt back into my diet, a week or so later I had one hiccup, as I was sitting next to a bag of Celtic salt at the time, I put a few grains of salt on my tongue, then some water and the hiccups was gone. It is the fastest cure I have ever had, and to put it blunt the only cure I found that works. While I am sure the salt is the cure, it seems you must have a bit of water for the hiccups to stop.
    It has only failed once, when I tried to shift my drinking from late afternoon to the morning to avoid toilet visits half way in the night, so I must of drunk a few glasses of water too quick (I am aware that death can happen drinking too much water too fast) maybe one should dose up on a bit of salt before trying to drink more water, to often than normal.

  6. Slowly sucking on a spoonful of white sugar and letting it melt down the back of your throat has never not instantly worked for me and everyone I’ve ever told to try it. just a spoonful of sugar helps the hiccups go away…

  7. I have been curing my own hiccups easily for over 50 years. It just requires a glass of water. Take a sip, tip your head back, then open your throat. Do this three times in a row. Done. It has worked every time (sometimes it takes two tries) for me and I’m over 60. One of my sisters taught me this when I was just a little thing. Try it!

  8. Hiccups 100% cured every time with a sincere and “deeply loving” make out session with my spouse. For the last 20 years. I’ve always figured the kiss was engaging the parasympathetic system, thereby calming whatever was jostling was going on inside. Never fails.

  9. I haven’t had the hiccups since I was a young person.

    Maybe becoming allergic to meat got rid of them?

    I looked it up and several people asked, “Why do I get hiccups after eating red meat?” so maybe I got rid of whatever was triggering them.

    When I was young I remember having them for so long that I started crying and hiccuping at the same time thinking I would never be able to get rid of them.

    Good news, they went away and I pretty much never had them again.

  10. I must admit that I had to read this one a few times because it was challenging to believe the words that I was reading.

    I am pretty sure I have already forgotten what DAM stands for and will actively work on never remembering it again.

    I would be punching out the doctors.

    Maybe not because I am a Christian now an older, but if they try any of those things, there is going to be some great big misunderstandings and COVID has me seeing all of these sweet doctors but I used to beat up bullies as a child through junior high school. A bully came to our bus stop to try to beat up my brother and when my father drove by, he saw me beating the young man up.

    I am not sure which version of me I will have if I genuinely go down the Alzheimer’s path, but I already know that it will depend on whether I meet the sweet doctors, the sour doctors or the salty ones.

    1. “Maybe not because I am a Christian now an older, but if they try any of those things, there is going to be some great big misunderstandings and COVID has me seeing all of these sweet doctors but I used to beat up bullies as a child through junior high school.

  11. The only “cure” I’ve found for hiccups that consistently works for me is doing push-ups. 10-30 pushups does the trick every time.

    I’m sure it has to do with contracting the diaphragm and holding it but with way it works.

  12. This was a truly appaling yet delightful article! It was not quite on par with the experience of watching Pulp Fiction, but was still shocking AND humorous.
    I always thought hiccups were an imbalance of oxygen and carbon dioxide, but this gives me pause for thought.
    THANK YOU, as always, Dr. Gergor.

  13. The “drinking from the wrong side of the glass” trick has always worked for me – if the hiccups weren’t caused by something stuck in my esophagus and fixed by a simple drink of water. Got that out of some novel years ago. I always thought that the odd stretch to the neck muscles must be what did it. It’s hilarious that there are more anecdotal cures for hiccups than any other medical condition (except maybe colds?)

    1. yes that is right “if you try and drink a full glass of water from the side furthest away from you”, it is not so much the “strange activity you try to do” but it is the angle you put your neck at, that resets the muscle in the neck that stops the hiccups.

      But nobody has come up with a cause of the hiccups, just lots of strange things to try, I have tried lots of them, my salt one is the only thing that woks, if you you read my long story, I dont get hiccups anymore because I added more salt to my diet. the only thing I see that might make it fail is “will power” and what you believe in.

  14. Take a deep breath, hold it for as long as you can. When you finally have to breathe out, it’s gone! Always! 100% of the times!

  15. Seriously a fool proof trick from my father who was a bartender for years. I’ve never seen it fail. Assist the patient by firmly pulling down on the ear lobes(not to the point of pain, maybe slight discomfort), whilst they drink a pint of water (or as close to it as they can). I would be assuming if I were to take a guess at why it works, but I have seen it work hundreds of times and never had it not work.

  16. As a former bartender, I’ve seen my fair share of the hiccups. Put several dashes of bitters on a lime or lemon wedge and bite into it. That will do the trick. I suppose not unlike the effect of vinegar. Thanks.

  17. I once got in trouble as a student nurse by sharing our family remedy with a woman who had been hospitalized with unending hiccups. One pinches one’s nostrils closed and put one’s fingers in one’s ears, then drinks through a straw. My personal theory is that this reverses peristalsis, but whether that’s true or not, the woman’s hiccup stopped. Since then I have never seen this technique fail.

  18. My friend in Chilliwack in BC, Canada was born in 1953 and went into the Canadian military as a late teenager and was told in his training that if you are in “fox-holes” or trenches that to stay alive when hiccups start you were to put a pinch of sugar on your tongue and then pressure your tongue against the roof of your mouth, and the hiccups, due to the pressure, sugar, and the blood flow in the roof of your mouth, that it takes the sugar into the nerves/bloodstream, and almost instantly the hiccups cease…
    That way you were not located by the enemy by your uncontrolled sounds and dispatched… killed…
    Definitely worth a consideration if one wants to help someone…

  19. Michael, I’ve had terrible bouts of hiccups since I was in my 20s, they have gone for hours sometimes. my cure; get someone to try and pick me up by my ears. works every time. must be a vagal thing

  20. Over 14 years ago I underwent a mini bypass surgery (midcab) and when i came home , i had a severe case of hickups which would not stop with any trial of the known folk remedies. I needed my rest but i could not sleep, not to mention it was irritating my incision. Finally my wife called and spoke to a resident doctor who was available that night and she suggested to her giving me ibuprofin. We had a bottle of motrin sitting in the cabinet so i took a couple of them, never believing that this will work after all our failed attempts. Within 20 to 25 minutes, the hickups completely stopped and i was sound asleep soon after. Whether it was a placibo effect or a real cure i did not care since it did the job. We still talk about it every time the subject of hiccups comes up.

  21. There is a pre-print of a study of France and concepts such as lock-downs versus opening and closing.

    https://www.scilit.net/article/15ec9ad9a39fc7da97d1ae3b05951fd7

    There are so many people protesting to open now and I know that people like Dr. Popper believe we should open.

    The authors of this study don’t agree.

    It looks like places will be opening and that will mean more people dying. It is hard to follow the logic of that topic.

    All I know is that even in places where there are over 20,000 cases, people are rallying to open. People are losing so much money that the pressure will increase.

    It will be interesting to see what happens.

    What I see is that people who are outside of hot spots like California, Washington, NY, NJ, CT, MA, FL, and a few other states feel as if the models lied.

  22. Believe it or not, Since hicups are a contraction of the diaphragm muscle, I asked myself how can I force a reset or make it contract? Coughing?? Nope…. so as brutal as this sounds, I opted to put my finger (clean finger) into the back of my mouth to make me gag, once, max twice (cuz I don’t actually want to throw up anything) and so far it has ALWAYS worked for me… sorry for the grossness. But it works for me. (Thank God I dont get them often!)

    1. This is fool proof way to cure hiccups. I once had hiccups for three days so I know this works: use one hand to hold one earlobe between thumb and index finger and pull gently downward while using your other hand to drink a glass of water. This will instantly stop the hiccups. This method has never failed! Stay safe & healthy!

      1. I have a similar trick that has never failed me or anyone I have ever shown it too… put a pinky in each ear, pick up a glass of water with your index fingers and thumbs and drink. Maybe it’s the concentration aspect, but I’ve taught it to so many people with hiccups and haven’t once seen it fail.

  23. Yesterday and today, several times there have been television forecasts of serious global food shortages.

    Please be ready.

    And, by that I don’t mean to hoard food.

    Globally, we have an ever increasing population and there has always been projections that we will eventually have food shortages but pandemic is affecting supply.

    WFPB has options such as gardening but experts do think we are about to have more than a global toilet paper and PPE problem.

  24. Have you tried putting your fingers in your EARS and pressing firmly? It works, but only if you start it right away, not if the hiccups have been going on awhile. We use it in conjunction with (1) burping first, (2) taking a deep breath, and (3) pressing a finger in each ear for as long as it takes to hold your breath. Try it! But don’t wait too long to begin. Once the hiccups have been going on for a few minutes it doesn’t work as well.

  25. A spoonful of sugar on the tongue followed by drinking a small amount of water has worked 100% of the time for me and those I have encountered with hiccups.

  26. Seriously laughed my butt off reading this article and I nearly bypassed it! Thank you as one always needs a good laugh. Hot water! I always figured warmth for muscle spasms so I drink a couple gulps of nearly hot water and it has always worked. From the experiences above I think “mind over matter” works every time. Be safe

  27. How strange that doctors were baffled by hiccups. Like any child, I suffered from an occasional bout of hiccups. My mother would scoop up a teaspoon of sugar, add a little water to the spoon, and command me to swallow it in one gulp. Boom. Hiccups gone. Just like that. When my children got hiccups, I did the same for them. Boom. Gone. Not rocket science.

    1. You say “How strange that doctors were baffled by hiccups”
      That is because the doctors have a few clues upstairs and why more people are more suited to be “checkout” operators than brain surgeons. The body does not need any amount of toxic salt to function correctly as it reduces the White Blood Cell count and when that happens in the flu season you get the flu. try reading the book Pure White and Deadly by Dr. John Yudkin. (but I doubt the book will tell you about my no flu fix, when I stopped getting the flu after I stopped my sweet tooth)

      My few grains of salt on the tongue and a small drink works the same as your TOXIC sugar fix(read my story above) , The body needs a bit of salt each day, no salt gives high blood pressure (and hiccups) If you load heaps of salt on your childrens food and more keen to add lots more salt than to be lot less salt, then I am sorry I made this reply. it has been said you can overdose on “healthy salt” and it will not give high blood pressure like TOXIC (cheap refined) salt does. .

      Because of what happened in 2018 as I get hiccups I just add a little more daily salt to my diet so I regulate my salt intake to how much hiccups I get,

      1. RATS !!! sorry for the error , it should read
        “The body does not need any amount of toxic SUGAR to function correctly”

  28. For me, hiccups are induced by consuming foods that are tangy (Ex pepperocini peppers). They are instantly stopped by consuming a small amount of sugar or sweet drink or food. Hope that helps others.

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