For 10 days, Brazilian President Jair Bolsonaro has hiccupped constantly and was admitted to the hospital where doctors said an intestinal blockage could be to blame, according to NBC News. While nearly everyone’s had an annoying bout of hiccups in their life, some people have prolonged hiccups, a case that occurs for more than 48 hours.
Take Tom Sullivan. After eating a pretzel that burned his throat and then undergoing open-heart surgery in 2016, he had hiccups for about six to eight weeks. They impacted his ability to sleep and he started feeling down.
“I was depressed, despondent, because they didn’t go away and I was tired because it just wears you down. Your whole body shakes,” Sullivan, an 82-year-old retiree in Cornwall, Connecticut, told TODAY. “It was an annoying torture that didn’t quit.”
Sullivan tried all the old wives' tales remedies: drinking a glass of water upside down, taking shots of vinegar and eating large spoons of peanut butter. Still, he found no relief.
“Sleep was very difficult. You cannot sleep if you hiccup,” he said. “Sleep and exhaustion was the worst part.”
Why people get prolonged hiccups
Almost everyone experiences hiccups and they even occur in babies in the womb. For most people, they’re just temporary aggravations.
“Hiccups are basically a contraction of the diaphragm, the big dome-shaped muscle that’s at the top of the rib cage that helps with breathing,” Dr. Daniel Fain, section chief for pediatric neurology at Helen DeVos Children’s Hospital in Grand Rapids, Michigan, told TODAY. “It happens a lot in infants and children because of the way their digestive systems are — they can easily get their diaphragm irritated.”
Normal hiccups certainly are frustrating, but aren’t a sign of any underlying condition. In many cases, doctors are unsure why they even happen.
“There’s no physiological reason why you do it,” Dr. Anthony Lembo, professor of medicine at Harvard Medical School in Boston, told TODAY. “Many people do not hiccup at all.”
When it comes to prolonged hiccups, experts have some understanding of what causes them. The vagus nerve, which regulates sensation from the head to the gut, often plays a role.
“It’s a really extensive nerve network that can get irritated for some reason,” Fain said. “It can be something as common as gastroesophageal reflux (GERD) that will irritate the nerve, irritate the esophagus … and that can cause hiccups.”
When the esophagus becomes swollen that can put pressure on the vagus nerve.
“Any distention of the esophagus could do it,” Lembo said. “I’m a gastroenterologist so we see patients that have inflammation in their esophagus … that could trigger long standing hiccups.”
People who have had surgery in their chest or abdomen, people with GI blockages, people undergoing chemotherapy and people who had a stroke or other neurological condition can also experience extended hiccups. Lembo notes that they happen more often in taller men, but doctors aren't exactly sure why.
“(Prolonged hiccups) can happen to people sometimes for unknown reasons. But other times there’s some specific either nerve damage or a brain injury, brain tumor or stroke,” Fain explained. “They can be seen in people that have chronic electrolyte disturbances, like people with kidney disease or people that are abusing substances.”
Life with prolonged hiccups
People with long-lasting hiccups struggle to eat, drink and sleep and also feel depressed and anxious by the constant spasms.
“You can also get chronic stomach upset, too. If your vagus nerve is misfiring that means your digestion is probably not working properly either,” Fain said. “You just feel terrible. Nobody likes hiccups and we all think of it as just a temporary thing. But to have it ongoing like that causes a lot of anxiety and stress and even depression.”
As a hospice and palliative care nurse who works with patients undergoing chemotherapy, Karen Thornburg, saw the impact of prolonged hiccups on her patients.
“Many of them got hiccups chronically and they couldn’t get rid of them,” she told TODAY. “People lose weight. With chronic hiccups, you don’t want to eat … (they will) be slightly dehydrated.”
Doctors can try several medications to treat hiccups with varying results. People with GERD might take an acid-blocking medication that could provide relief, for example.
“We will add a prokinetic agent to help empty the stomach,” Lembo said. “In patients that don’t respond to that, we move on to muscle relaxants like baclofen or antipsychotics … or a seizure medication that are also relaxers. These are centrally active hacking medications that can reduce the nerve firing within the brain that can help reduce the symptoms of hiccups.”
For Sullivan nothing seemed to worked. Frustrated, he searched online and found a story about a girl who won a science fair competition for lollipops she developed to stop hiccups. He reached out to her father, Adam Kievman, who drove the lollipops, called Hiccupops, to him. That former science fair winner, MJ Kievman, started Meter Health, which is dedicated to researching hiccups and finding cures. Sullivan feels grateful he found something that helped.
“It was terrible watching the clock for hours … and they didn’t go away,” he said. “I keep the supply (of Hiccupops) because I’m afraid I could irritate that nerve that causes them.”