Hiccups: causes and which doctor to see

For hiccups you can first see: Family Medicine or Internal Medicine or Gastroenterology. In large hospitals, the Gastroenterology unit also deals with this. If you are not sure, a family doctor (general practitioner) can assess you first and refer you to the right specialist.

Common symptoms: sudden catches of breath with a “hic” sound, repeating at regular intervals; a feeling of mild contraction in the chest or upper abdomen; episodes usually lasting a few minutes, sometimes a few hours; when they last a long time, difficulty eating and sleeping, and tiredness. Symptoms vary from person to person; a doctor’s examination is needed for a diagnosis.

The most common causes: eating quickly or too much, the stomach filling suddenly; fizzy drinks, alcohol and very hot or very spicy food; sudden excitement, stress or a sudden temperature change; reflux and hiatus hernia; some medicines and the period after general anaesthesia; with long-lasting hiccups, causes such as kidney failure, diabetes, or nerve irritation in the brain or chest. Only a doctor’s examination can determine the exact cause.

Ordinary hiccups usually pass on their own within a few minutes; methods such as holding your breath and sipping cold water can help interrupt the hiccup reflex. With hiccups lasting more than 48 hours, the doctor looks for the cause; when a problem such as reflux is treated, the hiccups usually improve too. In very persistent cases, the doctor may plan medicine treatment.

It is more common in: babies (very common after feeds and harmless); people who eat quickly and drink fizzy drinks and alcohol; people with reflux; patients in the period after surgery; men (long-lasting hiccups are more common in men).

No tests are needed for short hiccups. For hiccups lasting more than 48 hours, the doctor may request an examination, blood tests (kidney function, sugar, salts), a chest X-ray and, if needed, endoscopy or brain imaging.

Eating slowly, smaller portions, cutting down on fizzy drinks and alcohol and treating reflux reduce hiccup episodes.

Yes. Hiccups are very common in babies, especially after feeds, and are harmless; they usually pass on their own. Holding the baby upright and burping them can help. If there is frequent vomiting, fussiness or poor weight gain with the hiccups, see a paediatrician.

Most hiccups pass on their own within a few minutes. Hiccups lasting more than 48 hours are called persistent and need a doctor’s assessment.

They are most often linked to reflux and hiatus hernia, some medicines and alcohol. Less often, kidney failure, diabetes, irritation of the nerves in the chest or neck and brain diseases can be the cause; so hiccups lasting more than 2 days should be investigated.

If the answer to any of these questions is yes, call 112 without delay: “With the hiccups, is there chest pain, shortness of breath or pressure spreading to the arm or jaw?” “Is there slurred speech, difficulty swallowing, double vision, or numbness in the face, arm or leg?” “Is there vomiting like coffee grounds or black stools?” “Is there confusion, fainting or difficulty waking up?” “Is there facial drooping, slurred speech or sudden weakness in an arm or leg?” “Are you struggling to breathe even at rest?”

See a doctor: the hiccups last more than 48 hours; you cannot eat or sleep because of them; they started after beginning a new medicine; there is heartburn, difficulty swallowing or weight loss.