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The science behind hiccups

The science behind hiccups

A seemingly simple bodily behaviour, hiccupping has a complicated process behind them


On June 13, 1922, one Charles Osborne fell while trying to hang a 158kg hog for weighing at a farm near Nebraska. Although he “felt nothing” at the time, his doctor later told him that he had “busted a blood vessel the size of a pin” in his brain, Osborne told People magazine in 1982. After that day, Osborne hiccupped nonstop for nearly seven decades. His doctor, Dr Terence Anthoney from Illinois, told him he had “destroyed a small area in the brain stem that inhibits the hiccup response” in the accident. Osborne continued to have hiccups up until a year before his death in 1991. At a rate of 20 hiccups per minute, Osborne hiccupped at least 420 million times in his life, according to the magazine. He still holds the Guinness world record for the longest attack of hiccups, spanning 68 years, from 1922 to 1990.

Although Osborne’s was an unusual case, many people who have experienced embarrassing hiccup episodes, even short ones lasting a few minutes, would empathise with his situation.


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Hiccupping has its uses?

Fast-forward to more than 30 years later, and scientists still can’t say conclusively what purpose hiccups serve in humans.

In a paper titled ‘Why do we hiccup?’, Dr Peter Kahrilas, professor of gastroenterology and hepatology at the Feinberg School of Medicine, Northwestern University, Chicago, said that hiccupping is observed in utero and the tendency to hiccup continues after delivery. He said that premature infants spend an average of 2.5 per cent of their time hiccupping.

“Hiccupping spells occur in utero and in premature babies without any identifiable stimulus for initiation or for cessation,” Dr Kahrilas said. “This suggests that during the perinatal period, when the respiratory tract needs to mature rapidly, hiccupping does have a survival value.”

Several people may start hiccupping after overindulging in food, alcohol or both, and in some cases hiccups become intractable (uncontrollable), leading to insomnia and exhaustion. However, unlike vomiting, gagging and coughing, hiccupping has no discernable survival value in adults, he said.

Another popular theory is that people hiccup as a consequence of evolution. In his book ‘Your Inner Fish’, American evolutionary biologist Neil Shubin contends that hiccups and gill breathing are the same phenomenon.

Rob Dunn, a biologist and a professor in the Department of Applied Ecology at North Carolina State University, is of the view that the first air-breathing fish and amphibians used gills to breathe underwater and a primitive form of the lungs when on land.

“When underwater, the animals pushed water past their gills while simultaneously pushing the glottis down,” Dunn wrote in an article in Smithsonian magazine. “We descendants of these animals were left with vestiges of their history, including the hiccup. In hiccupping, we use ancient muscles to quickly close the glottis while sucking in (albeit air, not water).”

What causes the ‘hic’ sound?

Although the purpose of hiccups is still unclear, the bodily behaviour that causes the ‘hic’ sound to emerge is well-understood.

Dr Purushottam Vashistha, consultant, gastroenterology, Apollo Hospitals, Navi Mumbai, says that simply put, the signature ‘hic’ sound associated with hiccups occurs due to a sudden contraction of the diaphragm.

“Hiccups start much lower in your body though — in the diaphragm, the dome-shaped muscle between your lungs and stomach,” says Dr Sachin Kumar, senior consultant, pulmonology and critical care medicine, Sakra World Hospital, Bengaluru.

Normally, the diaphragm pulls down when you inhale to let air into the lungs and relaxes when you exhale so that air can flow back out of your lungs and exit through the nose and mouth.

“But if something irritates your diaphragm, it can spasm, forcing you to suddenly suck air into your throat, where it hits your voice box,” he says. “That makes your vocal cords suddenly close, creating the distinct ‘hic!’ sound.”

Speaking about short episodes of hiccups that occur out of the blue and stop in some time, Dr Vashistha says it is not difficult to stop hiccups if they are due to nonspecific and transient reasons. “However, for specific disorders we have to find out causes and then treat accordingly,” he says about hiccups that persist longer (for more than 48 hours).

According to the National Organization for Rare Disorders, a US-based non-profit working to provide support to people suffering from rare diseases, some of the illnesses which could be causing chronic hiccups include alcoholism, pleurisy (a condition in which the linings of the lungs become inflamed) of the diaphragm, pneumonia, uremia (a condition in which buildup of toxins in blood occurs due to the kidney’s inability to filter them out successfully), disorders of the stomach or esophagus and bowel diseases.

How to stop hiccups: facts vs myths

From hiccups being induced by someone thinking about you to startling somebody to scare the hiccups out of them, there are several misconceptions about this seemingly simple human behaviour. But it is important to separate facts from urban legends, say doctors.

Dr Kumar says that since hiccups are essentially involuntary contractions of the diaphragm, one must think about ways to stop these contractions.

For persistent hiccups (episodes that last longer than 48 hours), he recommends consulting a doctor to check the root cause. “Ideally the treatment is to identify the root cause and treat it,” Dr Kumar says. “Hence, if it is persistent hiccups, one should see a doctor and follow some basic tests like blood tests and ultrasound of the stomach.”

He says that some of the most common misconceptions about hiccups are that you can put a stop to it by tickling the roof of the mouth or by being scared.

Dr Kumar recommends trying a few breathing exercises instead, such as:

  • breathing in and holding the breath for about 10 seconds, then inhaling two more times before exhaling
  • breathing into a paper bag but taking care not to cover the head with the bag.

Share Your Experience/Comments

One Response

  1. Interesting read. Had no idea about hiccups. Nice way of explaining a scientific concept.

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