Constant Hiccups
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Try one of these related symptoms.
Constant hiccups
Hiccups keep coming back
Hiccups aren't stopping
Hiccups disturbing me
Frequent hiccups
About the Symptom
It refers to frequent repeated spasms of the diaphragm paired with a ‘hic’ sound from the vocal cords closing.
When to See a Doctor
Seek professional care if you experience any of the following symptoms
- Blurring of vision
- Muscle weakness in the limbs
- Numbness / sensory disorder
- Unilateral blindness
- Numbness of lower limbs
- Dysphagia
- Altered mental status (delirium)
- Involuntary movements
- Impossible to walk normally
- Visual field defect
- Disorder of consciousness
- Abnormal sensation (tingling, prickling)
- Slurred speech
- Seizure attack
- Head injury
Possible Causes
Generally, Constant hiccups can be related to:
- Neuromyelitis Optica (NMO)
Neuromyelitis optica (NMO) is a rare condition in which the immune system damages the spinal cord and the optic nerves.
- Multiple Sclerosis (MS)
Multiple sclerosis (MS) disease in which the immune system attacks parts of the brain and spinal cord. The direct cause of MS remains unknown, but certain risk factors have been identified such as low vitamin D levels, tobacco smoking, exposure to UV radiation, childhood obesity, and infection with the virus that causes mononucleosis. The disease tends to affect young people more commonly as well as people living in higher latitudes. MS typically occurs in "attacks" which can include but are not limited to painful eye movements, blurry vision in one eye, numbness or weakness in hands or feet on one side, or double vision.
Related Serious Diseases
Sometimes, Constant hiccups may be related to these serious diseases:
- Myocardial Infarction (MI) / Unstable Angina
These are often grouped together under the term "Acute Coronary Syndrome" (ACS) and are potentially life-threatening. This occurs when a blood vessel supplying the heart is blocked, usually by a blood clot. Risk factors include high cholesterol, high blood pressure, a sedentary lifestyle, diabetes, and a family history of cardiovascular diseases (e.g., stroke, heart disease).
- Subarachnoid Hemorrhage
- Cerebral Hemorrhage
- Cerebral Infarction
- Chronic Kidney Disease
Doctor's Diagnostic Questions
Your doctor may ask these questions to check for this symptom:
- Do you experience frequent or continuous hiccups?
Reviewed By:
Samantha Nazareth, MD (Gastroenterology)
Board-certified gastroenterologist. Experience managing gastrointestinal conditions (GERD, IBS, ulcerative colitis, Crohn’s, celiac disease, NASH) within healthcare organizations (three ambulatory surgical centers, single-specialty practice, multi-specialty practice and solo practice).
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Feb 6, 2025
Following the Medical Content Editorial Policy
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- Can't stop the hiccups from happening
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FAQs
Q.
Can’t Stop Hiccuping? Why Your Diaphragm Spasms & Medical Next Steps
A.
There are several factors to consider with nonstop hiccups: they are involuntary diaphragm spasms, and when they last over 48 hours they may signal GERD, medication effects, chest or lung conditions, metabolic problems, or less commonly nervous system disorders. See below for urgent red flags, when to seek care, what to try at home, which tests and treatments your doctor may use, and how these details can change your next steps.
References:
* Steger M, Schneemann M, Butler J. Hiccups: Pathophysiology and current treatment. J Clin Gastroenterol. 2015 Nov-Dec;49(10):809-17. doi: 10.1097/MCG.0000000000000323. PMID: 26030704.
* Moretti R, Torre P, Antonello RM, Boni S, Cazzato G, Capus L. Management of intractable hiccups. Curr Treat Options Neurol. 2016 Mar;18(3):13. doi: 10.1007/s11940-016-0397-9. PMID: 26909893.
* Launois C, De Broucker T, Lafitte JJ, Peillon C, Verin E. Intractable Hiccups: Aetiology, Investigation, and Treatment. Front Neurol. 2019 Jun 25;10:537. doi: 10.3389/fneur.2019.00537. PMID: 31281206.
* Marin-Collazo I, Valenzuela-Gamboa M, Sánchez-Escandon D, Marruffo-Melendez CA, Chavarria-Medina M, Orozco-Cabrera H, Flores-García H. Hiccups in neurologic disorders: a narrative review. Neurol Sci. 2023 Jan;44(1):15-22. doi: 10.1007/s10072-022-06414-9. PMID: 36195708.
* Naus C. Persistent and Intractable Hiccups. Am Fam Physician. 2023 Feb;107(2):161-164. PMID: 36791163.
Q.
Hiccups Won’t Stop? Why Your Diaphragm Spasms & Medical Next Steps
A.
Persistent hiccups happen when your diaphragm spasms and are usually brief, but if they last more than 48 hours they may signal GERD, nerve irritation, brain or metabolic conditions, or medication side effects; common short-term triggers include overeating, carbonated drinks, alcohol, spicy foods, temperature shifts, and stress. Urgent care is needed with chest pain, stroke-like symptoms, breathing difficulty, or vomiting blood. There are several factors to consider and important next steps for evaluation and treatment, so see the full details below.
References:
* Friedman L, Palmer A, Mungunsukh O, Torgovnick J, Kirschbaum M, Chaudhri M. Persistent and Intractable Hiccups: An Unexplored Clinical Entity. Curr Neurol Neurosci Rep. 2020 Aug 17;20(9):39. doi: 10.1007/s11910-020-01061-6. PMID: 32676766.
* Laman-Maver E, Eapen R, Coyle H, Rajasekhar P. Current Approaches to the Management of Persistent Hiccups. Curr Treat Options Neurol. 2021 May 26;23(7):22. doi: 10.1007/s11940-021-00688-6. PMID: 33772275.
* Kohse K, Bartelt A, Reiß K, Köhler H, Laufenburg K. Persistent and Intractable Hiccups: Aetiology and Management. Clin Drug Investig. 2020 Apr;40(4):307-313. doi: 10.1007/s40261-020-00902-1. PMID: 32249339.
* Thompson DF, Thompson DD. Intractable hiccups: Aetiology, investigation and treatment. BMJ Case Rep. 2018 Jun 22;2018:bcr-2018-224419. doi: 10.1136/bcr-2018-224419. PMID: 29930064; PMCID: PMC6018318.
* O'Mara K, O'Mara A, Hom J. Hiccups: causes, consequences, and cures: a review. Ther Adv Gastroenterol. 2012 Nov;5(6):387-95. doi: 10.1177/1756283X12458411. PMID: 23155496; PMCID: PMC3491475.
Q.
How to Stop Hiccups? Why Your Diaphragm is Spasming & Medically Approved Next Steps
A.
Most hiccups are brief diaphragm spasms often triggered by fast eating, carbonation, alcohol, or temperature shifts, and they usually stop with simple, medically supported maneuvers like holding your breath, sipping cold water, swallowing a teaspoon of sugar, or pulling your knees to your chest. If hiccups last more than 48 hours, affect sleep or eating, or come with red flags like chest pain, weakness, shortness of breath, or vomiting, see a clinician since reflux, medications, electrolyte issues, or rarely neurologic problems can be the cause. There are several factors to consider and important next steps that may change based on your situation, so see the complete guidance below.
References:
* Wang, Z., Li, J., Cui, X., & Deng, B. (2023). Neural mechanism of hiccup. *Frontiers in Neurology*, *14*, 1146743.
* Friedman, N. L. (2020). Hiccups: from the common to the intractable. *Current Gastroenterology Reports*, *22*(8), 38.
* Lee, G. W., & Kim, R. B. (2021). The Central and Peripheral Causes of Persistent Hiccups and Potential Treatments. *Korean Journal of Internal Medicine*, *36*(5), 1019-1029.
* Steger, M., Schneiders, H., & Eisele, G. (2015). Hiccups: Aetiology, diagnosis and therapy. *Zeitschrift fur Gastroenterologie*, *53*(9), 920-928.
* Porzio, G., Aielli, F., Verna, L., & Cannita, K. (2015). Pharmacological management of persistent hiccup. *Expert Review of Gastroenterology & Hepatology*, *9*(12), 1475-1481.
Q.
Is there a way to stop hiccups on your own?
A.
Methods such as holding one's breath or drinking cold water are considered effective. For persistent or refractory conditions, oral medication may be used for treatment as well as a search for other underlying causes of the hiccups.
References:
Steger M, Schneemann M, Fox M. Systemic review: the pathogenesis and pharmacological treatment of hiccups. Aliment Pharmacol Ther. 2015 Nov;42(9):1037-50. doi: 10.1111/apt.13374. Epub 2015 Aug 25. PMID: 26307025.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Rouse S, Wodziak M. Intractable Hiccups. Curr Neurol Neurosci Rep. 2018 Jun 22;18(8):51. doi: 10.1007/s11910-018-0856-0. PMID: 29934880.
https://link.springer.com/article/10.1007/s11910-018-0856-0Steger M, Schneemann M, Fox M. Systemic review: the pathogenesis and pharmacological treatment of hiccups. Aliment Pharmacol Ther. 2015 Nov;42(9):1037-50. doi: 10.1111/apt.13374. Epub 2015 Aug 25. PMID: 26307025.
https://onlinelibrary.wiley.com/doi/10.1111/apt.13374Leung AKC, Leung AAM, Wong AHC, Hon KL. Hiccups: A Non-Systematic Review. Curr Pediatr Rev. 2020;16(4):277-284. doi: 10.2174/1573396316666200508112951. PMID: 32384036.
https://www.eurekaselect.com/article/106467Bredenoord AJ. Management of belching, hiccups, and aerophagia. Clin Gastroenterol Hepatol. 2013 Jan;11(1):6-12. doi: 10.1016/j.cgh.2012.09.006. Epub 2012 Sep 13. PMID: 22982101.
https://www.cghjournal.org/article/S1542-3565(12)01047-6/fulltextKohse EK, Hollmann MW, Bardenheuer HJ, Kessler J. Chronic Hiccups: An Underestimated Problem. Anesth Analg. 2017 Oct;125(4):1169-1183. doi: 10.1213/ANE.0000000000002289. PMID: 28759492.
https://journals.lww.com/anesthesia-analgesia/Fulltext/2017/10000/Chronic_Hiccups__An_Underestimated_Problem.17.aspx