What are the causes of hiccups (synchronous diaphragmatic contractions)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Article Review Status
Submitted
Under Review
Approved

Last updated: March 28, 2025 • View editorial policy

From the Research

Hiccups are primarily caused by involuntary contractions of the diaphragm, often triggered by factors such as eating too quickly, consuming carbonated beverages, or medical conditions like gastroesophageal reflux disease (GERD), which can irritate the phrenic nerve controlling the diaphragm. The causes of hiccups can be multifaceted, including:

  • Eating too quickly or consuming carbonated beverages
  • Drinking alcohol or experiencing sudden excitement or emotional stress
  • Sudden temperature changes
  • Medical conditions such as GERD, pharyngitis, or laryngitis, which can irritate the phrenic or vagus nerves
  • Certain medications like steroids, benzodiazepines, and some chemotherapy drugs
  • Rare cases involving central nervous system disorders, metabolic conditions like kidney failure or diabetes, or structural abnormalities affecting the diaphragm

According to the most recent study 1, GERD is a significant factor in many cases of hiccups, as it can influence the phrenic nerve and lead to involuntary diaphragmatic contractions. This study highlights the importance of considering GERD as a potential cause of hiccups, especially in cases where other causes are not apparent.

It is essential to note that while most hiccup episodes are brief and self-limiting, persistent hiccups (lasting more than 48 hours) warrant medical evaluation, as they may indicate an underlying health issue requiring specific treatment 1. In such cases, a thorough medical assessment, including the consideration of GERD and other potential causes, is necessary to determine the appropriate course of treatment.

The management of GERD, a common cause of hiccups, involves lifestyle modifications, medication, and in some cases, surgery 2, 1. The use of proton pump inhibitors (PPIs) is a common treatment approach for GERD, but it is crucial to use the lowest effective dose and monitor for potential adverse effects, especially with long-term therapy 1.

In conclusion, the causes of hiccups are varied, and GERD is a significant factor to consider, especially in cases of persistent hiccups. A thorough medical evaluation and appropriate treatment can help alleviate symptoms and address any underlying health issues.

References

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.