Why Do My Hiccups Hurt?

#Hiccups are a common experience that many people go through every day. Science tells us that an average person’s hiccup starts in the womb, even before people are born. Sometimes ultrasound has shown unborn babies having hiccups. Some argue that these hiccups prepare babies to breathe because they act as exercise. Some claim that hiccups teach unborn babies to self-burp once they are born and these two theories are equally accepted. However, sometimes these hiccups get worse or happen more frequently, and this raises questions. Medically, hiccups are called singultus, and apart from humans, other animals also experience hiccups. So, if you were asked to define hiccups, what would you say? To help you understand, allow me to explain. Hiccups are defined as involuntary contractions of the diaphragm, the muscle that separates your chest from your abdominal cavity. Diaphram plays a vital role when breathing in and out because it contracts and relaxes, enabling you to inhale and exhale. When your diaphragm contracts, your lungs get in oxygen while when it relaxes, the lungs exhale the air, which contains carbon dioxide. When the diaphragm contracts without a simple pattern, it causes hiccups. This is because each spasm your diaphragm makes induces a sudden closure of the larynx (voice-box) and the vocal cords. The air then rushes into the lungs suddenly. Since your body is not used to this type of oxygen rush, it reacts to this gasp, creating a hiccup sound. The exact cause of hiccups is not known, but the following factors are thought to cause hiccups.

To know the factors linked to hiccups, first understand that hiccups are of two types. There are short-term hiccups that come and go on their own after a few minutes. They can be due to overeating, consuming too hot or too cold foods, alcohol consumption, drinking caffeinated beverages, and eating spicy foods. Aerophagia (swallowing too much air) causes this type of hiccups, as well as emotional stress, i.e., extreme cry or laughter.

Long-term hiccups

These are hiccups that last over 48 hours and can go up to two months or more. They are caused by:

Damage to the Central Nervous System. The central nervous system comprises the brain and the spinal cord. These two organs are very critical because they contain nerves and blood vessels that serve various parts of the body. When CNS is damaged, some of these vital structures may be impaired, making you lose the ability to control the hiccup. The damage does not cause hiccups on its own, but the diseases that arise from the injury. Stroke is a condition that occurs when a blood vessel in the brain ruptures and bleeds. It also happens when there is a blockage of the blood supply to the brain. When this happens, it disrupts the hiccup reflex arc, which contains phrenic and vagal nerves. It also contains intercostal muscles which regulate breathing. In such a situation, you can get a long-lasting hiccup. Another common condition that causes hiccups is brain tumors. A growing tumor may press on the important nerves triggering hiccups. Meningitis, encephalitis, hydrocephalus, neurosyphilis, head trauma, and multiple sclerosis are also known to cause hiccups.

Injury to the Nerves. Most chronic injuries are related to the injury of the vagus or phrenic nerve. These two nerves are important because they regulate the normal functioning of the diaphragm. Many things irritate these nerves and result in hiccups. Examples of irritants, in this case, are irritation of the eardrum because of foreign objects, throat irritation or soreness, an esophageal tumor, and gastroesophageal reflux disease (GERD). Injury to the phrenic nerve can also lead to difficulty in breathing, fatigue, recurrent pneumonia, insomnia, and many others. The Vagus nerve is involved in swallowing and breathing as well. Any injury that affects the vagus nerve causes digestive problems, hoarseness of the voice, paralysis of the vocal cords, and a slowed heart rate.

Metabolic Disorders. These are medical conditions that occur when the metabolism process in the body fails. This then causes the body to either produce too much or too little of the essential substances needed to function properly. These conditions create problems in the body where you either have more or less blood pressure, blood sugars, body fat, cholesterol, etc. Kidney disease, for example, causes hiccups. I know you may wonder how, but let me explain. Kidneys play a vital role in eliminating toxins through the filtration of blood and other fluids. These toxins are then eliminated through the urine. When kidneys are damaged, they cannot filter fluids and waste from the blood efficiently. These toxins then accumulate in your bloodstream, they irritate some nerves, causing hiccups. This also causes tiredness and nausea. Hydrocephalus is another condition that causes the accumulation of fluid in the brain. This accumulation may press both phrenic and vagal nerves, causing hiccups.

Some Types of Medications. There are drugs that, when taken for long, can induce hiccups. An excellent class of drugs is tranquilizers, drugs used to treat anxiety, fear, tension, agitation, and disturbances of the mind. Examples of such drugs are iproniazid and phenelzine. These drugs induce hiccups, migraines, and other gastrointestinal problems as side effects. Also, anesthetic drugs (used to induce sleep, numbness, and comfort, especially during medical procedures like surgery. General anesthesia, for example, causes muscles paralysis diaphragm included. Epidural injections of anesthetics may cause persistent hiccups solely due to change in the cerebrospinal fluid volume. Hiccups during the postoperative period can complicate the recovery phase through sleep disturbance, exhaustion, and wound dehiscence. Steroids are another class of drugs that can induce hiccups. A shot of cervical epidural steroid to control chronic pain is one drug that gives patients chronic hiccups. A few studies have reported on the physiological and pharmacological aspects of hiccups after an epidural steroid injection and there have been some case reports published.

Additional Causes Include:

Some medical procedures like bronchoscopy, where the doctor inserts a thin lighted tube to examine your lungs and airways. Tracheostomy is another procedure that involves the creation of a surgical opening in the neck to allow breathing around an airway obstruction. Insertion of the esophageal stent to open up a blocked esophagus can also irritate the nerves around the diaphragm, hence inducing hiccups. Misuse of alcohol and tobacco has been in the frontline to cause hiccups, and there is a reason for that. Alcohol also irritates the digestive system, including your esophagus, which can also trigger hiccups and increase acid production, which can lead to acid reflux. Acid reflux can also cause hiccups. Smoking or chewing gum also can cause a person to swallow air and get hiccups.
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Hiccups happen when there is an abnormal contraction of the diaphragm. A variety of things, like medications, medical conditions, can cause hiccups, as well as taking some types of foods like spicy ones, or alcohol overuse. The best thing is that hiccups have a treatment that can enable you to resume your normal life. If you have hiccups that are longer than 48 hours and are accompanied by pain and numbness, get immediate medical attention because you could suffer from a serious health problem.