EVERYONE gets hiccups.
For most of us, it’s an inconvenient but short interruption to our day and we tend to think of them as harmless.
As many as 40 per cent of cancer patients are plagued by hiccups
There’s often not an obvious cause behind the annoying little spasms – they can be caused by stress, gulping down food or a fizzy drink, or drinking a bit too much alcohol.
In some rare cases, however, hiccups can be a sign of something serious.
The innocuous bodily tic could be a sign of cancer, Cancer Research UK said.
A study published in the American Journal of Hospice & Palliative Medicine confirmed that as many as 40 per cent of patients with cancer develop hiccups.
For one in 10 cancer patients, their hiccups can drag on for over 48 hours, another study found.
The Atlantic reported that people who have cancer in their chest, throat, or head – anywhere in their body that is along the route of a hiccup – might experience them.
But medications prescribed to cancer patients – including chemotherapy drugs, steroids, and opioids – can also set them off.
Regardless of their cause, persistent hiccups can be very disruptive and add another layer of misery to someone who is going through cancer and the necessary treatments.
One study published in 2022 showed that hiccups affected the quality of life of about one in 20 of the cancer patients surveyed.
Among those with hiccups, one in three said they struggled to relax and some said they couldn’t enjoy meals.
In another study of 320 cancer patients, hiccups sent one in 10 to the hospital for help.
About 40 per cent of healthcare providers participating in a survey said their cancer patients’ hiccups were worse than their nausea and vomiting.
What are hiccups?
Hiccups occur when you get a spasm in your diaphragm between normal breaths, according to Cancer Research UK.
Your diaphragm is a large, dome shaped muscle that sits underneath your lungs that contracts rhythmically to help you breathe.
Two things happen that make your body emit that eponymous ‘hic’ sound:
- your diaphragm contracts and pulls down between your normal breaths, sucking air in
- immediately after this, the top of the windpipe (trachea) closes briefly, to stop more air getting in – this is when you’ll emit a ‘hic’ sound
The spams aren’t something you can control but – in most cases – hiccups do just tend to go away on their own.
In some cases however, the annoying jerking feeling in your chest can go on for minutes or hours – these are ‘acute’ hiccups.
They become ‘persistent’ if they usually last more than 48 hours.
And hiccups are described as ‘intractable’ if they plague you for over a month.
Persistent hiccups may cause complications such as tiredness, exhaustion or poor sleep, Cancer Research UK said.
They can also trigger psychological distress or embarrassment.
Should hiccuping interfere with your everyday life, such as eating and sleeping, it is important to get them checked by a doctor.
The same goes if experience hiccups that last longer than two days, the NHS suggests.
“Hiccups that last longer than 48 hours can be due to a medical condition or a medicine you’re taking,” NHS guidance said.
What causes hiccups?
Though the cause of hiccups is mostly mysterious, Cancer Research UK said they might be set off if the nerve that controls the diaphragm (the phrenic nerve) is irritated.
Things that might trigger hiccups include:
- eating and drinking too quickly, particularly gulping fizzy drinks
- over eating
- heartburn
- stress
- sudden changes in air temperature
- over stretching your neck
- certain drugs, such as medicines to treat anxiety (benzodiazepines)
- alcohol
But if you have cancer you might also get hiccups if:
- your stomach stops working and becomes extended and bloated
- you have an infection affecting your chest or food pipe (oesophagus)
- you are having chemotherapy, steroids or an opioid painkiller such as morphine
- the cancer is pressing on your diaphragm
- you have symptoms because of a brain tumour
- your kidneys are not working normally and your blood chemistry changes
- you have high blood calcium levels (hypercalcaemia)
What other conditions can cause hiccups?
Patient UK gave a few examples of other conditions that might be behind persistent hiccups.
- Certain medicines could be the culprit. Patient UK gave the examples of steroids, tranquillisers, painkillers containing opiates (such as morphine) and methyldopa, which prescribed for blood pressure.
- Changes in blood chemistry such as from alcohol, high blood sugar, or lack of calcium or potassium in the blood.
- Gut problems such as acid reflux, stretching of the stomach, a gallbladder infection or an infection under the diaphragm.
- Other gut conditions that can cause hiccups include hiatus hernia and oesophageal cancer.
- Abdominal masses, such an enlarged liver (hepatomegaly) or spleen (splenomegaly).
- General anaesthetic.
- Conditions affecting the neck, chest or tummy. This ranges from surgery to infections such as pneumonia. Swellings or tumours in these parts of the body could also be a factor.
- Some heart conditions could also cause hiccups, such as a heart attack or inflammation around the heart.
- Brain conditions such as stroke, head injury or brain infection.
If you visit a doctor about hiccups lasting for longer than 48 hours, they will try and identify the cause of them and they will treat the cause if they find it.
For example, the hiccups may go away if your doctor changes one of the drugs you take.
