Hiccups and the Vagus Nerve

[HowToBe]

A search turned up nothing for me, so I figured I would post this in case it was helpful to anyone annoyed by occasional hiccups. If others have information about hiccups to add, feel free, and this could be the official thread for the topic.

Occasionally, I get hiccups, usually after eating. They are slightly annoying to me, but I had never managed to reliably get rid of them by holding my breath and/or drinking water, so I'm used to just waiting until they resolve themselves. But recently, I discovered on my own (sorta, with help) a method that has worked every time, immediately. Pipe breath! I breathe in, restricting my throat a little, hold a moment, and breathe out slowly, hold a moment, and repeat a few times for good measure (not that you folks need instruction on this, I suppose ;) ). After the first pipe breath is completed, no hiccups interrupt my continued breathing. About three full rounds work like a charm. I just decided to try it one day, and it has since worked immediately and flawlessly on about six or seven separate occasions. I suggest to any of you to try a few pipe breaths next time you get the hiccups, to see if there is a result. If enough people experience results, this could be something new to add to the Eiriu Eolas info.

Now for research. After this worked for me yet again, I figured hiccups must be connected with the vagus nerve. Wikipedia said:

Hiccups are caused by many central and peripheral nervous system disorders, all from injury or irritation to the phrenic and vagus nerves, as well as toxic or metabolic disorders affecting the aforementioned systems. Hiccups often occur after consuming carbonated beverages, alcohol, or spicy foods. Prolonged laughter or eating too fast are also known to cause hiccups. Persistent or intractable hiccups may be caused by any condition which irritates or damages the relevant nerves.

So yeah, the vagus nerve is connected, and also if I'm reading this correctly, "ordinary" hiccups might be less benign in cause than I thought.

Also, some theory about why we hiccup at all:

Christian Straus and co-workers at the Respiratory Research Group, University of Calgary, Canada, propose that the hiccup is an evolutionary remnant of earlier amphibian respiration; amphibians such as frogs gulp air and water via a rather simple motor reflex akin to mammalian hiccuping.[4] In support of this idea, they observe that the motor pathways that enable hiccuping form early during fetal development, before the motor pathways that enable normal lung ventilation form. Thus, according to recapitulation theory the hiccup is evolutionarily antecedent to modern lung respiration. Additionally, they point out that hiccups and amphibian gulping are inhibited by elevated CO2 and can be completely stopped by the drug Baclofen (a GABAB receptor agonist), illustrating a shared physiology and evolutionary heritage. These proposals explain why premature infants spend 2.5% of their time hiccuping, indeed they are gulping just like amphibians, as their lungs are not yet fully formed. Fetal intrauterine hiccups are of two types. The physiological type occurs prior to 28wks and tend to last @ 5–10 minutes. These hiccups are part of fetal development and are associated with the myelination of the Phrenic nerve (which drives the diaphragm).

So hiccups might be telling us we need to breathe, or that our breathing is inadequate for some reason? :)

Next, I tried to see if vagal maneuvers are known to be effective for hiccups:

Most of the home remedies are based on case reports or series but some have a physiologic basis. Several remedies involve stimulating the nasopharynx. These remedies, which include forcible traction of the tongue, gargling water, drinking from the far side of the glass, swallowing granulated sugar or ice cubes quickly, may function by disrupting the vagal afferent limb of the hiccup reflex arc. Even when ineffective, these maneuvers are usually quite benign, with the worst adverse event being the potential for spilling water down the front of one’s shirt. Direct vagal stimulation, such as by carotid massage, Valsalva maneuver, ocular pressure, and digital rectal massage may also be effective, though digital rectal massage may be a bit of an atypical way to solve the problem of hiccups. Remedies that involve sympathetic nerve stimulation such as startling someone or ejaculation can disrupt the reflex arc as well and may be more enjoyable for some than the previous maneuvers. Breath holding and breathing into a paper bag has been reported to help with hiccups by producing a mild respiratory acidosis, which can have a direct inhibitory effect on diaphragmatic contractility. Other manual maneuvers include C3 to C5 dermatome stimulation by percussion of the back of the neck or acupuncture (1,2,4).

So there you have it. I hope this helps keep any annoying hiccups at bay. Also, I wonder if pipe breathing might be effective for the rare clinical case of chronic hiccups? I think it's definitely worth trying.

 

[Odysseus]

That's an interesting observation you made there.

I'll definitely try curing via pipe breaths next time I get a hiccup (rather seldom, but also annoying because in my case it's very noisy).

 

[rrraven]

we have a new puppy ,about 6 month old now. She used to get hiccups in her sleep!!!

a long long time ago I read somewhere that hiccups are like thunder in the sense that if you take in too much energy too fast,like when you eat too fast or drink sugary carbonated beverages,the body discharges that energy like invisible lightning and the hiccup you hear is like the thunder :)

I used to know a lady that had non stop ones while she was on a sugar drip in hospital again too much energy too quick

digital rectal massage may also be effective, though digital rectal massage may be a bit of an atypical way to solve the problem of hiccups.

I will remember this for next time when everyone comes up with their tried and tested home remedies for hiccups

 

[HowToBe]

Atypical, indeed!

 

[Ben]

I sometimes get massive hiccups after eating (basically I need to slow down!) and often they go away but sometimes I can tell that they are going to stay for a while. I have a variation on the 'holding breath' technique which my mother taught me and works EVERY time for me, I also find it has worked without fail for everyone else I have shown in to. Basically you need to gulp water while both your ears and nose are blocked with your fingers. Either get someone to hold the glass of water and tip it for you so you can hold the sides of your nose with the little fingers and block your ears with your thumbs, or take the slightly more risky option of tilting the glass yourself using your mouth so you can do it on your own (spillage likely!).