Persistent Hiccups: Causes and Solutions for Relief

Hello, doctor. I would like to ask about the issue of persistent hiccups?

Since last Thursday (December 14, 2018), after having eaten too much for dinner, I have been experiencing almost constant belching every day until now (December 21, 2018).
It feels like there is gas trapped in my throat, and I have to burp to release it from my chest.
Occasionally, I do have genuine belching accompanied by a sour stomach odor.
Three days ago, I visited a doctor who diagnosed me with gastroesophageal reflux disease (GERD) and gastritis of unknown origin.
I have been taking the medication prescribed by the doctor, and the symptoms of sour belching have resolved, but the constant belching persists.
I am unsure of the cause, and it has been a week without improvement.
I am really struggling and hope the doctor can provide some advice.
Thank you.

SS, 20~29 year old female. Ask Date: 2018/12/21

Dr. Chen Qifeng reply Gastroenterology and Hepatology

It is recommended to undergo a gastroscopy.

Reply Date: 2018/12/21

More Info

Persistent hiccups can be quite bothersome and may indicate underlying issues that need to be addressed. Hiccups occur when the diaphragm, the muscle that separates the chest from the abdomen and plays a crucial role in breathing, involuntarily contracts. This contraction is followed by a sudden closure of the vocal cords, which produces the characteristic "hic" sound. While most hiccups resolve on their own, persistent hiccups lasting more than 48 hours can be a sign of a more serious condition.

Based on your description, it seems that your hiccups began after a large meal and have persisted for over a week. You mentioned that you have been diagnosed with gastroesophageal reflux disease (GERD) and gastritis, which can contribute to hiccups. GERD occurs when stomach acid flows back into the esophagus, leading to symptoms such as heartburn, regurgitation, and discomfort. This acid reflux can irritate the diaphragm and esophagus, potentially triggering hiccups.

There are several potential causes of persistent hiccups, including:
1. Gastrointestinal Issues: Conditions like GERD, gastritis, or even peptic ulcers can irritate the diaphragm and lead to hiccups. The sensation of fullness or pressure in the stomach can also trigger hiccups.

2. Nerve Irritation: The phrenic nerves, which control the diaphragm, can become irritated due to various factors, including inflammation or injury. Conditions affecting the neck or chest can also impact these nerves.

3. Metabolic Disorders: Imbalances in electrolytes, such as low potassium or sodium levels, can lead to hiccups. Additionally, conditions like diabetes or kidney disease can contribute to this issue.

4. Psychogenic Factors: Stress, anxiety, or excitement can sometimes trigger hiccups. If you are experiencing anxiety about your health or the hiccups themselves, this could exacerbate the problem.

5. Medications: Certain medications can cause hiccups as a side effect. If you have started any new medications recently, it may be worth discussing with your healthcare provider.

To manage and relieve persistent hiccups, consider the following strategies:
1. Dietary Changes: Avoid large meals, spicy foods, carbonated beverages, and alcohol, as these can exacerbate GERD and gastritis symptoms. Eating smaller, more frequent meals may help.

2. Hydration: Staying well-hydrated can help dilute stomach acid and reduce irritation. Drinking water slowly or sipping on warm liquids may provide relief.

3. Posture: Maintaining an upright posture after eating can help prevent acid reflux. Avoid lying down immediately after meals.

4. Relaxation Techniques: If stress or anxiety is contributing to your hiccups, practicing relaxation techniques such as deep breathing, meditation, or yoga may help.

5. Medical Follow-Up: Since your hiccups have persisted despite treatment for GERD and gastritis, it is essential to follow up with your healthcare provider. They may consider further evaluation, such as imaging studies or referral to a gastroenterologist, to rule out other underlying conditions.

6. Medications: In some cases, medications that suppress acid production or promote gastric motility may be prescribed to help manage symptoms.

In conclusion, persistent hiccups can be a frustrating experience, especially when they interfere with daily life. Understanding the underlying causes and implementing lifestyle changes can help alleviate symptoms. However, it is crucial to maintain open communication with your healthcare provider to ensure that any serious conditions are addressed and managed appropriately. If your symptoms do not improve or worsen, seeking further medical evaluation is essential.

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