Hiccups are caused by the involuntary myoclonic contraction of the diaphragm and the auxiliary respiratory muscles in irregular series, followed by abrupt closure of the glottis. Each contraction is followed by a sudden closure of the vocal cords, which produces the characteristic “hic” sound.

Hiccups are quite common and can be overlooked as a cause of distress for a child with palliative care needs. They can cause considerable interruption to normal activity and may also be responsible for low mood, feeding and sleep disturbances, thus affecting quality of life.

Hiccups can be classified as follows:

Causes of hiccups

Intractable hiccups are likely to have more sinister causes which could include:

• Irritation of the phrenic nerve or diaphragm by a tumour or chest infection
• Irritation of the vagus nerve from gastro-oesohpageal reflux, oesophagitis, hiatus hernia, acsites or hepatic tumour
• Metabolic disturbances such as uraemia and hyponatremia
• CNS tumours (especially brain stem)
• Certain medications such as benzodiazepines, corticosteroids and barbiturates

Hiccup, Causes, Signs and Symptoms, Diagnosis and Treatment

Watch the excellent short video below from Medical Centric that describes the causes, possible diagnoses and treatments for hiccups.

Management of hiccups