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Hiccups and cancer

Hiccups are a common problem that we all have from time to time. For most people, hiccups are usually mild and go away without any medical treatment. But when hiccups are a symptom of cancer, or a side effect of cancer treatment, they can go on for longer. This makes them tiring and difficult to cope with.

Hiccups are uncontrolled spasms of your diaphragm between normal breaths. The diaphragm is the dome shaped muscle under your ribcage. Normally, your diaphragm helps to pull air into your lungs by pulling downwards as you breathe in. And when you breathe out, your diaphragm pushes upwards.

But when you hiccup, 2 things happen:

  • 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 makes the 'hic' sound.
Diagram showing the lungs and diaphragm

Causes of hiccups

We don’t know the exact cause of hiccups. It might happen 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)

Things to try for mild hiccups

Most people find that their hiccups go away either on their own or by trying one of the following suggestions:

  • gargling or drinking ice water
  • eating a piece of dry bread slowly
  • drinking water from the far side of a glass – you will need to be able to bend over to do this
  • taking a deep breath, holding it for as long as you can and repeating this several times
  • sucking on a lemon
  • drinking peppermint water
  • pulling your knees up to your chest
  • breathing in and out of a paper bag (not a plastic one and don’t do this for any longer than 1 minute)

Treatment for more severe hiccups

Some hiccups can last for more than a couple of days. Doctors call these persistent hiccups. If they last longer than a month, doctors call them intractable. If they last this long they can cause other problems, including:

  • weight loss
  • difficulty in sleeping
  • feeling sick (nausea)
  • embarrassment
  • feeling sad or depressed

People with persistent or intractable hiccups need medical treatment. First, your doctor will try to find out what is causing your hiccups. They may disappear by treating the cause, for example, changing the drugs that may be responsible for the hiccups.

But your doctor may treat the hiccups directly. Drugs they may use include:

  • the anti sickness drug metoclopramide (Maxolon)
  • a sedative, such as haloperidol or chlorpromazine
  • a drug to relax your muscles such as baclofen
Last reviewed: 
13 Dec 2019
  • Hiccups
    AJ Lembo
    UpToDate website, Accessed 13/12/2019

  • Management of hiccups in palliative care patients
    YS Jeon and others
    BMJ Supportive and Palliative Care, 2018. Vol 8. Pages 1-6

  • Oxford Textbook of Palliative Medicine (5th edition)
    NI Cherny, MT Fallon, S Kaasa, RK Portenoy and DC Currow (eds)
    Oxford University Press, 2015

  • Interventions for treating persistent and intractable hiccups in adults
    EN Moretto and others
    Cochrane Database of Systematic Reviews, 2013. Issue 1

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