What are my hiccups telling me?

Everyone gets hiccups in their life. The majority of the time they are completely harmless and are more of an irritant than a symptom of an underlying condition, but, if you experience hiccups that last more than 48 hours this could potentially signal serious health complications.

"You should seek advice from your health care provider if your hiccups progress from happening every once in a while to becoming persistent or intractable," said Timothy Pfanner, M.D., assistant professor of medicine at the Texas A&M Health Science Center College of Medicine.

Hiccups happen when the diaphragm and respiratory organs experience a sudden, involuntary spasm. This spasm is usually followed by the closure of the glottis (the slit-like opening between the vocal cords and larynx) and a characteristic sound like that of a cough. Persistent hiccups are hiccups that last more than 48 hours but less than 30 days while intractable hiccups are classified as hiccups that last more than 30 days.

Occasional hiccups are mostly harmless

Pfanner added hiccups are normally seen in smokers and people who consume large amounts of alcohol. "Anything that causes your stomach to become distended can cause hiccups," he said. "Smokers are prone because they are constantly swallowing air. Drinking alcohol can induce hiccups because it irritates the esophagus and may result in a flare-up of acid reflux."

Acid reflux disease is a common culprit behind hiccups, and surprisingly, ear infections may cause them as well. When the tympanic membrane (the membrane in the ear that vibrates in response to sound waves) becomes irritated this can result in hiccups.

"This membrane can become irritated due to infection -- especially if a hair makes its way into the ear and sits next to the membrane," Pfanner said. "This is a very common cause for hiccups that don't subside."

If your hiccups last more than two days talk to your physician

"Generally, when someone is diagnosed with intractable hiccups, we start worrying that something more serious is going on internally," Pfanner said. "However, since intractable hiccups are also a symptom of acid reflux disease it's always important to discuss your symptoms with your physician."

Cancer is never a word thrown around lightly, and according to Pfanner, intractable hiccups could be a symptom of certain cancers. "Sometimes we see intractable hiccups in patients diagnosed with cancers of the brain, lymph nodes or stomach cancer," he said. "They can also indicate stroke. It's still unclear why many of these incidents occur."

Since hiccups convulse the muscles that control the diaphragm, patients who experience persistent or intractable hiccups can suffer nerve damage in the nerve that controls these muscles. "This may also point to a tumor in the neck or goiter," Pfanner said.

Pesky hiccups that refuse to subside may even be symptoms of heart muscle damage or a heart attack. "Persistent or intractable hiccups can indicate inflammation around the heart or a pending heart attack," Pfanner said. "That's why we always want patients who are experiencing these type of hiccups to immediately consult their health care provider."

Don't panic

While hiccups can be tell-tale signs of serious health complications, common hiccups are more of a nuisance than a health risk.

To quickly ease your occasional hiccup woes, Pfanner recommends a few different methods. "You can hold your breath (for a short period of time) or breathe into a bag to ease hiccups," he said. "Other methods include putting a cotton swab in the back of the throat to induce a gag reflex, gargling with ice water, swallowing granulated sugar, biting a lemon and pulling your knees to the chest to compress it. Pressing lightly on the eyeballs will also activate your vagus nerve and result in a reflex that hinders the spasm of hiccups."