2023-05-26 09:13:16
Uncontrollable, hiccups are triggered in multiple situations. If it is often banal, it is not always without gravity.
After a heavy meal, a heavy consumption of alcohol or soft drinks… Everyone has already had hiccups. More or less bothersome, it is generally benign and ceases spontaneously. However, a chronic and persistent hiccup can betray a more serious pathology. What are the types of hiccups? What are the causes? How to get rid of it? “Le Figaro” takes stock with Dr. Michel Charbit, gastroenterologist and hepatologist at the American Hospital in Paris.
What is the mechanism of hiccups?
From a physiological point of view, hiccups correspond to the sudden involuntary contraction of the inspiratory muscles at the level of the diaphragm and muscles intercostaux (between two adjacent ribs) which results in spasm of the glottis, the segment of the larynx located between the lower vocal cords “, explains Michel Charbit. It is the spasm of the glottis that produces the characteristic sound of hiccups. Resulting from a complex nervous activity, the latter is in fact a symptom which translates an irritation of the glottis, the aerodigestive passages or the esophagus. Hiccups occur when the opening in the muscle at the junction of the diaphragm and the stomach, the cardia, malfunctions. “ Normally, the cardia opens and closes spontaneously to allow food to circulate, but if it is too open, the acidity of the stomach may rise into the esophagus, burning its walls. “, explains Dr. Charbit.
What are acute hiccups?
Acute hiccups can occur at any age. Most often benign, it usually lasts a few minutes and never lasts longer than 48 hours. However, it can be annoying due to the uncontrolled twitching of the respiratory muscles. Several causes can explain it. Most of the time the triggering factors are of food origin: Typically it occurs when you do not chew enough, when you talk while eating, if the meal is hearty and consists of very fatty, sweet or spicy foods or following an abuse of carbonated drinks and / or alcohol “, explains Dr. Charbit. Other causes can be stress or strong emotions. In the particular case of the baby, acute hiccups can be explained by the fact that the cardia is not yet fully formed. The frequency of hiccups therefore decreases with age as this muscle matures.
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When is hiccups worrisome?
When the hiccups persist for more than 48 hours, it is possible that it is of pathological origin: we speak of chronic hiccups or recurrent hiccups. “ In 8 out of 10 cases, chronic hiccups are due to esophagitis, i.e. inflammation of the esophagus related to the gastroesophageal reflux. Acid reflux through the cardia, which leads to burning, inflammation and even small ulcers in the esophagus, is the most common organic cause of chronic hiccups “says Dr. Charbit. But this type of hiccup can also be associated with more serious causes such as a hiatal hernia (when the upper portion of the stomach enters the thorax), a peptic ulcer in the first part of the intestine, more rarely a tumor of the peritoneum (the membrane that surrounds all the digestive organs), a neurological disease of the larynx, pharynx or organs of the thorax, or even taking certain medications (benzodiazepines, corticosteroids, barbiturates, morphine, anesthetics, etc.).
“If recurrences of hiccups over more than two days are sufficient for the patient to seek medical attention, the record for chronic hiccups is however held by an American, Charles Osborne, who suffered from them continuously for nearly 68 years. »
How to get rid of acute hiccups?
« What works best is to stop breathing: when you hold your breath the intercostal muscles freeze, thus blocking the diaphragm which then stops going up and down “says Michel Charbit. Grandma’s tricks, like drink water without breathing and head thrown back, put an ice cube on his navel or scare to the person suffering from hiccups, do not cure the causes of the hiccups. However, they all have in common to cause temporary apnea and divert attention. These methods therefore remain effective. “ Drinking upside down allows you to focus on something else. When you are lightly punched or frightened, you involuntarily stop breathing for a brief moment. Same with the ice cube: as soon as it is placed on the stomach the feeling of cold is such that the body reacts by suddenly cutting off the breath for a few seconds “, explains Michel Charbit.
In the event of heartburn associated with food or drink, the use of gastric dressings, for some available over the counter (such as Gaviscon), may be necessary. These dressings are traditionally presented in the form of a paste which lines the stomach lining and neutralizes gastric acidity. This also explains why honey is often indicated once morest hiccups because its viscosity has a barrier effect quite similar to dressings.
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What treatment for chronic hiccups?
Chronic hiccups can be treated with a standard treatment for gastroesophageal reflux, the effect of which is to reduce the acidity of the stomach. As with acute hiccups, gastric dressings work by calming the inflammation of the esophagus. However, for ulcers and major acid reflux, dressings sometimes prove insufficient, in which case they can be combined with stomach acid inhibitors. « One of the most common is omeprazole, a proton pump inhibitor (PPI) that exhibits a prolonged but delayed action on reducing acidity “explains the doctor.
As for the duration of treatment, there is no rule. If it is linked to a “ error » food (having eaten too much fat, too quickly), the hiccups pass quickly. “ In the case of a pathology of gastroesophageal reflux, the treatment can extend between 1 and 2 months “says Dr. Charbit.
” READ ALSO – Acid reflux: how to relieve them?
What to do with babies?
Baby hiccups are often linked to a feeding problem. Sometimes it is simply lactose intolerance or an unsuitable thickness of milk. “ Thicker milk descends faster in the stomach and is therefore assimilated more quickly, which prevents acid reflux explains Dr. Charbit. After a meal, however, burping is essential because if the baby immediately finds himself in a lying position, the chances of triggering hiccups are greater. “ To pass the hiccups of the infant, one of the techniques is to raise the arm of the baby which stops breathing for a quarter of a second. “, underlines the gastroenterologist.
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