Hiccups and MS: Another bothersome multiple sclerosis symptom?

Probably everyone has experienced these sudden spasms known as hiccups, or hiccoughs. Many people who live with multiple sclerosis can readily attest to this, as hiccups seem to be particular problems at times.

These surprising contractions of the diaphragm are generally harmless, but they can be a nuisance and a distraction. In fact, they can be downright embarrassing, if they occur at inappropriate times . . . such as during a written exam, church service, theatrical performance, or job interview.

What causes hiccups?

Eating or drinking too much or too fast is the most common cause. Consuming large quantities of carbonated or alcoholic beverages may sometimes be blamed. At times, hiccups may be an involuntary defense against choking.

Surprise, excitement, and stress can cause us to gasp, and the sudden intake of air may cause hiccups. Laughing, being tickled and burping contests can cause them too.

For MSers, intermittent swallowing difficulties may contribute to hiccups as well.

How do hiccups happen?

The diaphragm is the dome-shaped muscle inside the abdominal cavity. It is essential to normal breathing. When you breathe in, the diaphragm helps pull the oxygen into your lungs. When you breathe out, it pushes up to help your lungs expel the air.

Place your hands on your abdomen, just below your rib cage. Breathe in and out. You can feel your diaphragm rise and fall. (Singers actually perform this exercise to build breath support for sustaining long notes.)

If your diaphragm is somehow irritated, it can begin twitching and lurching. Suddenly, you find yourself sucking air, which comes popping back into your larynx, or voice box, with a gulping sound. That’s a hiccup.

And if hiccups should strike during an MS hug, look out!

How can hiccups be halted?

Many home remedies have been offered over the years. Some recommendations may require more physical agility and stamina than others, making them suitable or unrealistic for anyone with MS.

You can have someone startle you, breathe into a small paper bag, drink a large glass of water, do a few sit-ups, hang from your knees upside down (as on a trapeze), hold your breath (and count to 20), hold your nose, massage the roof of your mouth, place a teaspoonful of sugar under your tongue, press your tongue against the roof of your mouth as hard as you can, pull gently on your tongue, sip a water bottle (while upside down), or take a walk.

Many people swear by any of these anti-hiccup ingredients: chocolate, corn syrup, dill pickles, honey, jalapeno peppers, marshmallows, mustard, peanut butter, peppermints, or sugar.

How long do hiccups last?

Often, hiccups will abate on their own within a few minutes. Occasionally, they may last for several days or even weeks. When this happens, the hiccups usually signal a more serious medical condition. Irritations of the throat or stomach, such as acid reflux, may trigger hiccups.  In severe cases, recurrent hiccups may be a symptom of pneumonia, kidney failure, or even esophageal cancer.

Generally, medical help is not needed for hiccups, unless they occur repeatedly, last for more than a couple of hours, or lead to the spitting up of blood.

In most cases, if you can just wait it out, the hiccups will cease. However, uncontrollable hiccups have been identified as a symptom of multiple sclerosis. These intractable hiccups seem to last a very long time before abating on their own, and they tend to return unpredictably in affected individuals.

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