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Hiccups may occur individually, or they may occur in bouts. The rhythm of the hiccup, or the time between hiccups, tends to be relatively constant. A bout of hiccups, in general, resolves itself without intervention, although many home remedies are often used to attempt to shorten the duration. Medical treatment is occasionally necessary in cases of chronic hiccups.
Hiccups may present as an audible chirp, squeak, «hupp», or if controlled, a quick inhaling gasp, sigh, or sniff. Hiccups may be triggered by a number of common human conditions. In rare cases, they can be a sign of serious medical problems. A recent explanation by Howes in 2012 suggests that hiccups may have evolved along with other reflexes developed in mammals creating hypothesis allow them to coordinate suckling milk and breathing.
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Hiccups are only found in mammals, and are most common in infants, becoming rarer as mammals age. An international respiratory research group composed of members from Canada, France, and Japan proposed that the hiccup is an evolutionary remnant of earlier amphibian respiration. Fetal intrauterine hiccups are of two types. The physiological type occurs prior to twenty-eight weeks after conception and tend to last five to ten minutes. These hiccups are part of fetal development and are associated with the myelination of the phrenic nerve, which primarily controls the thoracic diaphragm.
The phylogeny hypothesis explains how the hiccup reflex might have evolved, and if there is not an explanation it may explain hiccups as an evolutionary remnant, held over from our amphibious ancestors. Hiccups are normally waited out, as any fit of them will usually pass quickly. Folkloric ‘cures’ for hiccups are common and varied, but no effective standard for stopping hiccups has been documented. Numerous medical remedies exist but no particular treatment is known to be especially effective, generally because of a paucity of high-quality evidence. The effect can be immediate, and also have lasting effect after the lidocaine effect expires after about two hours.
Persistent digital rectal massage has also been proven effective in terminating intractable hiccups. It is notable, that an Ig Nobel Prize has been awarded for this discovery. The administration of intranasal vinegar was found to ease the chronic and severe hiccups of a three-year-old Japanese girl. Lockhart stated that hiccups can sometimes be cured by pinching the skin that covers the surface of the deltoid muscles, which is supplied by the axillary nerve which shares the c5 nerve root with the phrenic nerve. There are many superstitious and folk remedies for hiccups, including headstanding, drinking a glass of water upside-down, being frightened by someone, breathing into a bag, and eating a large spoonful of peanut butter. Placing sugar on or under the tongue has also been used.
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