Every single person has hiccups. They are involuntary contractions of the diaphragm. Diaphragm is the muscle which separates the chest from the abdomen and it plays an important role in breathing. Each contraction is followed by sudden closure of the vocal cords and this is producing the characteristic “hic” sound. Hiccups can result from sudden excitement, carbonated beverages, alcoholic beverages or a large meal. Also there are some cases when hiccups can be a result from some underlying condition. For most people, a bout of hiccups usually last only a few minutes and there are very rare cases when hiccups can last for months. If they last for months, then this could result in exhaustion and weight loss .
Symptoms of hiccups
You should know that the hiccupping is a symptom. Also there are some cases in which it can be accompanied by a slight tightening sensation in the chest, throat or abdomen. You should visit your doctor if your hiccups last for more than 48 hours or if they are so severe so they are making you problems with breathing, sleeping or eating.
Causes of hiccups
Here are the most common triggers for hiccups which last for more than 48 hours:
- Swallowing air with chewing gum or sucking on candy
- Sudden temperature changes
- Excitement or emotional stress
- Eating too much
- Drinking too much alcohol 
- Drinking carbonated beverages
Those hiccups, it is meant for hiccups that last more than forty-eight hours, can be caused by different factors and they can be grouped in the following categories:
- Metabolic disorders and drugs: These long – term hiccups can be triggered by:
- A condition irritating the vagus nerve, which is a nerve that controls the diaphragm, such as meningitis, pharyngitis or goitre
- Benzodiazepines, which is a type of sedative that can help to reduce the anxiety
- A psychological reaction, such as stress, excitement, grief, fear and shock
- Methyldopa, which is medication used to treat high blood pressure also known as hypertension
- Kidney disease
- Corticosteroids, which is medication that is used to reduce the inflammation (swelling)
- Electrolyte imbalance
- Conditions which are involving your metabolism (metabolism is the way your body is digesting food), such as hyperglycaemia, hypoglycaemia or diabetes
- Chemotherapy medications, which are medications used to kill cancer cells
- Barbiturates, this is a type of sedative which is sometimes used to prevent seizures (fits)
- Opioids, which are medications that are used to treat pain. Two strong opioids are methadone and morphine.
- Anesthesia, which is a medication that is given before a surgical operation or procedure which can cause a loss of sensation or consciousness
- Alcoholism 
- Central nervous disorders: An infection or tumor in the central nervous system or damage to the central nervous system as a result of trauma can disrupt the normal control of our bodies for the hiccup reflex. [1,3] Here are some examples:
- Tumor affecting the brain
- Traumatic brain injury
- Multiple sclerosis
- Nerve irritation or damage: A cause of long – term hiccups is a irritation or damage to the phrenic nerves or vagus nerves and this can serve the diaphragm muscle.  Here are some factors which can cause irritation or damage to these nerves:
- Sore throat or laryngitis
- Gastroesophageal reflux disease (GORD)
- A tumor, cyst or goiter in the neck
- IBD (inflammatory bowel disease)
- A hair or something else in the ear touching the eardrum
- Small bowel obstruction
Risk factors: It is known fact that men are having increased chances of developing long – term hiccups compared to women. Also there are other factors which can increase your risk of hiccups such as
- Surgery: There are some people who develop hiccups after undergoing general anesthesia of after procedures that involve abdominal organs. 
- Mental or emotional issues: Excitement, stress and anxiety have been associated with some cases of long – term and short – term hiccups. 
Complications: When someone has prolonged hiccups, then they can interfere with:
- Wound healing after surgery 
- Sleeping 
- Eating 
 Chang FY, Lu CL. Hiccup: Mystery, nature and treatment. Journal of Neurogastroenterology and Motility. 2012;18(2):123–30.
 Loyola University Health System. Intractable hiccups may be more common than we think. Science Daily. 2018. Retrieved from www.sciencedaily.com/releases/2018/07/180724174317.htm
 Nausheen F, Mohsin H, Lakhan SE. Neurotransmitters in hiccups. Springerplus. 2016;5(1):1357.
 Quiroga JB, Garcia JU, Guedes JB. Hiccups: a common problem with some unusual causes and cures. British Journal of General Practice. 2016;66(652):584–6.
 Bannon MG. Termination of hiccups occurring under anesthesia. Anesthesiology. 1991;74:385.
 Lee AR, Cho YW, Lee JM, et al. Treatment of persistent postoperative hiccups with stellate ganglion block: Three case reports. Medicine. 2018;97(48):e13370.
 Arnulf I, Boisteanu D, Whitelaw WA, et al. Chronic hiccups and sleep. Sleep. 1996;19(3):227-31.