But… But… I Have Anecdotal Evidence!


While I generally stay away from listicles, I will occasionally read a few that I come across on iflscience.com, usually involving popular health or science myths. Debunking things is something that I enjoy, and I definitely don’t want to continue believing things that have been shown to be false. Occasionally, though, I find myself trying to cling to beliefs given my own personal anecdotal evidence, despite the fact that I should really know better, as I work in science.

This happened to me recently, when I was watching this video about 25 popular health myths

 

My issue was with number 15: startling someone will not get rid of hiccups.

Really? That’s a myth? But but but… I have a colleague who is both prone to hiccups and easily startled. In the two years that I have known her, I have startled her about 10 times when she was hiccuping, and it worked immediately every single time. That is of course completely anecdotal, but there must be a reason for that, mustn’t there?

I became confused, though, when he explained why startling someone is supposed to relieve hiccups. He says that it is believed that causing someone to yell causes the diaphragm to stretch, and relieving the hiccup.

Well, that doesn’t make any sense at all, on its face. You could just take a deep breath and yell, if that was all it took to relieve hiccups. You didn’t have to go through the bother of successfully startling someone. I had developed my own theory as to why startling helped hiccuping, and it took my seeing this video to realize that the explanation I always had in my head was one that I had completely made up, without ever checking up on it.

When I was growing up, I noticed that the various things that you were supposed to do to relieve hiccups (drinking from the wrong end of a glass, holding your breath, drinking a glass of water while turning it and staring at the bottom) all worked to varying degrees, and then stopped working completely. I then realized that, when the various tricks stopped working for me, personally, was when I had gotten quite good at them. I realized that, at the beginning, I was so focused on the tricky task at hand that I was distracted from my hiccups, and then they would stop. If the task became too easy, I could do it while focusing on the fact that I was hiccuping the entire time, and it would not work. That was why I thought scaring was the only thing that seemed to work every single time: you can’t be startled if you’re expecting it, by definition, and so it is always distracting.

All of my experience with hiccuping dovetailed into this explanation I came up for myself many years ago, but is that confirmation bias, or has this hypothesis been tested and debunked? Well, to the scientific literature!Case Report: sexual intercourse as potential treatment for intractable hiccups. Ha! well, that will surely distract you, but let’s move on. Is there anything about the idea that a distraction can help relieve hiccups? Or any studies that show that startling does not relieve hiccups?The problem is, most of the scientific literature is dedicated to persistent hiccuping, defined as a bout of 48hr or longer, which has adverse health implications. Your casual bouts of 3-5 minutes of hiccuping, while annoying, do not seem to be quite as worthy of scientific study. While they all seem to be clear that nobody really understands why we hiccup, the only sources that I could find about relieving hiccups that did not involve intravenous drugs or sticking ether up someone’s nose (o.O) was this webpage from the HCA Virginia Health System:Most of the popular hiccup remedies presumably work by attempting to “distract” or stimulate the vagus nerve (which connects the brain to the abdomen) with another sensation. Others may work by interfering with the carbon dioxide levels in the blood, which also prompts the brain to focus on more important matters than hiccups.

Aha! Distracting! I knew I wasn’t the only one to have connected the two. However, I have no idea how reliable the HCA Virginia Health System is, it certainly doesn’t qualify as a peer-reviewed scientific paper.

However, there is a little bit (well, a case study of one) in the scientific literature that seems to give credence to this vagus-nerve-stimulation hypothesis

A 23-year-old male student presented with 4 days of persistent hiccups that disturbed his daily activities and sleep.
Distressed by the ongoing symptoms, the patient searched for an alternative cure and found the following technique to be effective: the tip of a moistened cotton bud is firmly rubbed along the border between the soft and hard palate for approximately 1 min (…). The cure was instantaneous and long-lasting. On follow-up, the patient admitted to the successful use of the ‘‘cotton bud technique’’ to relieve a subsequent bout of hiccups
The ‘‘cotton bud technique’’ stimulates the nasopharynx, increasing vagal tone and thereby interrupting the vagal afferent limb of the hiccup reflex. We suggest that this technique is an ideal treatment for persistent hiccups, once sinister pathology is excluded.
Well, there you have it. So, what are we to conclude from this rambling search through the literature for a cure for hiccups?
1. Just because someone says “that has been debunked”, it doesn’t mean it has! Sometimes, debunking a myth is a myth in itself.
2. hiccups are really annoying

Comments

  1. johnson catman says

    I have only ever had hiccups rarely. What worked to cure the bout for me was to drink water for a certain number of swallows without taking a breath (I think maybe 15). I always thought it had some kind of calming effect on the diaphragm. I have never had hiccups that lasted for an extended period. And I would not have gone four days without seeking professional help for them!

  2. anat says

    Anything that uses control of one’s breathing can potentially break up a burst of hiccups. Taking deep breaths and not breathing for a while both work.

  3. Numenaster says

    I like the distraction method of mentally drawing a triangle in the air. The concentration needed to visualize the triangle and slowly push a line from one vertex to the next is enough to completely break up the hiccup within moments, even though I’ve gotten pretty good at it.

  4. Raucous Indignation says

    True, they are all vagal maneuvers. Sedatives and older anti-psychotic medications also are marginally effective. Numenaster, do you hold your breath or alter your breathing when you are triangling?

  5. Numenaster says

    RI, I definitely alter my breath, but it’s unconscious. When I’m concentrating on the visual, my breathing slows down.

  6. Anders Kehlet says

    I only get hiccups when eating too fast (especially stuff like white bread) and I get rid of the hiccups again simply by swallowing whatever I’ve been stuffing my face with, relaxing and breathing normally. I don’t remember the last time it lasted more than 10 seconds.

    I remember a trick an old teacher of mine once used on a hiccuping student. She just waved the student over and said something like “Come see this”, then went “So… no more hiccups?”

  7. DonDueed says

    Speaking of anecdotes…

    Over the last several years, I have twice been prescribed hydrocodone for pain relief after surgery. The most recent time was a month ago. In both cases I experienced persistent hiccups that lasted several days (on and off).

    Apparently this is a thing. It’s sometimes called dope hiccups, opioid hiccups, or codeine hiccups. The official jury seems to be out, though, since it’s not listed as a potential side effect on the fact sheet. Nobody seems to have identified a mechanism to link the drug to the symptom.

    I had no luck with any of the cure techniques I tried. In both episodes, the hiccups lasted (with brief respites) until I stopped taking the hydrocodone, and then continued for another day before finally stopping for good. I wish I’d known about the cotton swab trick, it would have been interesting to try.

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