Hiccup’s Secret

Sierra Pisenti knows Hiccup and really wishes she didn’t. Her hiccups are long and painful, lasting for hours, and since she was just a child, they have appeared more than ten times a month. Every rain is like a punch in the chest. “It’s a nightmare,” says Pizzenti, a stay-at-home mom in California.

Your hiccups probably aren’t as bad as Pizenti’s, but you probably know that painful feeling: a tightness in your chest, that familiar “hiccup,” and the desperation to end them. You are probably asking yourself the same question:

“How come there is no solution?”

“Things like this are often considered obvious or very simple by many doctors and they don’t address them,” says Mark Fox, MD, a gastroenterologist at the University Hospital in Zurich, Switzerland. Swallowing, eating, drinking, whatever happens in normal life, none of these things will kill you if done right. But it will ruin your life.”

Little by little, scientists are cracking down on two halves of the hiccup equation: first, why does such a thing exist at all; And secondly, how should we get rid of it?

Are our hiccups because we were once fish?

Hiccups are a simple reflex; Like when the doctor taps your knee and your leg jumps. Hiccups are common among mammals; From domestic dogs to horses and rabbits.

Treatment of hiccups
For generations, we’ve been turning to home remedies to relieve pesky hiccups—like this woman from 1955 who drank a glass of water upside down. But by understanding the deep evolutionary history of hiccups, science is moving toward effective treatments.

Hiccups are controlled by a reflex “bow” that sends nerve signals back and forth from the diaphragm to the brain. First, something triggers the diaphragm—a sheet of muscle at the bottom of the lungs—to contract. The diaphragm moves down (flexes) and creates space for the lungs to expand; Just like a regular tail. But in the middle of a breath, the reflex tells your epiglottis — a small flap at the top of your throat that keeps food out of your windpipe — to close. This creates a “whooping” sound and the cycle continues until something disturbs the bow.

The initial impulse usually originates from the intermediate nerve, or vagus nerve, which evolved in our gilled amphibian sac ancestors.

The common culprit is the intermediate nerve; A long, irregularly shaped string that winds down from the chest to the diaphragm. This nerve first appeared in mammalian fish ancestors – but they were short. In them, it was directly connected to the gills, which were located next to the brain; instead of traveling a long way to the diaphragm. In modern mammals, the number of nerves is so large that they are easily hit and stimulated.

The hiccups themselves could have been useful: when fish evolved into amphibians that spent part of their lives on land. They needed to move between different methods of breathing: gills underwater, lungs in air. The “hic” that closed the epiglottis of our ancestors allowed them to get water into their mouths and then into their gills without filling their lungs.

It’s good to remember that evolution doesn’t make things perfect—it just makes use of what it has.

Evolutionary origin of hiccups
Scientists believe that the ability of our amphibian ancestors to use the diaphragm to keep water out of the lungs while breathing underwater is the origin of our hiccups.

Or maybe we have hiccups because we were once children

Now that we no longer live underwater, why hasn’t this reflex disappeared?

Maybe because hiccups can have other benefits, says Dan Howes, a hiccups-loving emergency physician at Queen’s University in Canada.

One of the things that (almost) all breastfed babies do is suck. Children hiccup much more often than adults. When they drink milk, they also take in extra air; Huse says that hiccuping may help keep swallowed air out of their stomachs by reflex; Like a spontaneous belch.

There is evidence that after burping, children can drink 20-30% more milk; A significant jump in calories and “an important survival bonus,” according to Hose.

It’s not just young babies who hiccup a lot (up to 1% of the whole day); Fetuses as small as 10 weeks have hiccups and are clearly not yet suckling.

Kimberley Whitehead, a researcher at University College London, believes that hiccups can help map the fetus’s brain inside their body.

“A child has to learn,” he says Where is my aperture? Where can I control my breathing?” Hiccups can help them “practice” breathing so they’ll be ready when they’re born.

In one of his studies, he connected a number of babies (some premature and some a few months old) to an EEG machine and studied their brains while they were experiencing hiccups.

The activity of the part of the cortex that is related to the activity of the chest (place of the lungs and diaphragm) peaked during hiccups. This showed that hiccups caused activity in the brain and helped the babies “map” those muscles in the brain.

Hiccups in babies
According to some experts, hiccups help babies’ brains to be aware of the position of the muscles inside the chest.

Can someone cure me of hiccups?

About 4,000 people a year in the United States go to the hospital for treatment of this mostly harmless condition, but everyone has a problem: treating hiccups is almost always one of the most frequently asked medical questions.

Most cases resolve independently in less than two days. Longer ones can be a sign of an underlying problem; Like a brain tumor. Also, “intractable hiccups” are more permanent and persistent than the side effects of chemotherapy or steroids; More than 90% of these cases occur in men over 50 years old. In intractable hiccups, the best treatment is to address the underlying problem.

Doctors have tried a variety of medications for hiccups: some relax muscles, calm possible diaphragm spasms, or change nerve reactivity. But according to a 2018 study by neuroscientists at Loyola University in Chicago, “there is insufficient high-quality evidence to recommend a specific treatment.”

A Japanese research group uses a different strategy: getting people to breathe CO2 with high concentration.

Toshiro Obuchi, a thoracic surgeon and hiccup specialist at St. Mary’s Hospital in Japan, writes, “Simply speaking, maintaining a level of CO2 In the body, it tricks the brain into thinking there is a life-threatening emergency and forgets about the hiccups.”

Reeds to treat hiccups
HiccAway straws eliminate hiccups by creating difficult conditions for sucking fluids and engaging the intermediate and vagus nerves.

But if you can’t fly to Japan to have Dr. Obuchi treat you, the old wives’ tales of drinking a full glass of water in one gulp, standing on your head, or being really scared can really work; Because they all share one key principle: interfering with the reflex arc so that the nerves and muscles are distracted by something else. Ali Seifi says this; A neurologist at the University of Texas at San Antonio became interested in finding a cure after seeing a patient wake up with unexplained hiccups after brain surgery.

For example, downing a glass of water all at once forces your diaphragm muscle to produce constant suction, which engages the median nerve and interferes with one of the reflex areas. Fear activates the vagus nerve, which controls relaxation responses, thereby interfering with another part of the reflex.

But Siffy has designed a more sustainable tool: a straw called the HiccAway that forces a person to suck hard; Like drinking a thick milkshake. He suspects that the effort engages both nerves and hampers their ability to continue hiccups.

Like many other long-term hiccups sufferers, Pizzenti has never been diagnosed with intractable hiccups; Medicine does not always take treatment seriously. So finding the same straw was a consolation. He goes to her at the first signs of hiccups; While the straw won’t get rid of hiccups forever, it will suppress them temporarily. “This straw has changed my life,” he says.

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