Hiccups are repeated diaphragm spasms accompanied by a “hic” sound from the vocal cords’ closing. In case of hiccups, the diaphragm pulls down between two breaths. Hence, one sucks in the air. It is followed by closing of the space between the vocal cords or the glottis to prevent more air from going in. The hiccup process happens quickly, and generally, one returns to normal in only a few minutes or hours sans any treatment.

Symptoms
When one’s diaphragm gets a spasm, the lungs quickly suck in the air, making the vocal cords shut abruptly, producing the “hic” sound. As part of the hiccup, the muscles between the ribs contract, resulting in the pulling up of the abdomen and the ribs. Over time, this movement becomes uncomfortable. Usually, hiccups occur just once or in clusters. Typically, there is hardly any duration between two hiccups and they resolve latest within 48 hours, but intractable hiccups can last for some months, and one may need medical intervention.

Causes
Common triggers for hiccups that last less than 48 hours are:

• Eating too much
• Drinking a carbonated beverage
• Being under emotional stress or excited
• Swallowing air, such as when chewing gum
• Experiencing sudden changes in temperature

However, sometimes one may experience hiccup symptoms for over 48 hours. Central nervous system disorders, nerve irritation or damage, or metabolic issues may cause such hiccups. 

Central nervous system disorders
Infection or tumor in the central nervous system or any damage to the system because of an injury may disrupt the body’s ability to control the hiccup reflex. Some examples of disorders that may cause hiccups include:

• Brain inflammation or encephalitis
• Stroke
• Tumors
• Serious brain injury
• Meningitis or inflammation in the membranes surrounding the spinal cord and brain
• Multiple sclerosis or hardening of the spinal cord or brain tissue, resulting in tremors or paralysis

Nerve irritation or damage
Irritation or damage to the phrenic or vagus nerves can also be one of the causes of long-term hiccups. Some factors that may irritate or damage these nerves are:

• Laryngitis or sore throat
• Cyst, tumor, or growth in the thyroid gland in the neck
• Hair in the ear touching the eardrum
• Stomach acid moving back into the esophagus

Metabolic issues
One may experience long-term hiccups when the metabolism does not work well. A few examples of such issues are:

• Kidney disease
• Electrolyte imbalance
• Diabetes

Risk factors
Long-term hiccups are more common in males than females. Some factors that aggravate one’s risk of developing hiccups include:

• Surgery
  Some people develop hiccups after going through procedures involving the stomach organs or post-general anesthesia.
• Emotional or mental health issues
  Excitement, stress, and anxiety can also trigger long-term hiccups.

Remedies
Usually, hiccups go away after a few minutes or hours. Hence, they will need no treatment. But if they prolong, one must see a healthcare expert. 

Here are some tips that can help one get rid of hiccups.

• Gargling with cold water or sipping ice-cold water slowly
• Holding the breath for a brief period and then breathing out 
• Putting mild pressure on the nose while swallowing
• Biting on a lemon
• Placing pressure on the diaphragm
• Swallowing granulated sugar
• Breathing in and out of a paper bag
• Leaning forward to compress the chest
• Rubbing the eyes
• Gently pulling on the tongue
• Taking vinegar in small quantity
• Trying alternative treatment options like hypnosis or acupuncture
• Sitting down and clutching the knees as close to the chest as possible
• Touching one finger to the throat, triggering a gag reflex

If these general home remedies do not work, there may be an underlying health condition causing hiccup symptoms. For this, one will need a prescription treatment. Usually, doctors prescribe a two-week course for treating hiccups. However, one’s age, general health, and hiccup severity determine the dosage and course. Moreover, when no other treatment options work, doctors may suggest a surgery to temporarily block the nerve’s action.