Hiccups are involuntary contractions of the diaphragm, the muscle separating your chest from your abdomen, followed by a sudden closure of the vocal cords, producing the characteristic “hic” sound. While often a minor annoyance, hiccups can sometimes occur after surgery, raising concerns for patients. This article explores the commonality of post-surgical hiccups, their underlying causes, when medical attention is necessary, and strategies for relief.
How Frequently They Occur
Hiccups are common, usually resolving within minutes to a few hours. After surgery, hiccups can be a relatively common occurrence, though precise statistics on their frequency are limited. Certain surgeries, especially those involving the abdomen or requiring general anesthesia, can increase the likelihood of hiccups.
Reasons for Post-Surgery Hiccups
Hiccups after surgery often result from irritation to the nerves controlling the diaphragm, such as the vagus and phrenic nerves. During abdominal surgery, the diaphragm can become irritated, particularly with laparoscopic procedures where gas is inflated into the belly to create space for visualization. This distension can press against the phrenic nerves, triggering spasms.
General anesthesia is another factor that can contribute to post-surgical hiccups. Certain anesthetic agents, including propofol, muscle relaxants, and opioids, may induce hiccups. The breathing tube used during surgery can irritate the diaphragm. Inflammation of the stomach or changes in the digestive system following surgery, such as slowed digestion, can also irritate the diaphragm and nerve pathways, causing hiccups. Electrolyte imbalances or gastroesophageal reflux disease (GERD), which might be exacerbated post-surgery, are known to trigger hiccups.
When to Seek Medical Attention
While most hiccups resolve quickly, some situations warrant medical attention, especially after surgery. Hiccups that last longer than 48 hours are “persistent” and should prompt a call to a healthcare provider. If hiccups continue for more than a month, they are termed “intractable” and often indicate a more serious underlying issue.
You should contact your doctor if hiccups interfere with eating, drinking, sleeping, or speaking. These prolonged episodes can lead to complications such as weight loss and extreme tiredness. Seek immediate medical care if hiccups are accompanied by other concerning symptoms, such as sudden numbness, coordination issues, or heart-related symptoms, as these could signal a serious medical condition. Your healthcare provider will assess your medical history, current medications, recent surgeries, and other symptoms to determine the cause and appropriate course of action.
Relief Strategies
For short-lived hiccups after surgery, several non-invasive methods can alleviate the spasms. These strategies often work by stimulating the vagus nerve or by disrupting the normal breathing rhythm. Simple physical maneuvers include holding your breath for 10 to 20 seconds, sipping cold water, gargling with iced water, pulling on the tongue, pressing on the eyeballs, or breathing into a paper bag.
If hiccups persist, medical intervention may be necessary. Healthcare providers might consider prescribing medications. Chlorpromazine is the only medication specifically approved by the FDA for intractable hiccups, though other drugs like baclofen, gabapentin, and metoclopramide are also used. Addressing any underlying causes, such as electrolyte imbalances or gastric distension, is also a crucial part of managing persistent post-surgical hiccups. In rare, severe cases, nerve blocks or surgical procedures on the phrenic or vagus nerves might be explored.