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Why Chili Peppers and Spicy Foods Trigger Hiccups
Reproduced from original article:
https://articles.mercola.com/sites/articles/archive/2024/05/28/why-spicy-foods-trigger-hiccups.aspx
Analysis by Dr. Joseph Mercola May 28, 2024

STORY AT-A-GLANCE
- There are specific health benefits to spicy foods that range from helping your body fight some cancers, to reducing mucus production in your lungs and helping to prevent emphysema
- The chemical compound in spicy chili peppers may trigger hiccups by irritating the nerves that innervate your diaphragm or by being sprayed during chewing into your lungs and triggering a response from irritated lung tissue
- Hiccups are annoying and uncomfortable, but often self-limited; several home remedies may help get rid of them, including sucking on a lemon, squeezing your fingernail or gargling with ice water
I love spicy foods and enjoy the benefits of the spicy chemical in peppers — capsaicin — that may improve health. Chili peppers, one of the main sources of capsaicin, are a staple in diets of Central America, Asia and India. Even in the U.S. there are many who believe “the spicier the better.”
One food industry report found the number of people who enjoy spicy foods is growing, up to 54% from 46% in 2009.1,2 The same report found those between 18 and 34 were the most likely to order spicy food from a restaurant menu. Interestingly, the heat you experience from the chili pepper is a protection for the plant, designed to make you not want to eat them.
As far as scientists know, humans are the only animal who willingly chooses to eat chili peppers.3 On some level you may have learned to tolerate the heat, and may even crave the peppers. This ability to desensitize to the heat in peppers is well-documented, but other studies also demonstrate it may not play as large a role in your desire for spicy peppers as once thought.4
Researchers from Pennsylvania State University dug further and discovered people who enjoyed hot peppers also enjoyed sensation-seeking, including activities like riding roller coasters or exploring. Interestingly, individuals who enjoyed the peppers didn’t feel any less heat from the capsaicin than those who didn’t enjoy hot foods. In other words, this study group didn’t demonstrate desensitization to the peppers.
Your preference for spicy foods may be determined by not only your personality type, but also your genetics.5 Using identical and non-identical twins from Finland, researchers evaluated their responses to capsaicin-laced jelly. Genetic factors accounted for a wide range in variation between people who perceived the spicy jelly as pleasant or unpleasant. Those who did find the experience pleasant shared a genetic variance.
Spicy Food May Trigger Hiccups
If you love a bit of heat with your meal, you’re in luck, as spicy foods are some of the best for your health. The capsaicinoid found in the in the food has been linked to the prevention of chronic diseases. Coupled with their high concentration of vitamins and antioxidants, those spicy peppers are a unique superfood, if you can tolerate the heat. However, while tasty and healthy, these little spice bombs may also trigger the hiccups.
Hiccups may be triggered from stomach distension or irritating the nerve to your diaphragm when you drink too quickly. Spicy peppers don’t trigger hiccups in this way though. Although the exact way in which the pepper triggers hiccups has not been definitively established, scientists do know that not everyone gets hiccups from chili peppers.
Although some people get hiccups just anticipating eating hot peppers, others never get them. The chemical in peppers, capsaicin, that generates the heat, is believed to irritate the nerve that triggers hiccups.6 Others believe the chemical is released in the mouth in a fine spray that enters the lungs and disrupts the normal rhythm of the diaphragm.7 As your diaphragm begins to contract and relax to expel the substance from your lungs, it triggers a hiccup.
What’s Happening When You Have Hiccups?
Hiccups are an involuntary spasm in your diaphragm, the muscle separating your chest from your abdomen, which plays a significant role in breathing.
In this short video, you’ll see how hiccups may start after an irritation to nerves that service your chest and lungs. When your diaphragm contracts the space between your vocal cords closes and creates the characteristic “hic” sound. In order to draw breath, your diaphragm pulls down toward your abdomen, creating negative pressure in your lungs causing air to enter.
During the hiccups your diaphragm spasms, causing you to draw in an involuntary breath. In the simplest cases your stomach may get overdistended or you may have drunk fluid too quickly, irritating the nerve that innervates the diaphragm. Although the true reason for hiccups has not been determined, some believe an irritant triggers the diaphragm to contract helping to rid your gut of air that is trapped, or to draw food down your esophagus to your stomach.
Hiccups are usually self-limited and are nothing more than an uncomfortable nuisance. However, sometimes they can last for a long period of time, or be a signal that something else is wrong. A disturbance in the nerve pathway between the brain and the muscles involved can also trigger hiccups, which explains why you may get hiccups with an emotional situation and why they may be stopped when you are shocked.8
Hiccups are an involuntary movement triggered in part by your autonomic nervous system, the part of your nervous system that controls your breathing, heartbeat and other involuntary functions. Even unborn babies hiccup, which may perhaps prepare them for breathing. But, while virtually everyone gets hiccups, the reason you do has not been established and there is no hard and fast cure you may use each time you get them.

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Hiccups That Last Longer Than 48 Hours May Need Attention
Most cases of hiccups are self-limiting, lasting no more than several minutes to a day. However, in some cases hiccups may last for days — or even years. A persistent case of hiccups lasting more than 48 hours may signal a cause for concern. Hiccups that last more than one month are called intractable hiccups. In some cases, hiccups also persist during sleep.
Since the condition is uncomfortable, some who suffer with persistent or intractable hiccups seek medical care in the hospital. In one study of a community hospital between 1995 and 2000, 54 of more than 100,000 visits were related to hiccups. Most of these patients were over 50 and had other health conditions.9 According to the Journal of Clinical Sleep Medicine:10
“Chronic persistent hiccups can be debilitating and have been associated with weight loss, insomnia and fatigue. They can be caused by a wide variety of medical conditions, including central nervous system abnormalities, metabolic imbalances, and chest and abdomen pathology. Among the medications known to cause hiccups, the most common include corticosteroids, antidepressants, dopaminergics, and opioids.”
Irritation to the nerves that serve your diaphragm is often the cause for long-term hiccups and may be triggered by gastroesophageal reflux, laryngitis, a tumor, cyst or goiter in your neck or even a hair touching your eardrum.11 Other causes may be related to infection, damage or trauma to your central nervous system, including stroke, head injury, tumor or multiple sclerosis. Long-term hiccups may also be triggered by:
| Alcoholism | Anesthesia |
| Barbiturates | Diabetes |
| Electrolyte imbalance | Kidney failure |
| Steroids | Tranquilizers |
How Capsaicin Interacts With Your Body
Your body has transient receptor potential vanilloid 1 (TRPV1) pain receptors which are activated by capsaicin, opening the floodgates to pain. This is one of the reasons your mouth likely feels as if it’s on fire when you eat something spicy.12 However, while the chemical does trigger pain, it also has a unique side effect. After exposure, your TRPV1 receptors go through a period of rest.
During this time, the receptors cease transmitting pain signals to your brain, and while your body may continue to experience the pain, your mind won’t recognize it. This is one of the ways capsaicin pain creams help treat peripheral pain. Scientists call this process “defunctionalization.”13 These creams are produced from highly purified capsaicin and also deplete the neurotransmitter, substance P, which sends pain messages to your brain.14
Although you may experience an increase in the intensity of pain when you first use capsaicin cream, it usually decreases with the second use.15 In some cases, it may take a week or more to help treat pain originating in your joints, as your levels of substance P must be depleted and the cream must be continued to keep the substance from building up again.16 The cream has been used to relieve pain from neurological pain, cluster headaches, surgical pain and arthritic disorders.
Capsaicin has also been used as a dietary supplement as there is evidence it may improve digestion, help reduce diarrhea triggered by bad bacteria in your intestines and fight bacterial infections in your body.17 As a supplement, it may help thin the mucus in your lungs and is an antioxidant that may help fight free radicals.
The Benefits of Spicy Foods
Capsaicin’s interactions in your body explain many of the benefits you may experience when you eat spicy foods. Eating spicy foods helps increase your satiety, or feelings of fullness after a meal. You often feel full faster eating less food, and the peppers may rev your metabolism a bit, helping you to burn more calories at rest. Researchers have discovered including spicy foods may help shrink fat cells and lower blood fat levels.18
Past research has suggested that thermogenic ingredients, or those compounds that increase your body’s heat production, may increase your metabolism by up to 5% and the ability of your body to burn fat by up to 16%.19 Capsaicin is a thermogenic substance that may temporarily increase the ability of your body to burn fat to produce heat.
In fact, when eating spicy foods, you may feel your internal heat rising, even though the temperature in the room has remained the same. The heat you’re feeling is the result of the activation of the TRPV1 receptors.
Although the activation of TRPV1 helps to reduce pain, it may also be responsible for many of the other health benefits you experience. In a journal article in Open Heart, scientists explored a mechanism that may explain the favorable results researchers have found in animal studies using capsaicin-rich diets, including a positive effect on health conditions such as metabolic syndrome, obesity, hypertension, atherosclerosis and stroke.20
As capsaicin thins mucus, it may help to clear your lungs during an illness, strengthen your lung capacity and may help prevent or treat emphysema.21 Various studies also demonstrate that capsaicin may effectively help your body fight prostate cancer.22
Animal studies have found oral supplementation is effective against H. pylori, the bacteria that triggers gastritis and ulcerations of the stomach wall. Capsaicin has also demonstrated some effectiveness against breast cancer, lymphoma and some lung tumors.
The continued application of capsaicin cream may help reduce the proliferation of skin cells common to psoriasis.23 Participants in this study did report the initial week of application caused skin irritation. Men and women with diabetes experienced some improvement in their blood glucose levels, and women who suffered from gestational diabetes (altered blood glucose/insulin resistance during pregnancy) also experienced improvements.
Different Peppers Produce Different Levels of Heat
The intensity of the heat you experience is measured in Scoville units, first developed by William Scoville in 1912.24 Human tasters used to identify the different levels of heat in peppers that originates from the amount of capsaicin in the pepper. Today, machines do that job.
To put the heat in your peppers into perspective, pure capsaicin would have a Scoville unit rating of 16 million.25 Police pepper spray has a unit rating of 2 million and the hottest pepper, the Carolina Reaper, has a unit rating of 2.2 million.26 As of August 2013, the Guinness World Record book states this is the hottest pepper known to man. Well down the list is the Chocolate Habanero, ranking between 300,000 and 577,000 Scoville units.
Scotch Bonnet chili peppers, often used in spicy Caribbean foods, measure between 100,000 and 350,000 Scoville units. Jalapeno peppers, common in the U.S., measure 2,500 to 8,000, while Cubanelle peppers are a mild 100 to 1,000 Scoville units.27
Control Your Hiccups
There are a number of different methods you may have read or heard about to get rid of hiccups. Dr. Tyler Cymet, head of medical education at the American Association of Colleges of Osteopathic Medicine, conducted a five-year study on 54 patients hospitalized for hiccups to evaluate treatment methods.28 What he found was that despite using a variety of treatments, from breath holding to strong medications, none of his patients successfully got rid of their hiccups.
He has continued to use a variety of treatments for patients who suffered from hiccups long enough to seek medical attention and found his patients may experience a 20% to 25% success rate.29
Those treatments include cognitive behavioral therapy, breathing exercise, yoga and Pilates. Each of these treatment options help reduce anxiety and control breathing, which seems to be the modalities that worked best for persistent hiccups. Other alternative remedies that appear to have success with people who don’t suffer from persistent or intractable hiccups include:
- Having someone squeeze your pinky fingernail for 10 seconds30
- Gargling with ice water or sipping cold water
- Hypnosis
- Acupuncture
Additionally, there are a surprising number of hiccup remedies that have been studied, albeit using small participant numbers. For instance:31
- Eating a spoonful of sugar eliminated hiccups in 19 of 20 patients, possibly by stimulating the vagus nerve32
- Eating a lemon wedge soaked in bitters worked to eliminate hiccups in 14 out of 16 individuals33
- Triggering your gag reflex by blowing up a balloon may also work, possibly by causing a temporary break in respiration34
- Rectal massage using a finger cured intractable hiccups in 7 out of 7 patients, possibly by stimulating the sympathetic and parasympathetic nerves35
- 1 Technomic, November 7, 2013 (Archived)
- 2 Time Magazine, July 31, 2014
- 3, 6, 12, 13 Medical News Today, July 6, 2017
- 4 Popular Science, December 6, 2012
- 5 Physiology and Behavior 2012;107(3):381
- 7 The Times of India, November 30, 2003
- 8 Medical News Today, June 23, 2023
- 9 Journal of the National Medical Association 2002;94(6):480
- 10 Journal of Clinical Sleep Medicine, 2013;9(1):92
- 11 Mayo Clinic, Hiccups: Symptoms and Causes
- 14, 16 Arthritis Foundation, Supplement Guide: Capsaicin (Archived)
- 15, 17, 21 WebMD Capsaicin Topic Overview (Archived)
- 18 Journal of Proteome Research, 2010;9(6):2977
- 19 International Journal of Obesity (London) 2010;34(4):659
- 20 Open Heart, 2015;2(1):e000262
- 22 Oncotarget. 2016 Jan 12; 7(2): 1569–1583
- 23 J Am Acad Dermatol. 1986 Sep;15(3):504-7
- 24, 25 Cooks Info, Scoville Units
- 26 Cayenne Diane, The Big List of Hot Peppers
- 27 Pepperscale, Hot Pepper Scale
- 28, 29 The Washington Post, June 2, 2014
- 30 Huffington Post, May 12, 2013
- 31 Mind the Science Gap, November 5, 2012 (Archived)
- 32 New England Journal of Medicine 1971; 285:1489
- 33 New England Journal of Medicine 1981; 305:1654
- 34 Medical Hypotheses, 2005;65(6):1206
- 35 Journal of Internal Medicine, 1990;227(2):145
Chronic Hiccups Could Be a Sign of Something Serious
Reproduced from original article:
https://articles.mercola.com/sites/articles/archive/2023/04/15/chronic-hiccups.aspx
The original Mercola article may not remain on the original site, but I will endeavor to keep it on this site as long as I deem it to be appropriate.
Analysis by Dr. Joseph Mercola Fact Checked April 15, 2023
STORY AT-A-GLANCE
- Hiccups can happen to anyone, at any age. Most are mild and stop within minutes, but in some cases, persistent hiccups may go on for months. These may indicate a significant health problem, including stroke, diabetes, kidney disease or cancer
- Certain irritations can trigger hiccups, such as eating or drinking too quickly, drinking very hot or cold liquid, carbonated beverages, consuming alcohol, overstretching your neck, or experiencing high levels of stress like fear or excitement
- Hiccups are an orphan symptom of cancer treatment, so-called as they are more common than most doctors know and are seldom evaluated. Chronic hiccups can lead to fatigue, lower food intake, weight loss, sleep deprivation and aspiration pneumonia, which may hasten death in cancer patients
- It’s crucial to learn how to live with chronic hiccups until they can be stopped. Avoid triggers that increase the risk of hiccups such as spicy food or carbonated drinks, sip water throughout the day to stay hydrated, and take small bites to lower the risk of aspiration
- There is anecdotal evidence that some home remedies can stop hiccups, such as breathing into a paper bag, sipping vinegar or swallowing sugar, gently applying pressure over the eyeballs, squeezing the fingernail on the pinky finger for 10 seconds or stimulating the vagus and phrenic nerve while swallowing
Hiccups can happen to anyone at any age. Even unborn babies get hiccups, which some believe may help prepare them to begin breathing air. Although there is no consensus on the role that hiccups play in adults, researchers from University College London1 announced in 2019 that hiccups in newborns trigger brain signals, which may help the infant learn how to regulate their breathing.
Hiccups describe the sound that is triggered by spasms in the diaphragm. The diaphragm separates your abdomen and your chest, resting under your rib cage. It plays an important role in breathing. As the diaphragm moves downward it creates negative pressure in the chest and you inhale. When you exhale, the diaphragm moves back into place.
An involuntary spasm of the diaphragm causes you to suck in air and at the same time the glottis closes to prevent more air coming in. This causes the classic ‘hic’ sound of the hiccup. For most people, hiccups are self-limited and last for several minutes. They are usually nothing more than annoying. However, for others, hiccups can be persistent, lasting over two days, or intractable when they last over one month.
If you have multiple episodes of hiccups over a prolonged time, this is also considered chronic hiccups. Intractable or chronic hiccups can become a medical issue in and of itself. However, what is also known is that chronic or intractable hiccups in adults are associated with several medical conditions, including cancer.
Chronically Persistent Hiccups May Signal Something Serious
A 2022 case study2 presented in the Open Journal of Urology discussed the case of a 66-year-old man with a two-year history of intractable hiccups. When he presented to the physician, he had no symptoms that were suggestive of kidney cancer. However, an abdominal CT scan revealed a well-defined mass on the right kidney that was growing into the perirenal space.
The researchers noted that 80% of intractable hiccups could be traced to an organic cause and the remaining 20% were linked to a psychogenic trigger. They wrote that “Pathologies in the adrenal glands and kidney, particularly the superior pole, irritate the diaphragm and phrenic and vagus nerves, activating the hiccup reflex.”3
Tumors that irritate the diaphragm and phrenic nerve may trigger chronic or intractable hiccups. This can include4,5 liver cancer, pancreatic cancer or pancreatitis, bowel cancer, renal cancer and adrenal tumors. In addition to being a presenting sign of tumor growth, hiccups occur in as many as 40% of cancer patients.6
Dr. Aminah Jatoi, a medical oncologist from Mayo Clinic Rochester, and two colleagues developed a survey7 to gauge health care providers’ understanding and awareness of the significance of hiccups in patients with cancer. Ninety completed surveys were returned from physicians, nurse practitioners, nurses and physician assistants.
The survey found hiccups were an under-recognized issue in cancer patients and even when it was recognized and treated, 20% of the health care providers noted that current therapies were not effective, and more treatment options are needed.8
A 2013 paper9 suggested that refractory hiccups may be associated with hyponatremia, and physicians should consider this in their differential diagnosis when cancer patients present with chronic hiccups. A 2021 paper10 noted that one-fifth of the cancer patients in their study suffered from hiccups and 54.1% of those had gastrointestinal cancer.
As The Atlantic notes,11 cancer patients may have two ways that hiccups are triggered. Those who have cancer close enough to irritate the phrenic nerve, such as tumors in the chest, throat or head may have a higher risk of developing chronic or intractable hiccups. Researchers have also found that the drugs used to treat cancer, such as chemotherapy and steroids, also increase the risk.
Other Medical Conditions Associated With Chronic Hiccups
As you have likely noticed, certain things can trigger mild hiccups that go away within minutes.12 Anytime you eat or drink too quickly, drink very hot or cold liquid, drink carbonated beverages or alcohol or overstretch your neck, you may trigger mild hiccups. Additionally, hiccups can start when you experience high levels of stress, such as fear and excitement.
In addition to certain types of cancer, chronic or intractable hiccups are also associated with other serious health conditions. As with the types of cancers that trigger chronic hiccups, these health concerns can irritate the diaphragm or phrenic nerve.13,14,15
| Stroke | Brain injury | Multiple sclerosis |
| Mechanical irritation of the eardrum | Gastrointestinal or abdominal disorders | Growth on the thyroid gland |
| Diabetes | Electrolyte imbalance | Pleurisy |
| Pneumonia | Ear infection | Sore throat |
| Asthma | Pregnancy | Pancreatitis |
| Hepatitis | Bladder irritation | Kidney disease |
| Parkinson’s disease16 | Some medications |
A 2021 paper17 presented the case history of a man with Parkinson’s disease who developed severe hiccups when taking dopamine agonists to treat the disease, but the hiccups did not occur when using Levodopa, a central nervous system agent. Corticosteroids, benzodiazepines,18 acid reflux drugs, barbiturates and opioids19 are also associated with drug-induced hiccups.

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The Benefit of Treating Orphan Symptoms for Cancer Patients
Hiccups are one of the “orphan symptoms” in cancer patients,20 which are symptoms that are seldom evaluated in assessment tools. Yet, as The Atlantic describes Colleen Kennedy’s experience during chemotherapy and radiation treatment for stage 3 lung cancer, the pain and discomfort can be overwhelming.21
“She hadn’t expected the hiccup fits that started about halfway through her first treatment round. They left her gasping for air and sent pain ricocheting through her already tender body. At times, they triggered her gag reflex and made her throw up.
After they subsided, she felt tired, sore, breathless — as if she’d just finished a tough workout. They were, Kennedy, now 54, told me, “nothing compared to what we would consider normal hiccups at all.” They lasted for nearly a year.”
In most people, hiccups are transient and appear to develop randomly. This makes them extremely difficult to study. A 2015 systematic review22 found only 341 patients across 15 published studies who had been treated for persistent or intractable hiccups. Based on the paucity of data, the researchers concluded “This systematic review revealed no high-quality data on which to base treatment recommendations.”23
While the condition may be difficult to treat, it can be very challenging for patients. A 2022 paper in BMC Cancer24 evaluated 320 patients and found the median age when hiccups were first reported in this group of cancer patients was 63 years and was notably more prevalent in men than women.
In the group of 320 patients, 89% who reported hiccups were men and only 11% were women. In 62% of the patients, hiccups were reported daily; nine patients had daily hiccups for over six weeks; five had symptoms for years.
Hiccups are a nuisance for most people, but chronic or intractable hiccups can lead to weight loss, lower food intake, sleep deprivation, fatigue and aspiration pneumonia.25 They can also trigger anxiety, depression and decreased cognitive function.26 In patients with cancer, some of these issues can hasten death.
Tips to Cope With Chronic Hiccups
When home remedies or off-label medications do not successfully stop chronic or intractable hiccups, it is crucial to learn how to live with them. Charles Osborne27 had a case of intractable hiccups that lasted 68 years. His was the longest-recorded case as confirmed by Guinness World Records.
Osborne was born in 1893 and developed hiccups after he fell and hit his head. Kevern Koskovich described how Osborne managed his hiccups to the Smithsonian Magazine as he experienced up to 40 diaphragmatic spasms each minute.
“He’d flex his chest three or four times every minute,” says Koskovich, who knew one of Osborne’s sons and now lives in nearby Correctionville, Iowa. “You could tell he was hiccupping, but he wouldn’t make any noise. He heaved — that’s the best way to describe it.”28
For unknown reasons, Osborne’s hiccups stopped suddenly in 1990. He died in May 1991 at the age of 97. For most people, chronic hiccups are stressful and disrupt normal routines. Trying to explain the condition can help alleviate some stress.
Chronic hiccups make it difficult to sleep, which in turn lowers your energy level the next day and may trigger you to eat more to stay awake. However, the hiccups also make it difficult to eat and drink, which can lead to weight loss, dehydration and malnutrition. People with chronic or intractable hiccups find it easier to eat smaller amounts during the day as opposed to three larger meals.
Carbonated drinks and spicy food can trigger hiccups, so they should be avoided. It may be easier to drink small amounts of liquid throughout the day to stay hydrated. Since hiccups are unpredictable, they can increase the risk of choking on food or drink, so taking small mouthfuls can help prevent aspiration.
Home Remedies That May Help Alleviate Hiccups
When you’re trying to get rid of mild hiccups at home, there are a few remedies you can try. The idea is to engage in activity that interrupts the hiccup reflex, which hopefully stops the hiccups. If these remedies are not successful, or your hiccups continue to reoccur, it may be time to identify what is irritating the vagus or phrenic nerves.29
| Supra-supramaximal inspiration — Inhale and hold your breath for 10 seconds. Before exhaling, inhale two more times, each time holding your breath for five seconds. |
| Breathing into a paper bag — This raises your CO2 level. |
| Stimulate the vagus nerve — Pull on your tongue, drink or gargle a cold drink, place gentle pressure over your eyeballs, sip vinegar or swallow sugar. Stimulating the uvula or posterior nasopharynx with nasal vinegar or smelling salts, gargling or gagging may also stimulate the vagus nerve. |
| Compressing the chest — Bring your knees to your chest and hug them or lean forward while sitting. |
| Movement — Dr. Tyler Cymet, vice president for institutional effectiveness at the Maryland College of Osteopathic Medicine,30 has found some treatments that work up to 25% of the time, including breathing exercises, yoga and Pilates.31 |
| Acupressure point — Squeeze the surface of the fingernail on the pinky finger for 10 seconds.32 Dr. John Talbot believes this has worked on just over 50% of the people he’s used it on. |
| Nerve stimulation while swallowing — Ali Seifi was a neurosurgeon at the University of Texas Health Science Center when he invented the HiccAway.33 Seifi explains that sucking water forcefully through a bent device, or drinking through a thick paper towel,34 draws the diaphragm down while swallowing, which breaks the spasm cycle.35 |
- 1 University College London, November 12, 2019
- 2 Open Journal of Urology, 2022; 12(5) 2. Case Presentation
- 3, 5 Open Journal of Urology, 2022; 12(5)
- 4, 12, 13 Cleveland Clinic, Hiccups, What does it mean if my hiccups last for more than two days?
- 6, 8, 25 Medscape November 4, 2022
- 7 American Journal of Hospice and Palliative Medicine, 2022; doi: 10.1177/10499091221130
- 9 Indian Journal of Palliative Care, 2013; 19(2)
- 10 Journal of Pain Symptom Management, 2021; 62(3)
- 11, 14, 21 The Atlantic, April 3, 2023
- 15 Mayo Clinic, Hiccups
- 16 Parkinson’s Disease, September 25, 2020
- 17 Archives of Neuropsychiatry, 2021;58(3)
- 18 Canadian Pharmacists Journal, 2007; 140(2)
- 19 Bon Secours, July 15, 2020
- 20 ESMO Open, 2020
- 22, 23 Alimentary Pharmacology and Therapeutics, 2015;42(9)
- 24 BMC Cancer, 2022;22(1) Abstract
- 26 Oncology Times, 2018;40(17)
- 27, 28, 35 The Smithsonian Magazine, June 13, 2022
- 29 Singultus, August 7, 2022, Treatment and Management
- 30 Maryland College of Osteopathic Medicine, Tyler Cymet DO
- 31 The Washington Post, June 2, 2014
- 32 Huffington Post, June 12, 2013
- 33 HiccAway
- 34 USC Digital Folklore