Table: Some Causes and Features of Persistent Hiccups-Merck Manual Consumer Version

Some Causes and Features of Persistent Hiccups

Cause	Common Features*	Tests†
Esophagus
Gastroesophageal reflux disease	Heartburn (burning pain that begins in the upper abdomen and travels up to the throat, sometimes with an acid taste in the mouth) Chest pain Sometimes a cough, hoarseness, or both Symptoms sometimes triggered by lying down Relief with antacids	A doctor's examination Sometimes trying treatment with drugs to suppress acid production Sometimes endoscopy of the upper digestive tract (examination of the esophagus and stomach using a flexible viewing tube)
Abdomen
Abdominal surgery (recent)	Obvious history of recent surgery	A doctor’s examination alone
Gallbladder disease	Pain in the upper right part of the abdomen, under the rib cage Sometimes nausea and vomiting	Ultrasonography
Hepatitis	A general feeling of illness (malaise) Poor appetite Nausea and sometimes vomiting Sometimes darkening of the urine, then yellowing of the skin and whites of the eyes (jaundice) Mild discomfort in the upper right part of the abdomen	Blood tests
Liver cancers (including cancers that metastasized to the liver)	Long-standing discomfort in the upper part of the abdomen Weight loss Fatigue	Ultrasonography, CT, or MRI of the abdomen
Pancreatitis	Severe, constant pain in the upper part of the abdomen Usually vomiting	Blood tests Imaging tests of the abdomen (such as CT, MRI, and MRCP)
Pregnancy	Usually a missed menstrual period Sometimes morning sickness and/or breast swelling	A pregnancy test
Chest
Chest surgery (recent)	Obvious history of recent surgery	A doctor’s examination alone
Inflammation of the membrane around the heart (pericarditis)	Sharp chest pain that worsens with breathing and coughing	Electrocardiography (ECG)
Inflammation of the part of the membrane around the lung (pleura) near the diaphragm (diaphragmatic pleurisy)	Sharp chest pain that worsens with breathing and coughing	A chest x-ray
Pneumonia	Cough, fever, chills, and chest pain Sometimes shortness of breath	A chest x-ray
Other
Alcohol use disorder	History of excessive consumption of alcohol	A doctor’s examination alone
Certain brain tumors or strokes	Sometimes in people who are known to have had a stroke or who have a tumor Sometimes recurring headaches and/or difficulty walking, talking, speaking, or seeing	MRI and/or CT of the brain
Kidney failure	Usually in people who are known to have kidney failure	Blood tests
* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present.
† Although a doctor's examination is always done, it is mentioned in this column only if the diagnosis can sometimes be made by the doctor's examination alone, without any testing.
CT = computed tomography; MRCP = magnetic resonance cholangiopancreatography; MRI = magnetic resonance imaging.

Cause

Common Features*

Tests†

Esophagus

Heartburn (burning pain that begins in the upper abdomen and travels up to the throat, sometimes with an acid taste in the mouth)

Chest pain

Sometimes a cough, hoarseness, or both

Symptoms sometimes triggered by lying down

Relief with antacids

A doctor's examination

Sometimes trying treatment with drugs to suppress acid production

Sometimes endoscopy of the upper digestive tract (examination of the esophagus and stomach using a flexible viewing tube)

Abdomen

Abdominal surgery (recent)

Obvious history of recent surgery

A doctor’s examination alone

Gallbladder disease

Pain in the upper right part of the abdomen, under the rib cage

Sometimes nausea and vomiting

Ultrasonography

Hepatitis

A general feeling of illness (malaise)

Poor appetite

Nausea and sometimes vomiting

Sometimes darkening of the urine, then yellowing of the skin and whites of the eyes (jaundice)

Mild discomfort in the upper right part of the abdomen

Blood tests

Liver cancers (including cancers that metastasized to the liver)

Long-standing discomfort in the upper part of the abdomen

Weight loss

Fatigue

Ultrasonography, CT, or MRI of the abdomen

Pancreatitis

Severe, constant pain in the upper part of the abdomen

Usually vomiting

Blood tests

Imaging tests of the abdomen (such as CT, MRI, and MRCP)

Pregnancy

Usually a missed menstrual period

Sometimes morning sickness and/or breast swelling

A pregnancy test

Chest

Chest surgery (recent)

Obvious history of recent surgery

A doctor’s examination alone

Inflammation of the membrane around the heart (pericarditis)

Sharp chest pain that worsens with breathing and coughing

Electrocardiography (ECG)

Inflammation of the part of the membrane around the lung (pleura) near the diaphragm (diaphragmatic pleurisy)

Sharp chest pain that worsens with breathing and coughing

A chest x-ray

Pneumonia

Cough, fever, chills, and chest pain

Sometimes shortness of breath

A chest x-ray

Other

Alcohol use disorder

History of excessive consumption of alcohol

A doctor’s examination alone

Certain brain tumors or strokes

Sometimes in people who are known to have had a stroke or who have a tumor

Sometimes recurring headaches and/or difficulty walking, talking, speaking, or seeing

MRI and/or CT of the brain

Kidney failure

Usually in people who are known to have kidney failure

Blood tests

* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present.

† Although a doctor's examination is always done, it is mentioned in this column only if the diagnosis can sometimes be made by the doctor's examination alone, without any testing.

CT = computed tomography; MRCP = magnetic resonance cholangiopancreatography; MRI = magnetic resonance imaging.