Hiccups are usually minor and short lived..........surgery are options but only for the most intractable cases.

Hiccups are usually minor and short lived, if a little embarrassing and inconvenient. But they are often associated with good times -- a bit of overacting perhaps or getting drunk.

Some of the remedies are amusing: drinking from the wrong side of the glass, Having someone jump at you and shout "boo", biting a lemon, and drinking pickle juice, to name a few. According to a 16th century advice from England, "it is good to cast cold water in the face of the person who has hiccups." There are also standbys like holding your breath or breathing into a paper bag. Some of these cures make more sense than others but they are all pretty much untested.

Sometimes, nothing works. Hiccups can go on for a long time. According to the Guinness Book of World Records, an Iowa resident named Charles Osborne had the hiccup for 68 years. But even a few days' worth can be distressing. And if hiccups go on longer, they can cause serious problems including difficulty in eating, dehydration, depression and loss of sleep (it is possible to hiccup while you sleep).

Hiccups are emphatically no laughing matter when they are associated with an underlying medical condition. Tumors can impinge on nerves in the chest or abdomen. Hiccups are also a fairly common side effect of chemotherapy used to treat cancer and can be a symptom of diseases that affect the central nervous system such as strokes.

A hiccup begins if you are taking a big breath of air much faster than normal. Your diaphragm contracts and pulls down and your chest muscles go to work. A fraction of a second later the narrow opening between the vocal cords snaps shut -- and you hear the distinct hiccup sound. It is unclear whether the voice box is pulled shut or if it closes because of negative pressures from expansion of the chest.

Neurologically, hiccups are an unthinkable reflex, like the kicking action of your leg when a doctor taps your knee. Typically, a reflex begins with a signal from the body to the spinal cord or brain that triggers a second signal from the spinal cord or brain back to the body.

Nobody is completely sure how the hiccup reflex is triggered and the cause may differ in different people. But doctors say when nerves are stimulated, the message is sent to the medulla oblongata, an area of the lower brain involved in regulating breathing and other basic functions. Some researchers have suggested that this region contains a "hiccup" center entirely separate from any control of breathing. After passing through the medulla oblongata, the "hiccup message" gets sent down to the diaphragm.

Many of the remedies for mild hiccups may work by creating a stimulus that interrupts the signals causing the reflex. For example, when you drink from the wrong side of the glass, you may be exciting nerves in the back of the mouth, nose and throat that aren't stimulated by normal drinking. Breathing into a paper bag works in a different way. It increases the carbon dioxide level in your blood and it has been shown that as carbon dioxide levels go up, hiccups tend to recede.

Delivering a strong jolt to the nervous system may also work. Another method is to exhale and then take a very deep breath and hold it for 10 seconds. Then without exhaling you breath in again, pause and then breathe in a third time. The doctors say that three consecutive inhalations increase carbon dioxide levels in the blood and by immobilizing the diaphragm.

Serious cases of hiccups can be treated with a number of medications. Nerve blocks and surgery are options but only for the most intractable cases.

Summary: Hiccups are common and short lived though inconvenient and distressing. They can cause serious medical problems. Hiccups occur when you take a big breath of air rapidly. The diaphragm contracts and affects chest muscles followed by shutting of the opening between the vocal cords. Hiccups are a reflex. When nerves are stimulated, the hiccup message is sent to the brain which delivers it to the diaphragm. Remedies work by interrupting the signals causing the reflex. Breathing into a paper bag increases the carbon dioxide level in your blood that stops hiccups. Other measures include a jolt to the nervous system and taking a deep breath and holding it for 10 seconds. Three consecutive inhalations increase carbon dioxide levels immobilizing the diaphragm. Serious cases of hiccups are medically and surgically treatable.