8 (3): 195–201. doi:10.1111/j.1463-1318.2005.00887.x. PMID 16466559. S2CID 36384160. Toxic Megacolon at eMedicine


== External links ==
They may also present as brief but distracting or painful interruptions in normal breathing, with sudden momentary pain of the throat, chest, or abdomen. Causes
Pathophysiological causes
Swallowing air excessively
Gastroesophageal reflux
Hiatal hernia
Rapid eating
Carbonated beverages, alcohol, dry breads, and some spicy foods
Opiate drug use
Laughing vigorously or for a long timeHiccups may be triggered by a number of common human conditions. In rare cases, they can be a sign of serious medical problems. In rare cases, hiccups can be the sole symptom of myocardial infarction. Pre-phrenic nucleus irritation of medulla
Kidney failure

CNS disorders
Stroke
Multiple sclerosis
Meningitis

Nerve damage
Damage to the vagus nerve after surgery

Other known associations
Although no clear pathophysiological mechanism has been described, hiccups is known to have been the initial symptom of Plasmodium vivax malaria in at least one documented case. Evolutionary theories
The burping reflex hypothesis
A leading hypothesis is that hiccups evolved to facilitate greater milk consumption in young mammals. The coordination of breathing and swallowing during suckling is a complicated process. Some air inevitably enters the stomach, occupying space that could otherwise be optimally used for calorie rich milk.The hypothesis suggests that the presence of an air bubble in the stomach stimulates the sensory (afferent) limb of the reflex through receptors in the stomach, esophagus and along the underside of the diaphragm. This triggers the active part of the hiccup (efferent limb), sharply contracting the muscles of breathing and relaxing the muscles of the esophagus, then closing the vocal cords to prevent air from entering the lungs. This creates suction in the chest, pulling air from the stomach up into the esophagus.