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.
The Food and Drug Administration approved the vagus nerve stimulator in 1997 as a way to control seizures in some patients with epilepsy. "Persistent digital rectal massage has also been proven effective in terminating intractable hiccups. Folk remedies
There are many superstitious and folk remedies for hiccups, including headstanding, drinking a glass of water upside-down, being frightened by someone, breathing into a bag, eating a large spoonful of peanut butter and placing sugar on or under the tongue.Acupressure, either through actual function or placebo effect, may cure hiccups in some people. For example, one technique is to relax the chest and shoulders and find the deepest points of the indentations directly below the protrusions of the collarbones. The index or middle fingers are inserted into the indents and pressed firmly for sixty seconds as long, deep breaths are taken.A simple treatment involves increasing the partial pressure of CO2 and inhibiting diaphragm activity by holding ones breath or rebreathing into a paper bag. Other potential remedies suggested by NHS Choices include pulling the knees up to the chest and leaning forward, sipping ice-cold water and swallowing some granulated sugar.Drinking through a straw with the ears plugged is a folk remedy that can be successful. In 2021 a scientific tool with a similar basis was tested on 249 hiccups subjects; the results were published in the Journal of the American Medical Association (JAMA). This device is named FISST (Forced Inspiratory Suction and Swallow Tool) and branded as "HiccAway".