Exclusive Content

MS and the Hiccups

By Matt Cavallo

When you are living with MS, there is never a dull moment. In my case, I have been hiccupping for the last ten days straight. While you may think be thinking to yourself, what do hiccups have to do with MS? As I’ve learned, hiccups can be a less common symptom of MS.

This all started innocently enough. My wife made a really good green chile enchilada bake. It wasn’t too spicy, but it had a hint of heat. After dinner, I bent down to pick up some clothes the kids dropped on the floor. and When I did, I felt like I was going to regurgitate. When I stood up, the hiccups started. I thought it would be a momentary thing like hiccups I have had in the past. Unfortunately, that was just the start of my journey and ten days later they were still going strong.

So, what is a hiccup? A hiccup is an involuntary contraction, or spasm, of your diaphragm. Your diaphragm rests below the lungs and is the primary muscle used for breathing. This is why when you have the hiccups you can feel short of breath and why many of the homeopathic treatments involve breathing exercises. 

People living with MS are known to have spasms or spasticity in other muscles, so is the diaphragm any different? Unfortunately, as I have come to learn the hard way, it is not. The diaphragm is just as susceptible to MS activity as other muscles. 

A study was conducted about patients who had intractable hiccups, or hiccups lasting more than one month, and of the patients studied 8.5 percent had MS. The research concluded that MS should be seriously considered as a cause of the hiccups and that the patients ended up responding well to a course of intravenous steroids. 

My neurologist thinks my hiccups could be a result of an MS relapse. He ordered MRIs to determine if I have new MS disease activity and genetic testing to determine if I have neuromyelitis optica. NMO is different than MS but can have some of the same symptoms. Uncontrolled hiccups can lead to an NMO diagnosis. Genetic testing can be used to determine if you have NMO. I am scheduled for the genetic testing, so I will report back when I have the results and share all I have learned about NMO. 

If this is an MS relapse, living with the hiccups the past ten days has been far worse than any other MS symptom I have ever experienced. That included losing the use of my legs, going blind and experiencing cognitive difficulties. The hiccups have caused me to lose sleep, be short of breath and have caused my chest to be really sore from the constant spasms. I have tried every trick in the book, but none are working. 

In addition to my neurologist, I called my primary care physician and was referred to a gastroenterologist doctor for an endoscopy, meaning a camera they use to look inside your esophagus. I have been put on two different acid reflux medications, but they are not doing anything to stop the hiccups. All I can do is wait.

I have learned a couple of tricks that have helped a little. Peanut butter and toast seem to be foods I can tolerate, so I am on my eighth day of peanut butter sandwiches. I noticed eating the wrong foods will increase the intensity of the hiccups, so I went instantly to a bland diet. I also found sleeping with my chest a bit elevated helps. Sitting for too long causes the hiccups to increase in intensity, but I found getting up and walking around can calm them a bit. Speaking with the hiccups is hard. I find when I have to talk to someone that it is best to lead with the hiccup situation. It brings instant empathy because no one likes the hiccups and they understand that it is tough to talk.

Mentally, I had to accept I can’t control the hiccups and they are not going away on their own. The mental part has been the biggest struggle. I have used yoga and meditation techniques to try to relax, but it is hard to do. I trust in my medical team and I know these hiccups will eventually end and life will be normal again. In the meantime, I just have to stay positive, eat bland foods, concentrate on breathing and conserve my words. Like everything else with MS relapses, this too shall pass.