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Brian Krueger, PhD
Columbia University Medical Center
New York NY USA

Brian Krueger is the owner, creator and coder of LabSpaces by night and Next Generation Sequencer by day. He is currently the Director of Genomic Analysis and Technical Operations for the Institute for Genomic Medicine at Columbia University Medical Center. In his blog you will find articles about technology, molecular biology, and editorial comments on the current state of science on the internet.

My posts are presented as opinion and commentary and do not represent the views of LabSpaces Productions, LLC, my employer, or my educational institution.

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Wednesday, September 22, 2010


Credit: Jens Lagner

I'm going to preface this by saying that I am not a medical expert. I don't even begin to pretend I know anything about medicine or how to cure diseases. I do watch those cheesy "Untold stories of the ER" shows on Discovery and TLC though, and sometimes I partially remember things they say about diagnoses.

This story begins back when I was finishing up my PhD at Iowa. I had successfully defended my thesis (thank god) and was out on a drinking excursion with "the boys" the weekend before I was moving down to Florida to start my new job. The evening started out just like any other, we pregamed at my buddy's apartment drinking cheap beer, cooking up some quick dinner and bullshitting about how much being a graduate student sucks. You know, the typical poor graduate student routine.

We finally got a cab and made it down to "downtown" which in Iowa City consists of 3 businesses and 75 bars filled with helplessly drunken co-eds. I swear it wasn't more than 15 minutes into the night when my buddy, who shall be referred to as "Dr. Millner" from here on out, started hiccuping. These weren't your normal "Hiccup for 10 minutes and be done with it" type of hiccups, these things were going to last for hours. Of course, being a medical student and all, Dr. Millner knew every surefire cure and went through them one by one. Held his breath, HICCUP. Drank beer until he couldn't breathe, HICCUP. Someone tried to scare him, HICCUP.

***************

The Vagus Nerve in yellow and the organs it innervates

I'm just a graduate student in molecular biology. I haven't had the two years of "medical training" that Dr. Millner has, but I do know of the best hiccup cure on the planet. Many people have not heard of this cure, so you should all be very happy you stumbled on this blog post because if you ever get the hiccups, you too can cure them in a matter of seconds every single time. I came across this hiccup cure two ways. I was watching the discovery channel one day and there was a piece on about a girl who had hiccups for over a week and they were driving her boyfriend crazy. The doctors tried all of the classical cure methods, but none of them worked. The ER resident working with this patient finally remembered that the Vagus Nerve has been known to be involved in regulating a bunch of body processes including digestion and breathing. Stimulation of it can result in curing intractable hiccups (hiccups that don't go away after 48 hours). He remembered that one of the simplest methods for stimulating this nerve was through the tongue. The vagus nerve supplies the brain with sensory information from the ear, tongue, pharynx, and larynx. To cure this girl's hiccups, he poured a packet of sugar on the back of her tongue, and she didn't hiccup again after that. I thought this was an awesome hiccup cure, and of course decided that the next time I got hiccups I'd try it!

It wasn't long until I got a nasty case of the hiccups (I wolf my food down all the time, it really pisses my fiancee off). Fortunately, the hiccups occured while we were holding a cookout, so there were a few people around. I didn't instantly remember the Discovery Channel cure, so again, we all went through the lame "cures" that never work. Then I remembered the ER story and frantically ran around the house looking for sugar! Unfortunately, this place was a bachelor pad and unless the food item was previously living or was a condiment used to cover things that were previously living or came in a ramen package, we didn't have it. After my failed search was complete, someone's girlfriend suggested peanut butter. She said that her grandma or mother used to give them a whole spoonful of peanut butter whenever they got the hiccups. And at that point I thought, "Yeah, it probably works the same way that sugar does!" If you haven't ever put a full serving of peanut butter in your mouth, you have no idea what the feeling is like. It's indescribable, it certainly stimulates something.

***********

As the night wears on, Dr. Millner's hiccups don't get any better. At this point I'm just smiling, because I'm a dick and I know the greatest hiccup cure ever. I'm just letting him suffer. So finally, after all of his cures fail, I mention my peanut butter hiccup cure. The conversation went something like this:

Me: You know Dr. Millner, the best cure for hiccups is peanut butter
Dr. Millner: (Indignantly) Peanut butter? That'd never work
Me: It does, I promise, I was watching an ER show on the Discovery Channel and they cured a girl's hiccups by stimulating the vagus nerve using sugar. I've found that peanut butter seems to do the same thing!
Dr. Millner: (Even angrier now) HA! The vagus nerve? You have no idea what you're talking about, it doesn't even innervate the diaphragm, the Phrenic does!
Me: (No response, because I have no idea what I'm talking about)

Peanut butter Credit: Paige Foster

Dr. Millner, being the genius medical student he is, spent the entire night hiccuping. I continued to make fun of him, telling him that if only he had a spoonful of peanut butter, he'd be relieved of the annoyance. After a night of drinking, eating nasty bar food, and getting completely wasted, we caught a ride with Dr. Millner's wife. All the while Dr. Millner hiccuped in the passenger seat as I prodded him to give the peanut butter cure a try. As we were exiting the car, I asked Dr. Millner if he'd like to put his medical knowledge to the test and just try out the peanut butter cure. Now, being both drunk and exceedingly angry, Dr. Millner didn't appreciate me calling him out so he hopped out of the car and decided to put his manlihood to the test. All 2 years of medical school were now on the line. He had made a stand and there was no medical reason why the peanut butter cure could work (in his mind). I grabbed the biggest spoon in the kitchen that I could find (I was wasted, sue me) and put about half a jar of peanut butter on it. Dr. Millner, still enraged and hiccuping, took in a mouthful and coated his tongue with peanut butter. After a few seconds, the most resentful look came over his face and he said, "Fuck. They're gone."

To this day, Dr. Millner has not thanked me for curing his hiccups. He also doesn't believe in peanut butter's mechanism of action eventhough many published studies indicate that vagus nerve stimulation can cure intractable hiccups (and, in my case at least, they cure all hiccups). Dr. Millner and I somehow got into this discussion again last night over a text message. I presented my case, once again (but with a 160 character limit). Dr. Millner did not concede, stated that the vagus nerve was not involved in hiccups and stimulation of the tongue must cure them some other way. I asked him how that could happen (he now has 2 years of med school and 2 years of his PhD under his belt) and he stated that he didn't know, but it definitely wasn't through the vagus because "The phrenic controls the diaphragm."

*************

I guess the whole point of this post is, why does coating my tongue result in the curing of my hiccups? Could it possibly be through vagal nerve stimulation? Any neuroscientists out there care to comment? Wikipedia, Mayo Clinic, and discovery health along with 15 papers over at NCBI all say that vagal nerve stimulation can cure hiccups, but is that what is going on in my peanut butter case? Could Dr. Millner be right?? I want to know!

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Blog Comments

Nikkilina
Washington University School of Medicine
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Ha! I have no idea how it works, but I'm totally trying it!

Evie
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Dude, this is an awesome post. And I want to know how it works too!!

Thomas Joseph
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I've found that coughing extremely hard (forced) cures the hiccups in many cases as well. The evidence is all anecdotal however.

Brian Krueger, PhD
Columbia University Medical Center
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I forgot about the forced cough. But I definitely remember him trying that one too. I'm telling you, peanut butter is the way to go AND you don't have to look or sound like you're ralfing up a hairball in the process!

microbiologist xx
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My tried and true hiccup cure is something I learned watching Mr. Wizard when I was a wee microbiologist and it works every time. All you do is drink a glass of water (or probably any other liquid) upside down. You don't have to stand on your head, just bend at the waist and then drink from a glass. Of course, you have to drink from the side of the glass opposite from what you normally use or you'll just dump liquid all over your face. :) Slowly take a few drinks and then stand back up. The hiccups should be gone. I wonder if this "method is stimulating the same nerve.
I'm going to try your method next time I get the hiccups.
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