Gastroesophageal Reflux Disease and Hiccups

Pathophysiology and Proposed Mechanisms

The esophageal-bronchial reflex pathway may be involved in the link between GERD and hiccups, where refluxate in the distal esophagus can stimulate neural reflexes without requiring aspiration, according to the American Thoracic Society 1, 2
Direct esophageal irritation by refluxate may be sufficient to stimulate hiccups through neural pathways, as suggested by the American Gastroenterological Association 1, 2
Vagal nerve activation may initiate airway reflexes, including cough and potentially hiccups, from the stomach or esophagus via vagal pathways, as proposed by the American College of Chest Physicians 2

Up to 75% of patients with GERD-related extraesophageal symptoms may have no typical GI complaints like heartburn, so absence of heartburn does not exclude GERD as a cause, according to the American College of Chest Physicians 4
Positional therapy and dietary modifications may be useful adjunctive measures in the treatment of GERD-related hiccups, as recommended by the American Gastroenterological Association 3, 5