For most of us, hiccups are a fleeting nuisance—a few seconds of staccato spasms and… well, that’s mostly it. But for one elderly man in Lebanon, the spasms didn’t stop. Not for hours. Not for days, or even for months. They persisted for two relentless years.
He tried everything. Muscle relaxants. Antipsychotics. Antacids. The hiccups always came back.
Doctors were stumped. Then a blood test revealed something curious: a surge in eosinophils, the white blood cells known for fighting parasitic infections and triggering allergic reactions. In most people, eosinophils make up just 1 to 4 percent of white blood cells. His level was 18%.
That anomaly led physicians down a path they hadn’t expected.
The most annoying bout of hiccups in the world
There was nothing unusual in his body scans. An endoscopy peering into his esophagus showed no damage or telltale signs of disease. But after doctors noticed a spike in his eosinophil count they took a deeper look, quite literally. Biopsies of his esophagus revealed clusters of immune cells that pointed to a diagnosis that is typically reserved for younger men: eosinophilic esophagitis (EoE).
EoE is a chronic immune disease driven by allergens that causes the esophagus to become inflamed. In many cases, EoE causes symptoms like difficulty swallowing or persistent heartburn. But the Lebanese patient had none of these. Instead, doctors suspected that the high eosinophil levels were affecting the vagus nerve, which helps regulate the diaphragm. If misfiring, that nerve could spark the involuntary spasms known as hiccups.
“That’s the part that makes this case so fascinating,” said Dr. Louis Chaptini, senior author of the new case report published in the Journal of Medical Case Reports. “The patient didn’t have the classic symptoms. No heartburn. No food impaction. Just hiccups that wouldn’t go away.”
To test their theory, physicians prescribed something ordinary: a topical steroid cream, commonly used to reduce inflammation. Within a week, his eosinophil count returned to normal—and the hiccups vanished.
A Ghost from Hiccup History
If this story sounds extraordinary, it’s not without precedent.
Nearly a century ago, a man named Charles Osborne began hiccupping in 1922 after a farm accident involving a 350-pound hog. Doctors at the time believed he had ruptured a small blood vessel in his brain stem. From that moment on, Osborne hiccupped without pause for 68 years—an estimated 430 million spasms—until the condition mysteriously stopped in 1990, just months before his death at age 97.
Osborne learned to live with life-long hiccups. He learned to suppress the sound by flexing his chest and breathing strategically between hiccups. He married twice, raised eight children, and became a minor celebrity, appearing on shows like The Tonight Show and That’s Incredible. Still, his suffering was real. “I’d give everything I got in the world if I could get rid of them,” he once said. “I get so sore jerking all the time.”
His story remains the longest documented case of intractable hiccups, according to Guinness World Records.
When Hiccups Turn Dangerous
In most cases, hiccups are harmless, caused by quick swallows of air, fizzy drinks, or nervous laughter. They are caused by spasms of the diaphragm, the muscle that helps us breathe. Those spasms are controlled by a neural reflex arc involving the brain stem, phrenic nerve, and vagus nerve—the same vagus nerve that travels down into the chest and wraps around the esophagus.
The inflammation caused by EoE may irritate the esophagus enough to send abnormal signals through the vagus nerve, triggering the diaphragm to contract involuntarily.
If hiccups last more than 48 hours, they’re labeled chronic. Beyond a month, they’re called intractable. According to WebMD, about 1 in 100,000 people are affected by long-term hiccups. Some are caused by nerve damage, others by brain tumors or metabolic issues. The exact cause often remains elusive.
Doctors, lacking a standardized treatment, have tried everything from sedatives to bizarre breathing tricks. In one case, a Mayo Clinic physician halted Osborne’s hiccups using a mix of carbon monoxide and oxygen—though the side effects of inhaling carbon monoxide were, understandably, a deal-breaker. However, Dr. Ali Seifi, a neurosurgeon in Texas, invented the HiccAway, a straw-like device that uses pressure to stop hiccups through forceful suction. It works for everyday cases, but not so much for chronic ones.
The Mind-Body Mystery
The Lebanese man’s case adds a new wrinkle to this long-standing puzzle. Could the immune system be quietly triggering some of these cases? If so, EoE might be a hidden culprit in other unexplained hiccup disorders.
His recovery is a reminder of how much we still don’t know—and how something as small as a hiccup can hint at much larger mysteries within the body.
As for Charles Osborne, perhaps he said it best: “I don’t know what it would be like not to have them.” For two years, the man in Lebanon could relate. Until, suddenly, he didn’t.
