You never get them at a convenient time. They are almost inevitably embarrassing. They're hiccups, and you probably have no idea wherethey come from or why.

Hiccups are involuntary contractions of your diaphragm, which is that muscle which separates your abdomen from your chest. The contractions are followed by your vocal cords abruptly closing, from which hiccups get their signature sound.

Every cab driver and grandmother has a remedy, some of which may be downright dangerous (seriously: do not sneak up on someone and “scare” them!). But there is really no proven, consistent method to provide relief from hiccups, which are usually caused by a large meal, sudden excitement, or alcoholic drinks.

In some situations, however, hiccups may be symptomatic of a greater ill. If yours last more than 48 hours, be certain to see a doctor who will likely test your for nerve damage, nerve irritation, a tumor or infection.

The most common cause of long-term hiccups is irritation of or damage to the phrenic or vagus nerves. These service the diaphragm muscle. Common causes of this irritation/damage include:

·         Gastroesophageal reflux

·         Sore throat or laryngitis

·         A hair or something else in your ear touching your eardrum

·         A tumor, cyst or goiter in your neck

·         Central nervous system disorders

A tumor or infection in your central nervous system -- such as meningitis, encephalitis, multiple sclerosis – can also cause your body to lose control of your hiccup reflex. Long term hiccups may also be symptomatic of alcoholism, diabetes, kidney failure, electrolyte imbalance, and the use of barbiturates, steroids, or tranquilizers.

When you see your doctor, she will likely perform a neurological exam. A blood sample may be taken and analyzed for on one of the infections listed above. Standard imaging tests, such as an X-Ry, computerized tomography (CT scan), and magnetic resonance imaging (MRI) might be prescribed as well endocscopic testing. In this,  thin, flexible tube containing a tiny camera, which is passed down your throat to check for problems in your esophagus or windpipe.

If your hiccups are caused by some underlying condition the doctor will treat that condition. In some cases, hiccup-curbing drugs may be prescribed. These include chlorpromazine, metoclopramide, and baclofen.

On the more extreme and invasive side of the spectrum, conditions might warrant an injection of an anesthetic to block your phrenic nerve, or even the surgical implantation of a battery-operated device to that will deliver electrical stimulation to your vagus nerve, a procedure more commonly used to treat epilepsy.