The
vagus nerve controls many functions, including coordination of swallowing and
breathing. Branches variously control the
back of the mouth and throat, including some taste sensations. The vagus also coordinates the action of the
epiglottis in passing food over the trachea without choking, and of the phrenic
nerve in preventing inhalation while swallowing. Hiccups arise from interference with nervous
control of that coordination. The diaphragm
contracts suddenly, causing sharp intakes of breath, which the epiglottis abruptly
shuts off at the top of the throat.
Pungent
foods like strong pickled onions, chilli, fizzy drinks, anything irritating to
the back of the throat or tongue, may confuse relevant branches of the vagus. Also,
both phrenic and vagus nerves extend down the neck and might be affected when such
foods, or dry materials that are hard to swallow, go down the oesophagus. Nerve pathways and reactions vary in
different people, and non-specific stimulation of nerves gives unpredictable results,
so those very same stimuli are folk remedies for hiccups, stopping attacks by
the same means as they start! Even without involving swallowing, blood vessels pressing
on the vagus have directly caused inappropriate stimulation, resulting in hiccups
persisting for years in some people.