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This is inspired by this old question of mine on Skeptics.

Can scaring a person cure hiccups?

Someone posted in comments:

The point is, this doesn't appear to be amenable to research, because it's not possible to induce hiccups. A scientist couldn't just walk around waiting for passersby to hiccup so he could test cures on them. It might be possible to induce hiccups by tickling a nerve, as I've heard of such things causing sustained hiccupping before, but that seems unlikely to pass an ethics committee. And if tickling the nerve caused hiccupping, would any cure work except to stop tickling the nerve? So in sum, I don't think you're going to find any scientific work on this.

I know literally nothing about how medical research is done, so I thought it would be a good idea to ask if here.

As I said, I'm a layperson, so when I'm trying googling that, all I can find is pop science sites which don't cite any sources, and I don't have paid access to research archives.

Do medical scientists research cures and reasons for short, passing conditions like (brief, non-chronic) hiccups, sneezes, heartburns, headaches, flatulence and such like; mildly irritating things that everyone has once in a while but that are not generally deemed worthy of a doctor visit and that are hard to track? If yes, what's the usual approach to making this kind of research?

All I could find on Google was how clinical studies for drugs are done, with examples to roughly this effect:

Phase II studies are usually conducted at a small number of specialist clinical centres using carefully selected patients to provide a relatively homogeneous group to allow efficacy to be evaluated using small groups (circa 100 per treatment group).

Do they perform studies on something that most people have but don't go to clinical centers with (like hiccups once a month)?

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    "sneezes, heartburns, headaches, flatulence" -- Pharmacy shelves are overflowing with medications for all those things, and there are prescription medications for them as well. Someone had to discover them, formulate them, and run clinical trials to get them approved.
    – Carey Gregory
    Sep 16, 2023 at 20:19
  • Also, this site requires questions to demonstrate some degree of prior research. If you google "how are drugs discovered" you'll find a wealth of information.
    – Carey Gregory
    Sep 16, 2023 at 20:25
  • @CareyGregory: I'm sure they do, and I'm interested exactly in the mechanics of doing that, hence the question. How do they run clinical trials on something people don't go to the doctor with? As I said, when I'm trying to Google that, all I'm finding is pop science sites, probably my Google fu is not strong enough. Please excuse my ignorance.
    – Quassnoi
    Sep 16, 2023 at 20:50
  • Did you try actually googling what I suggested?
    – Carey Gregory
    Sep 16, 2023 at 22:56
  • @CareyGregory: yes, I did. The closest one I got was "these studies use the fewest number of patients possible to provide sufficient statistical power to determine efficacy, usually 100–500 patients, who are monitored and assessed continuously" from the second link in my yield. My question is how do they monitor and assess continuously someone with hiccups or heartburns that only happen once in a month, who don't go to the doctor with it in the first place? Do they find random people on the street and offer them... money? fame? nothing? What if the cure is not a drug, do they research that?
    – Quassnoi
    Sep 16, 2023 at 23:32

2 Answers 2

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Medical scientists go about trying to discover a cure for hiccups by trying things on people with intractable hiccups, not by trying to induce hiccups. The latter, as you were already informed, is unethical.

One of the basic tenets of medicine is "First do no Harm". As hiccups are pretty complex and involve the nervous system, there's a good chance that we could do real harm to a patient by trying to induce them, i.e. what if, in doing so, we caused intractable hiccups, requiring medications to treat (if they were treatable)? That is real harm.

Research should always be done ethically; it's not, but it should be, and situation ethics don't count. That's why research ethics boards exist to approve or deny funding for research.

There are three important obligations placed on the ethics committee. Firstly, and most importantly, the ethics committee must ensure that the rights of research participants are protected. This is achieved by ensuring that individuals receive sufficient information, which can be easily understood, and ensuring that appropriate strategies are in place to protect participants from potential adverse consequences of the research.

Edited to add: Minor things come to a health care provider's attention when they're frequent enough to be annoying, or worse, disruptive. There is a lot of research into most of the things things you've listed as irritating but not worthy of a doctor visit. Not hiccups (unpredictable), but heartburn? Do a Google Scholar search of GERD (frequent heartburn). It's a very costly condition both physiologically and financially. While an occasional headache might not seem like much, it's still been studied, as has flatulence and sneezing. "Trivial" things (e.g. the common cold) might have an enormous financial impact (missed work days due to illness, a parent who must stay home with a sick child, etc.), and the amount of research into the common cold is astounding.

Finally, scientists are curious people and like to understand how things work, so what might seem trivial to you might be intriguing to a scientist.

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  • Thank you for the answer. Did I get it right: they do research minor conditions, and they do it on people for whom they are major? Is the general assumption is that if something works on Alice who's getting hiccups or heartburn or whatever twice a day and goes to the doctor's with it, the same thing will likely work on Bob who's getting it twice a year? Do they verify (and how, if yes) if what works on Alice-like people, works on Bob-like people as well?
    – Quassnoi
    Sep 19, 2023 at 16:19
  • Not exactly, at least not for hiccups. In medicine (as with many things), the risk to benefit ratio must be weighed. Hiccups are benign enough, and of short enough duration, that taking the medication given to relieve an episode once a year is riskier than the hiccups. For heartburn, since we know what causes it, for infrequent episodes, an antacid is all that's needed; if it's more frequent, we medicate to reduce acid production. But researching what causes something gives us guidelines for treatment of both occasional and frequent occurrences, yes. And sometimes... Sep 19, 2023 at 17:17
  • @Quassnoi - ... the benefit of treating an irritating but infrequent episode, say, of hives, outweighs the risks of not treating. That (the risk:benefit) must always be weighed. Sep 19, 2023 at 17:18
  • Let me see if I understood you. To legally call something "a cure for hiccups" you need to fill out a lot of paperwork and perform rigorous clinical studies, which no one is going to do because it's just hiccups. But to publish a result saying "here's the evidence that hiccups are caused by this and this, and here's the evidence that doing A or eating B will stop them", you don't need that much hassle, and a small group of people can do that just out of sheer curiosity. Is that about right? If yes, how is the research of this latter type made? Do they watch people with severe hiccups?
    – Quassnoi
    Sep 20, 2023 at 1:05
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Designing a trial includes choosing the question. If the question is "does [free thing that anyone can do] stop hiccups", you have to try it on people who are hiccuping. But if you change the question to "does teaching [free thing that anyone can do] result in people reporting they stopped their own hiccups quickly and effectively" then you can design a study to test that and have people react to hiccups when they happen to get them.

There are two drawbacks to this. One is that it will be slow. You'll need a lot of people and you have to wait months or years for them to get hiccups and then report back to you. Also, the data may not be super accurate: they may over or underestimate how long it took to stop them, some may forget what they were supposed to do when hiccups start so you miss an opportunity to gather that data, and so on.

And then of course there's the matter of funding it. If you were going to invent a drug that people could sell for a lot of money, such people might fund tests of their drug. But if you want to teach people to startle each other or drink water backwards or whatever, who will pay for that?

As a result, I think it's extremely unlikely that anyone will do a test of the various home cures and folklore around hiccups and scientifically prove whether or not these things work. They are generally harmless (startling people could cause them to fall from a high place or get in a traffic accident, but that's going to be very rare.) It's entirely possible their only physiological function is to distract the person until the hiccups happen to stop, but since most of them involve breath pressure on the spasming muscle, it's also possible they genuinely work. If you insist on a randomized controlled trial to establish a stronger position than that, well, don't hold your breath :-)

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  • While I agree with most of this, I don't think such a study would be worth anything even if funded. Hiccups in general are so infrequent (I haven't had hiccups in decades, literally, and I'm in the age group in which hiccups are more common) that you'd need many thousands of participants, all self-reporting (terrible accuracy), a control group of many thousands participants, test for a placebo effect (a sham procedure), not to mention that normally hiccups are of short duration and may have stopped anyway. Sep 18, 2023 at 23:31

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