The People’s Pharmacy discusses how hiccup remedies actually work, food triggers for migraines, and the benefits of papaya.

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Q: I’ve suffered with hiccups all my life (I’m in my late fifties). The only remedy that really works is one I learned from a friend about six years ago: Raise your left arm straight over your head while drinking a glass of water.

Can you tell me why this works? I’m guessing it has to do with the stretching motion expanding or opening up the diaphragm.

A: Hiccups are heard when the diaphragm repeatedly contracts involuntarily and the vocal cords close immediately after each contraction. There are many triggers, including a large meal, hot peppers, alcohol, carbonated beverages and anesthesia. A number of serious health conditions also can set off hard-to-treat hiccups. That’s why persistent hiccups (beyond two days) should be brought to a doctor’s attention.

We have been collecting hiccup remedies for over 40 years. We suspect that many work by stimulating nerves in the mouth and throat. This in turn might interrupt the muscular contraction. Raising the left arm while drinking water may help stimulate the vagus nerve, much as swallowing a spoonful of sugar would. This is a time-honored remedy for hiccups (New England Journal of Medicine, Dec. 23, 1971).

Others, such as sipping pickle juice or eating olives, might work by activating transient receptor potential (TRP) channels in this same pathway. You can learn about many other hiccup remedies in our book “Quick & Handy Home Remedies.” It is available at www.PeoplesPharmacy.com.

Q: People with frequent migraine headaches often are advised to follow an elimination diet. Is there any evidence regarding its effectiveness?

A: A comprehensive review of diet and headache in the journal Headache (October 2016) notes that this is a controversial topic. The research is not as rigorous as one might wish.

Foods that are thought to trigger migraines include alcoholic beverages like red wine, chocolate, coffee, aged cheese, nuts, processed meats such as salami, citrus fruits and milk. MSG (monosodium glutamate), caffeine and artificial sweeteners also have been implicated.

A small, randomized, controlled trial found that patients had fewer headaches and less pain during the elimination-diet phase (Journal of Headache Pain, Oct. 23, 2014).

Better research would be welcome. People who suffer migraines may want to do their own experimentation to see if eliminating specific foods is helpful.

Q: I’ve found that a couple of slices of ripe papaya calms heartburn. It also provides a little fresh fruit to the diet. Papaya enzyme tablets work, but the fresh papaya is a better choice for me.

A:A doctor first reported the benefits of papain, an enzyme from papaya fruit, for treating heartburn in The British Medical Journal on April 3, 1886. Sadly, there has been very little well-controlled research over the subsequent decades.

As long as people are not allergic to papaya, your remedy is worth a try. Some people with latex allergy also are sensitive to papaya, mango, banana and avocado (Allergy, April 1997).