As we age, we sometimes see small threads cruise across our eyes. They are most visible when looking at something that is bright. They can be distracting and annoying, but they usually do not interfere with sight. They are actually strands that come from the vitreous, a gel like substance that keeps the eyeball round. Most people get used to them and short of finding them to be an occasional annoyance, pay no attention to them. They cause no medical conditions.

What causes hiccups and how do I treat them? (JG Saddle Brook NJ)

Brief episodes of hiccups are common to everyone, but constant hiccups are a concern and should be investigated by a stomach specialist called a gastroenterologist. There are many causes of hiccups, scientifically called singultus. These are the result of spasms of the diaphragm or the partition that separates the lungs and heart from the intestinal tract. Hiccups can come from eating or drinking too fast, drinking carbonated beverages, chewing gum, smoking or drinking a lot of alcohol.

As far as treatments go, there are many old remedies such as holding one’s breath, scaring someone, or putting a bag over your head (not tightly of course). There are only good medical ways to treat chronic hiccups. They include using drugs like chlorpromazine and Haldol. These have to be ordered by your doctor and are rarely used for chronic hiccups. A medical evaluation is required for bad hiccups that don’t seem to go away. Don’t try to treat yourself with drugs if you have chronic hiccups.

What is gingivitis? (RS Saddle River)

Gingivitis is inflammation around the gums and teeth due to poor dental hygiene. It starts when food debris mixes with saliva and bacteria forming plaque that sticks on the surfaces of teeth. This is avoided by dental flossing and brushing one’s teeth after eating. The buildup of material on the teeth is called tartar and is best removed by a dental hygienist even if you take good care of your teeth. If the gingivitis is bad, it could involve bone and lead to periodontitis. When that happens, the teeth recede away from the gums and deep pockets form. This could cause your teeth to loosen and actually fall out.

I heard that an antibiotic can cause problems with my joints. Is that true? (KW Saddle River)

There is a class of antibiotics called fluoroquinolones which are useful for a variety of infections. These drugs are widely known and some are familiar to the layperson; Levaquin, Cipro and others in the same family. These drugs are extremely useful for a whole variety of simple and serious infections. Rarely, these drugs can cause tendon rupture. We recommend that anyone with pain, swelling, or inflammation around a tendon or joint who is on these antibiotics, stop taking them and call their doctor. The tendon most commonly ruptured is the Achilles tendon, but hand , shoulder, and biceps tendons can also be affected.

Why is my hair falling out? I am on no medicines. (LM Paramus)

Hair loss is very common for a variety of reasons unrelated to medications. The term that we use in medicine for hair loss is called “alopecia”. A doctor will ask the patient about the hair loss; such as, the duration and the progression, the location, and the pattern and extent if any. Pain, tender scalp, itching or burning of the scalp are all important things to tell the doctor. Hair shedding versus hair breakage is also important for the doctor to establish. The patient can be savvy about how the hair is falling out, but not have the wherewithal to understand the different ways in which hair is lost. If one has pony tails, tight braids, or other constrictions which they place on the hair, it can be lost via something called traction alopecia.

Many times, hair loss can be ascribed to hormone issues. The patterned hair loss, irregular periods in women, beard growth or hair in places suggestive in women of hirsutism (a formal term for too much hair), and infertility, are all suggestive of a hormonal basis for hair loss.

To discuss hair loss in the absence of medications we can list the possible causes: poor diet (caloric or protein restriction), major illness or surgeries, psychologic stress, significant weight loss, chronic iron deficiency, thyroid disorders, childbirth, and finally poisoning from arsenic mercury or thallium.