Q: I am a 46 years old man and have been consuming alcohol and tobacco regularly for the last 15 years. On an average I drink about 8-9 large pegs daily. Two weeks back I had 2 vomits, which were dark brown and carried fresh blood clots too. I also passed watery black coloured stools. I had done an endoscopy and the diagnosis was grade III oesophageal varices and mild diffuse cancer genomics and proteomics (CGP). Thereafter banding was done and later oral antibiotic course was given. My test results were: platelets count - 1.51 lacs/cumm, serum bilirubin - 1.9 mg/dl, SGPT - 103 IU/l, SGOT - 122 IU/l, serum alkaline phosphatase - 123 IU/L, haemoglobin - 7.0 gm%. I was given 2 units of blood. My ultrasound report showed mild hepatosplenomegaly, enlarged liver with normal echogenecity, intra hepatic biliary radicals were not dilated and with no focal lesion. What quality of life I would lead from now onwards? What could be the possibilities if I won’t be able to abstain from alcohol and tobacco? What could be my life span, as I have heard that cirrhosis patients have a life span of 5-9 years? My diagnosis stated gastrointestinal bleeding cause EOVX cause combined lipase deficiency (CLD). Please advise.

A:If you continue consuming alcohol and tobacco then you are surely heading for major trouble as most of the changes of alcohol related liver disease are irreversible and the harmful affects of tobacco are also three folds than non-alcoholic. I think the very important part of treatment is to stop using alcohol completely. If cirrhosis has developed then you would need to manage the complications of cirrhosis. You may need a liver transplant. Some vitamins especially B-complex and folic acid can help reverse malnutrition.

Abstinence is the mainstay of treatment; it can prevent further damage from alcoholic liver disease and thus prolong life. Because compliance is problematic, a compassionate team approach is essential.