the Risks: Smoking, Drinking, and Liver Health Concerns

I'm not sure what kind of illness I have?

Dr.
Hsiao: Due to long-term smoking (one pack a day) and drinking alcohol (with every meal), my current health condition is not very good.
In September 2022, I experienced hematemesis, a high fever lasting three to four days, and jaundice.
I subsequently visited the Dongyuan Hospital in Zhubei, where the physician advised that if I continued to smoke and drink, I would develop cirrhosis.
The hematemesis has not recurred since treatment, but my habits of drinking and smoking have not improved.
Recently, I experienced hematemesis again.
Could this be a sign of cirrhosis? I kindly ask the doctor for clarification.

Guang Ge, 50~59 year old female. Ask Date: 2005/06/09

Dr. Xiao Jingqin reply Internal Medicine

The diagnosis of cirrhosis can be made through imaging studies such as ultrasound and computed tomography.
A simple abdominal ultrasound can diagnose cirrhosis, while jaundice and abnormal liver function tests cannot differentiate between cirrhosis and severe alcoholic hepatitis, as severe alcoholic hepatitis may present with profound jaundice, fever, hepatomegaly, ascites, and generalized edema, which are difficult to distinguish from end-stage cirrhosis.
In such cases, ultrasound can provide differentiation.
Regarding hematemesis, patients with cirrhosis and alcoholic hepatitis have a fourfold increased risk of developing peptic ulcers, making endoscopy essential.
Hematemesis may be due solely to ulcer bleeding; however, esophageal variceal bleeding, which is common in cirrhotic patients, has a high mortality rate and should not be taken lightly.
Additionally, when ultrasound cannot definitively diagnose cirrhosis, the presence of esophageal varices found during endoscopy can serve as corroborative evidence for the diagnosis of cirrhosis.

Reply Date: 2005/06/09

More Info

The concerns surrounding smoking, drinking, and liver health are critical, especially for individuals with a history of substance use and previous health issues. Your situation, characterized by long-term smoking (one pack a day) and regular alcohol consumption with symptoms such as vomiting blood, fever, and jaundice, raises significant health alarms.
Firstly, it is essential to understand the impact of smoking and alcohol on liver health. Both substances are known to exert considerable stress on the liver. Smoking introduces numerous toxins into the body, including carcinogens that can exacerbate liver conditions. Alcohol, on the other hand, is metabolized by the liver, and excessive consumption can lead to alcoholic liver disease, which encompasses a spectrum of conditions from fatty liver to alcoholic hepatitis and eventually cirrhosis.

Cirrhosis is a severe condition characterized by the replacement of healthy liver tissue with scar tissue, leading to impaired liver function. The symptoms you experienced, such as jaundice (yellowing of the skin and eyes), vomiting blood, and prolonged fever, are concerning and can be indicative of severe liver dysfunction or complications arising from liver disease. The fact that you have previously experienced these symptoms and have been advised by healthcare professionals to cease smoking and drinking is a clear indication of the potential risks you face.

The recurrence of vomiting blood is particularly alarming. In patients with liver disease, this symptom can be attributed to several factors, including esophageal varices, which are swollen veins in the esophagus that can rupture and bleed due to increased pressure in the portal vein system, a common complication of cirrhosis. Additionally, the risk of developing peptic ulcers is heightened in individuals who consume alcohol and smoke, which could also explain the bleeding.

Given your history and current symptoms, it is crucial to seek immediate medical attention. A thorough evaluation, including imaging studies such as an abdominal ultrasound or CT scan, can help determine the state of your liver and whether cirrhosis or other liver-related complications are present. Blood tests to assess liver function (including liver enzymes, bilirubin levels, and coagulation factors) are also essential.

Moreover, it is vital to address the lifestyle factors contributing to your health issues. Continuing to smoke and drink alcohol despite experiencing severe symptoms can lead to irreversible damage. Quitting smoking and reducing or eliminating alcohol consumption are critical steps toward improving your health and preventing further complications. Support from healthcare professionals, including addiction specialists and counselors, can provide the necessary assistance in overcoming these habits.

In summary, your symptoms and history suggest a significant risk for liver disease, potentially cirrhosis, especially given your lifestyle choices. It is imperative to seek immediate medical evaluation and adhere to recommendations for lifestyle changes. Early intervention can significantly improve outcomes and enhance your quality of life. Remember, your health is paramount, and taking proactive steps now can lead to a healthier future.

Similar Q&A

Can People with Favism Smoke or Drink Alcohol Safely?

Individuals with G6PD deficiency (commonly referred to as favism) should be cautious about smoking and drinking alcohol. Smoking can exacerbate oxidative stress, which may pose additional risks for those with this condition. Alcohol consumption can also lead to oxidative damage a...

Dr. Cai Mengru reply Family Medicine
Dear Xin, Regarding your question, it should be answered as follows: Although smoking and drinking alcohol are not absolute contraindications for G6PD deficiency (meaning there is no direct interaction), smoking and drinking are generally not suitable for everyone. Therefore, it...

Enhancing Liver Health: Nutritional Insights for Alcohol Consumers

Hello Director Guimei: Due to work-related reasons, I often have to drink alcohol and smoke. Additionally, I am somewhat overweight (174 cm/105 kg) and have a family history of gout, which makes me very concerned about my health. I would like to ask: 1. Do brewer's yeast, ga...

Dr. Shi Guimei reply Nutrition
Hello! The function of food is to provide the nutrients required by the human body and does not have therapeutic effects. If rigorous experiments prove that a food has special therapeutic effects on the human body, it must be submitted to the Department of Health for certificatio...

Managing Fatty Liver: Dietary Tips for High Cholesterol and Hypertension

I have hyperlipidemia, hypertension, fatty liver disease, and alcoholic hepatitis (without a drinking habit). Due to my work, I frequently enter chemical factories and occasionally inhale vinyl chloride gas. How should I maintain my health in daily life, and what medications shou...

Dr. Liu Qiaoyun reply Nutrition
Hello, you have quite a few health issues, including hypertension, hyperlipidemia, and fatty liver. For the first two conditions, please refer to the nutrition section on the Zhudong Hospital website, which provides detailed information on dietary management. As for fatty liver, ...

When to Avoid Alcohol: Health Indicators and Medical Conditions Explained

Dear Sir/Madam, 1. In general health check-ups, if certain values are elevated, it is advisable to limit alcohol consumption. Typically, if liver enzymes such as AST (aspartate aminotransferase) or ALT (alanine aminotransferase) are above 40 U/L, it is recommended to reduce alco...

Dr. Lin Mingxing reply Family Medicine
In general, almost all health check items that show abnormalities require restrictions on alcohol consumption, such as liver function tests (GOT, GPT, rGT), blood sugar (sugar), cholesterol, triglycerides, and uric acid. Abnormalities in these parameters can have direct negative ...