An alcoholic patient who continues to drink: case presentation

doi:10.1136/bmj.332.7532.33

BMJ 2006;332:33 (7 January), doi:10.1136/bmj.332.7532.33

Practice

Interactive case report

An alcoholic patient who continues to drink: case presentation

Stuart McPherson, specialist registrar¹, Colin John Rees, consultant gastroenterologist¹

¹ Department of Gastroenterology, South Tyneside Healthcare NHS Foundation Trust, South Shields NE34 0PL

Correspondence to: C J Rees Colin.rees@sthct.nhs.uk

The first 150 words of the full text of this article appear below.

Mr Bond is a 42 year old man with alcoholic cirrhosis who wasadmitted to our unit with haematemesis. He had had three previousadmissions with alcohol related problems and had twice bledfrom oesophageal varices. The varices had been treated by sclerotherapyand banding, and he was taking propranolol 40 mg twice dailyas secondary prophylaxis. His most recent endoscopy had shownthree, barely noticeable oesophageal varices.

Mr Bond has a history of excessive alcohol intake over fiveyears, with no periods of abstinence. He was drinking 3-4 litresof strong cider a day up until the day of admission. A consultantpsychiatrist had previously diagnosed depression and alcoholdependence syndrome. Although Mr Bond had been treated withparoxetine, he discontinued it as he thought it was unhelpful.He had also seen the drug and alcohol team several times. Hisattendance at appointments with the psychiatrist and drug and. . . [Full text of this article]

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