An alcoholic patient who continues to drink: endoscopic treatment is preferred

doi:10.1136/bmj.332.7538.423

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Mark Hudson, consultant hepatologist (Mark.Hudson@nuth.nhs.uk)

Freeman Hospital, Newcastle upon Tyne NE7 7DN

EDITOR—Patients like Mr Bond in the last interactive case report are increasingly common and present difficult clinical decisions.1 Leon and McCambridge highlighted the large increase in deaths from cirrhosis in the United Kingdom between 1987-91 and 1997-2001.2 Mortality doubled (104% increase) in men in Scotland during that time, and per capita alcohol consumption also doubled in the UK between 1960 and 2002. Treatment of Mr Bond's variceal haemorrhage and associated decisions on how far to go with intervention should be based on clinical need, …