Assuming the person still drinks heavily.
My SO’s father has been drinking about 4 30-packs of beer per week for going on 4 decades now. He’s finally been diagnosed by his doctor as having cirrhosis of the liver.
Doesn’t matter to him it seems, because he’s still drinking around 4 cases a week. He drinks from about 10am until bedtime.
How much longer will he be around at this rate?
It depends on the stage of the disease, the otherwise health of the patient, any comorbid factors (steatosis, hepatitis, autoimmune failures, et cetera) along with excess alcohol consumption. The actual damage done to the liver is essentially irreversible but it is possible to live decades with only a small faction of liver function provided that one maintains a healthy lifestyle and doesn’t suffer any aggravating conditions. I doubt even an internist can give a definitive answer to your question–sometimes liver function continues long past any reasonable expectations, and other times it just collapses suddenly–but given the description you offer a wild-ass guess would be a few years or less.
I guess you could encourage him to drink less (or not at all) and maintain a healthy diet, but someone who has been drinking 120 beers a week for decades is probably a devoted alcoholic that doesn’t live for much beyond drink. It hardly seems worth the bother.
Perhaps Qadgop the Mercotan will step in and give a qualified medical perspective on cirrhosis, since he is not only a physician but probably has extensive practical insight into the disease given his population of patients.
Stranger
Yeah, too many factors. Was he diagnosed during a routine checkup, or did he feel ill and that’s how he found out? A lot of it seems to be luck, the stage of deterioration, and genetics. Some people are more susceptible a couple genes are more sensitive, and the structure of his liver could allow a maximum of damage before it impairs him, or it could block up and he’d deteriorate quickly without a transplant or other option.
Either way, cutting back or stopping altogether is probably the best option, but a lot of folks with poor outlooks tend to give up, figuring they might as well continue if it looks bad anyway. I knew a guy in that situation, his explanation was it was better to enjoy himself and wreck his liver (transplant wasn’t an option, he was too old for the surgery), so when it did go, he went quickly. He was already getting bad, if he quit he would still die, just slower.
It’s not ideal logic, but I could kind of understand.
What stranger said. Much depends on the severity of the cirrhosis, how fast it is progressing, and what the complications are already.
Once one develops ascites, low platelets, or bleeding esophageal varices, those are signs that the scarred liver is physically impairing blood flow thru it to an extent that the rest of the body is suffering.
If the blood doesn’t clot properly, or the albumin level is low, or the ammonia level is above normal, then the liver isn’t doing its physiologic job of producing proper proteins and detoxing the blood for normal physiologic functioning anymore either.
But people can live a long time, even with those complications, if the continuing liver damage is arrested and their diet/meds adjusted.
I’ve one guy right now who has ascites and high ammonia levels but has muddled along for about 5 years because he no longer drinks, takes his meds, and watches the protein level in his diet. He may survive long enough to get a new liver.
So stopping drinking is the single key thing that needs to happen to significantly improve survivability. Otherwise, continuing damage occurs, more scarring happens, and things get worse.
Granted, stopping brings no guarantees that things won’t progress anyway; but it’s unlikely the disease will stabilize without that step.
Hey, Chief Pedant is back! 
I bet he’s got lots to say on this topic!
The liver is one of the more resilient organs when it comes to damage. He will kill himself early if he keeps up his drinking level. This comes from a person who drank much more for less time. He can live but don’t do something stupid like throwing out his drinks. That could kill him literally. Alcohol withdrawal is among the most serious of all drugs and can be fatal if not done correctly. I would research finding the best one in your area and getting him to go.
The problem is that most people don’t want to go and one detox/rehab isn’t usually enough. This is a terrible statistic but many major alcoholics requires 10+ detoxes and 100+ is common as well. It just becomes a matter of how much effort family members want to expend.
If you really want to save him, it will take a lot of effort on your family’s part. A trick to get into such a hospital is for him to get as drunk as possible and then get taken to the emergency room. That becomes a potentially clinical fatal case and has to be addressed right away. That is highly recommended if you just want to address the situation right away. It bypasses waiting lists which are usually quite lengthy.
What are the preconditions to be considered for a transplant? It was my understanding that people suffering from alcoholic liver disease are way down on the list for consideration, and I’d think being a felon probably doesn’t improve one’s chances. I remember when Mickey Mantle got a transplant (after years of drinking and suffering from untreated Hep. C) and there was a big stink about how he shouldn’t have been eligible or at least as high up on the list as he was.
Stranger
Unless you get cirrhosis. Which happens in only about 20% of alcoholics, but is a devastating consequence. And cirrhosis does not reverse itself.
Active drinking is a contra-indication. Most transplant programs require at least a year of sobriety. But a sober alcoholic can be a good transplant candidate.
Courts have ruled that inmate status cannot be taken into account when deciding rank on transplant lists.
Mickey Mantle met the abstinence criteria. But he should have been screened more rigorously for liver cancer before the transplant.
He’s drinking 120 beers a week?! That’s (on average_ more than one beer per waking hour!
And yet the body can process just about that much. If you time it perfectly, you won’t even get drunk. I was up past 30 a drinks day at my peak and I still held down a good job, a beautiful family, and a nice house. I have never had any formal law infractions either. I just got back from an AA meeting with 300 people in a town of 13,000.
Alcohol addiction is a horrible thing. It strikes all groups including doctors, lawyers, and homeless people. You can’t stereotype alcoholics no more than you can other groups. No one could ever tell that I was drunk because my drunk was their normal. It is hell on earth for someone that suffers from it but your drunk is not the same as their drunk. They just need drinks to function.
Thanks for all the answers everyone.
I know he’s not going to stop drinking, no matter what happens, so rehab is basically out the door.
I don’t really know any of his med stats are, but his health is in pretty bad shape (350+ lbs, need a breathing aparatus to sleep, requires oxygen for a couple hours a day [i think that’s more from smoking, which he also hasn’t stopped.])
I was just curious. I don’t really like the guy, but it’s obviously going to impact my SO when he does finally pass. I was imagining it would only be a couple months, surprised to here it could keep going on for years.
Can you elaborate on this? What is involved for an event to be classified a detox? 100+ detoxes sounds like a lot of intervention.
No argument, just looking for information and insight.
I’m curious about this, because I know that one of my sisters had to be in the hospital for a few weeks to get her off alcohol (because she needed a major surgery), but I didn’t really understand why.
He’s got 42 months, 11 days. 
C’mon Q; I appreciate the welcome back but if I could prognosticate via the web I wouldn’t be still holding my Tesoro shares. Can’t add anything worth adding to what you and Stranger said except that, like you, patients like to stick it to me when I throw a termination date out there for 'em. As long as they surprise me to the good side I am OK with that.
Mr Buttons:
If the wife’s Pop has turned bright yellow that’s a whole different “finally has cirrhosis” than if he had a biopsy showing some minor cirrhotic changes. With the liver and cirrhosis it is sort of all about function more anything else. When things the liver does (keep you from bleeding; clear toxins, e.g) stop happening, it’s a very bad sign b/c you don’t see clinical effects til it’s mostly crapped out. Or if you get so much cirrhosis your blood backs up and you get big veins that bleed, that’s a bad thing. OTOH doctors will often try some sort of warning (“Sir, you’ve finally got Official Cirrhosis”) as a last ditch effort to keep Pa and Sam Adams in separate rooms. Sometimes we’ll even hang a little crepe to save our own sorry arses in case things unravel rapidly. If they do unravel, the patient’s clan is not aggreived; if the patient outlives the prognostication the worst that happens is that they gloat a bit.
Shagnasty- seriously I wouldn’t recommend the old drunk and dump route. When Pop sobers up and discharges himself against medical advice or absconds to get drunk, it wastes everyone’s time. If people don’t want to stop drinking trying to force them into it is not the way to go.
Here, drunks sober up and usually discharge themselves, we don’t detox people who actually have drink in their system bcause you can’t assess capacity to consent, intention to maintain sobriety, suicide risk, any of that in a drunk person. Once sober, if you tell me you want to go home, I’ll let you. Hospital is not prison.
Less than 24 hours off alcohol and you get sent home with vitamin tablets and some Librium, more than 24 hours off drink, you’ll get taken seriously and probably admitted for inpatient detox.
Different if dad is confused, encephalopathic, bright yellow or vomiting blood, of course, but otherwise I wouldn’t go down the route of taking him to an ER in the hope of getting him detoxed.
Hi all,
I’m new to this forum. I found it searching for information on death by cirrhosis because my 69-year-old father-in-law has been dying a very slow death and we just got back from a visit. About 15 years ago he was diagnosed with cirrhosis but it only just started seriously impacting his health the last five years or so since he retired.
3.5 years ago we moved very far away and my husband is his only family so it’s difficult to help him. He drinks beer constantly and smokes cigarets. We are not going to get him to stop. He’s a stubborn curmudgeon who values his privacy and independence. It’s amazing he’s still alive. Must have a very strong constitution! I’m not new to alcoholism. I know you can’t change an alcoholic; you can only help them if they want to change and he doesn’t. My mother was an alcoholic and killed herself with a drug overdose.
This recent visit was especially tough. He’s been having some bouts of confusion and a couple of dangerous driving situations and finally he lost his driver’s license. We got him to consider making some end of life arrangements and he signed power of attorney for health and fiances. I had an opportunity to speak with his doctor and she said his ammonia blood levels were high but he did well on cognitive memory tests. The only thing more she would say was that he should stop drinking (NOT going to happen!).
I think he has bouts of hepatic encephalopathy and spends a lot of time in a stupor or asleep. When my husband arrived at his house this visit, he was asleep in the afternoon and he didn’t know the time or day. He was surprised that we were there. He has two little dogs and there was no dog food. His house was a mess. There was a 3-week-old turkey out on the counter. (Yuck!).
We spent the next two weeks making a lot of arrangements, cleaning up after him and making his house more livable. He’s pretty much confined to a scooter chair because he has hip and back problems. He is also suffering from diabetes and has heart problems (pacemaker). This time we also noticed that he has developed hand tremors which are related to his encephalopathy. His abdomen and feet are swollen and he complains of being cold all the time. The only cirrhosis symptom he doesn’t seem to have is jaundice.
We’ve suggested various agencies that can help him with food, transportation, etc, but he’s extremely resistant to any help from anyone but us. He does not want to go into assisted living. He doesn’t want anyone coming to check on him or providing any services. He’s a very cheap SOB and doesn’t want to spend any money on anything but beer and cigarets. We did work out an arrangement where we’ll call him once a week to check on him (but he didn’t like this idea at all and he rarely answers the phone.)
It would really help to have a better sense his prognosis and the timing of his death. He hasn’t seen his doctor that much so she really couldn’t tell us. From reading stuff on the internet and observing his symptoms, I guess is that he won’t live 6 months. It would be a blessing if he would slip into a hepatic coma and die peacefully. Anyone been through something similar? What can we expect? How can we help make his end of life as peaceful as possible? How can we best handling traveling back and forth to help him?
Thanks!
drtj, I’d advocate that you raise the topic of Home Hospice. Look for a qualified one in his area.
The goal of hospice is to make the patient with a terminal diagnosis more comfortable, and help them to enjoy what’s left of their lives. Hospice care will not try to cure the underlying problems, as the chance of doing so is rather miniscule. They will try to provide the hospice care in the person’s home environment if possible.
I can’t answer for Shagnasty, but detox is not the same as rehab. Medical “detox” is usually considered to be about at week, but that’s just from the immediate physical dependence. The physio-biological effect on one’s mental condition is more long-term. “Rehabs” are usually one month (and that’s mainly because they’re so expensive). It may include medical detox (if necessary), but otherwise it involves being holed up someplace where it’s difficult to sneak off and go back to drinking. They have classes, and counseling, etc. From what I’ve seen, though, one month just isn’t long enough. After 30 days people feel physically better, so they think they no longer have a problem–but they haven’t changed psychologically. They leave the rehab, get back out into the reality of the real world, and eventually just fall back into the same routines they had before, and end up drinking again. In quick time they’re as bad off–if not worse–than before, and so some circumstance (work or family) sends them back. That’s how it’s possible for someone to go to so many detoxes or rehabs, and still be drinking.
Hi Qadgop,
That’s a good idea. I think we need to get a better handle on his prognosis first. Doesn’t the doctor officially need to give him 12 months to live first?
DrTJ (not the medical kind)