### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi Doctor,  My name is Santos, and I was diagnosed with cirrhosis in the mild to moderate stage witChatDoctorplications of esophageal varices without bleeding status chronic, mild. I also have Barretts esophagus with status chronic, mild.  My meds. are Propranolol 10mg., Nexium 40 mg., and Lactulose. I am eating well healthy and taking meds. like I should, and would like to know what my prognosis is can I live for a good while or am I close to death.  I also forgot to mention that I had endoscopy with banding as a precaution.  This was done in Oct. 7, 2011.

### output:

Hello Mr Santos, I am so sorry to hear about your diagnosis. By your description, I understand you have developed "Portal Hypertension" which is a complication of cirrhosis of the liver. This manifests as either esophageal varices which can bleed or as ascites (fluid build up in the belly). Liver cirrhosis also prevents some chemicals in the body from being purified and this can enter the brain leading to sleepiness and confusion (Encephalopathy). Propranolol helps in decreasing the portal hypertension and prevents the varices from bleeding. Lactulose prevents the chemicals from being absorbed from the intestine and so will prevent the confusion (encephalopathy). The prognosis of your cirrhosis will depend on the cause of cirrhosis. Unfortunately irreversible liver damage has already occurred to your liver and now the aim will be to prevent further deterioration and prevent complications. If the cirrhosis was due to alcohol, complete abstinence will delay the progression of cirrhosis. If it is due to some form of hepatitis, unfortunately there is not a lot of left to do since anti-hepatitis treatment cannot be given in cirrhosis. The best treatment for cirrhosis, especially for someone in your stage is liver transplant. It will not only get rid of the cirrhotic liver, but also treat the portal hypertension completely. I would advise you to actively seek a Liver transplant center and get evaluated for candidacy for a transplant. Hope this helped and I hope you feel better. Please do not hesitate to contact me personally for any further details - rxsuresh@gmail.com