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

### input:
Dear Doctor,I have mild itching on the knees. No other symptoms of cirrhosis. L.F.T. is normal, Globulin, PT and INR are normal. I did a USG yesterday and the radiologists remarks are: " Liver normal in size- mildly abnormal echo structureabnormal nodules on margins. - Early cirrhosis- I have been having fatty liver due to alcoholic consumption for more than 10 years. I have no symptoms of any disease now. I am gravely worried. Can you give me your opinion whether I have early cirrhosis and if so what is the prognosis.

### output:

Hi, I am so sorry to hear about your diagnosis. Fatty liver can be caused by excessive alcohol intake (Alcoholic SEATO hepatitis, ASH) or due to excessive fatty food intake and sedentary lifestyle (Non-alcoholic SEATO hepatitis, NASH). ASH is usually the beginning stages of alcohol induced liver damage and is completely reversible if the patient refrains from alcohol. NASH is being much more commonly diagnosed currently owing to poor dietary habits and sedentary lifestyles of people.  If left unchecked, in final stages it may lead to cirrhosis of the liver which will necessitate a liver transplant. In your case, unfortunately, cirrhotic changes have already appeared, which is irreversible. But on the brighter side, it is very early cirrhosis, where you do not have any symptoms. You could go on to lead a completely normal life if you take precautions from now on. 1. Total and complete Abstinence is a must. Multiple research studies have shown that people who quit Chat Doctor.  2. A diagnostic upper GI endoscopy will be required to rule out varices (a sign of portal hypertension due to cirrhosis). This will need treatment with medication and possible banding .3. An urgent consultation with a medical gastroenterologist so he can do a complete work up and start prophylactic medications if necessary. I would also suggest a healthy diet and exercise regimen as well. Although there is no time limit on when to get a repeat scan, I would suggest one, once you have succeeded in losing some weight. Hope this helped, and please do not hesitate to contact me for further details - rxsuresh@gmail.com