<s>[INST] Hello, I have been diagnosed with cirrhosis from alcohol use. I was hospitalized for three separate episodes of esophageal varices. I have been stable for over a year and have brought my MELD score down from 19 to 12. My medications work well for ascites and hypertension and my health and diet are quite good now. My question is this: I have recently started bleeding rather heavily through the nose and mouth. This happens at any times in the day, but mostly in the morning. It s not enough to go to the ER or, I think, bother my transplant team with. Is there something I can do to ease this? Any recommendations for blood-stopping? Any immediate dietary adjustments? I generally let it bleed out over the course of one half hour, average. Thank you. [/INST] Hi There, Thanks for your query. From your inputs it seems you are already in decompensated stage of liver cirrhosis with ASCIIs and portal hypertension with bleeding episodes. Get the liver function test and Upper gastrointestinal endoscopy done to know the source for your bleeding. If the bleeding source is defined then treatment will be based on it as banding for varices and platelets and fresh frozen plasma transfusion for depletion of clotting factors, depending on the severity and continuing the beta blockers(propranolol or Adolf)Dietary adjustment in the form of avoiding hard solid foods which likely causative of mucosal injury and adhere to the diet you been following. Have an appointment with your transplant team to review the functional status. </s>