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ROUTINE HEALTH CHECK UP MUST PICK UP ALCOHOLICS

O P Kapoor
Hon. Visiting Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.

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Nearly half of the male patients who go for health check up to the hospitals are executives who are not paying from their own pockets for this check up. Most of them are working hard but at the same time socialising nearly every day in order to maintain their contacts. Many of them are not social drinkers but are drunkards or alcoholics. The latter type of people do not even realise that they have gone to a pathological stage of drinking. In their subconscious mind they think that the health check up will pick up if there is any damage due to alcohol.

The upper limit of consuming alcohol is supposed to be 3 measures or pegs of 30 ml liquor per day on an average of 7 days in a week or 21 pegs per week. Most of the executives and businessman drink a large peg (60 ml) at a time. Many of them drink 3-5 pegs (6-10 small pegs) in the evening, thus making the alcohol consumption to 2-3 times than the permissible limit.

How can we pick up such alcoholics and draw their attention to the fact that if they continue drinking this quantity, they will land up with irreversible alcoholic cirrhosis of the liver for which there is no treatment?

In my opinion, the following tests must be ideally included in a health check up which will pick up such population:

1. MCV and PCV which is increased along with polycythaemia
2. Gama GT raised
3. Serum transferin saturation increased
4. Serum ferritin levels increased
5. Triglycerides very high
6. Uric acid levels raised

Finally, HLA tissue group of every person should be done because if HLA group of B8 is found, such people are more likely to develop alcoholic cirrhosis than a normal population.

ACKNOWLEDGEMENT

I am thankful to Dr. Deepak Amarapurkar for going through my script.

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