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If You Think He’s Drinking Too Much, It’s Likely He Is

Dear Dr. Roach: I am worried about my husband, who is 52 years old. He is thin, in good physical health and is taking cholesterol pills. He works every day, and every night he drinks 12 or more beers. I have talked to him about this, and he gets upset. He says he is relaxing! He reads the paper and your column every day. Can you write about the effects of drinking so much every night and what it can do to your body? I think he is a functioning alcoholic. Many nights, when he drinks 12 or more, he sways to the bedroom! — V.

Answer: The terms “alcoholic” and “alcoholism,” along with the medical terms “alcohol dependence” and “alcohol abuse” are now classified as “alcohol use disorder.” It is very common in the U.S. and Canada, with more than 10 percent of adults meeting the criteria for alcohol excess.

Excess alcohol use has serious consequences, increasing risk for hepatitis and cirrhosis of the liver, high blood pressure, pancreatitis, tuberculosis, pneumonia, many cancers, dementia and stroke, and disease of the heart muscle.

Common symptoms of alcohol use disorder include a decreased ability to control drinking behavior, continued drinking despite adverse consequences, preoccupation with alcohol and distorted thinking — especially denial. Drinking quickly and drinking to relieve stress, as your husband has indicated, are symptoms of loss of control over alcohol.

While I can’t make the diagnosis of alcohol use disorder in your husband without a thorough history, the amount he is drinking and some of the comments you have reported make me very concerned that he indeed does have a real problem with alcohol. A visit to his doctor might include tests looking for damage to the liver, pancreas and bone marrow from alcohol.

I certainly can give your husband specific advice to reduce his drinking now, since doing so will reduce the damage the alcohol is doing to the body. I recommend NEVER exceeding five drinks at any one time. Cutting down now will make it easier and safer to stop entirely. However, only your husband can decide how ready he is to make a change. There are many resources available to him, from his own doctor to a specialist in alcohol use, such as a social worker, psychologist or addiction medicine specialist experienced in helping people with alcohol use. I have also had many patients have had success with AA and similar organizations.

Dear Dr. Roach: What would be the cause of a bowing of the penis, and what can treat it? I’m 83 and have had no pain or problems with urinating. — W.H.

Answer: If this is a new problem, you likely have Peyronie’s disease. It is caused by scar tissue within the penis, and about 5 percent of men have the condition, whose symptoms may include penile pain, curvature or difficulty with sexual function.

Medical treatment for Peyronie’s disease includes older treatments like vitamin E, in combination with colchicine. Pentoxifylline, another prescription medication, has been useful for many men with Peyronie’s. A new treatment, collagenase (Xiaflex), was just approved. It is injected directly into the penis.

Not everybody with Peyronie’s needs to be treated, and if you are having no pain and no difficulty with sexual function, you may choose not to treat it. Much more information is available at www.peyronies.org.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or write to P.O. Box 536475, Orlando, FL 32853-6475.