Ľubomír Skladaný, Svetlana Adamcová-Selčanová, Erika Čellárová
Liver cirrhosis is such an urgent problem that it is also discussed outside of epicentres. At the Memorial of Teofil Rudolf
Niederland he said that a human being cannot be helped – we have to like him. Who knows how the present internal
medicine would appear in this sense – if it is valid, also if not, or not completely or it depends. For example the revolutionary
treatment revealed cirrhosis reversibility for concerned wide public; it was allowed by targeted research at
diagnoses with a certain reputation, firstly hepatitis C. Subsequent more detailed recognition of reversibility pointed to
several ones, who knew long ago that cirrhoses differ – for example Laennec and Popper; they were also proved right
by the proposal of April 2015 to change the name cirrhosis in the clinical medicine to another one: advanced chronic
liver disease. In contrary to undistinguished effect of the fact that cirrhosis is a spectrum, bleeding at cirrhosis worked
in the history so intensively that overshadowed also more frequent and more fatal – so-called non-bleeding complications
– as ascites, infections and encephalopathies. So it was accepted with difficulties that the blood of a person suffering
from cirrhosis is normally coagulated, or more and it usually sheds due to the pressure from the portal hypertension.
It was proved right. And not just this: moreover the attitude to the examination needs to be changed as the examinations
were understood as reflecting homeostasis – e.g. INR; and to take into consideration the possibility that cirrhosis
progression might be stopped or reversed by coagulation treatment. Cirrhosis regression due to anticoagulation treatment
pointed to some scientists in the history – e.g. to the author of pathogenic hypothesis, that cirrhosis results from
microthromboses.