Chronic Liver Diseases and the Microbiome-Translating Our Knowledge of Gut Microbiota to Management of Chronic Liver Disease

Gastroenterology. 2021 Jan;160(2):556-572. doi: 10.1053/j.gastro.2020.10.056. Epub 2020 Nov 28.


Chronic liver disease is reaching epidemic proportions with the increasing prevalence of obesity, nonalcoholic liver disease, and alcohol overuse worldwide. Most patients are not candidates for liver transplantation even if they have end-stage liver disease. There is growing evidence of a gut microbial basis for many liver diseases, therefore, better diagnostic, prognostic, and therapeutic approaches based on knowledge of gut microbiota are needed. We review the questions that need to be answered to successfully translate our knowledge of the intestinal microbiome and the changes associated with liver disease into practice.

Keywords: Cirrhosis; Diet; Fecal Microbial Transplant; Hepatic Encephalopathy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Animals
  • Brain / microbiology
  • Brain / physiopathology
  • Chronic Disease
  • Diet
  • Disease Models, Animal
  • Disease Progression
  • Dysbiosis / etiology
  • Dysbiosis / microbiology
  • Dysbiosis / physiopathology
  • Dysbiosis / therapy
  • End Stage Liver Disease / etiology
  • End Stage Liver Disease / microbiology
  • End Stage Liver Disease / prevention & control
  • End Stage Liver Disease / therapy
  • Feces / microbiology
  • Gastrointestinal Microbiome / physiology*
  • Humans
  • Liver Diseases / etiology
  • Liver Diseases / microbiology*
  • Liver Diseases / prevention & control
  • Liver Diseases / therapy