Change in Composition

Changes in the gut microbiome of patients with CLD are associated with the underlying etiology and disease progression.3

  • In a study of patients with and without fibrosis caused by NASH, patients with fibrosis had increased relative abundance of Bacteroides and Ruminococcus.3,5
  • In another study, patients with NASH and cirrhosis had a higher abundance of certain families from the Bacteroidetes phylum and a reduction in Veillonellaceae compared with patients with other causes of cirrhosis.3,4 Additionally, a significantly higher abundance of Enterobacteriaceae and Halomonadaceae, and lower volume of Lachnospiraceae, Ruminococcaceae, and Clostridiales XIV was observed in patients with alcoholic cirrhosis.4

Regardless of underlying etiology, a generally higher prevalence of pathogenic bacteria (eg, Enterobacteriaceae and Streptococcaceae) and a lower abundance of beneficial bacteria (eg, Bifidobacteria and Lachnospiraceae) have been found in patients with cirrhosis compared with healthy individuals.6 SIBO and bacterial translocation across the intestinal epithelial lining are also common in patients with cirrhosis.1-3

CLD = chronic liver disease
NASH = nonalcoholic steatohepatitis
SIBO = small intestinal bacterial overgrowth

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  1. Acharya C, Bajaj JS. Gut microbiota and complications of liver disease. Gastroenterol Clin North Am. 2017;46(1):155-169.
  2. Oikonomou T, Papatheodoridis GV, Samarkos M, Goulis I, Cholongitas E. Clinical impact of microbiome in patients with decompensated cirrhosis. World J Gastroenterol. 2018;24(34):3813-3820.
  3. Acharya C, Bajaj JS. Altered microbiome in patients with cirrhosis and complications. Clin Gastroenterol Hepatol. 2019;17:307-321.
  4. Bajaj JS, Heuman DM, Hylemon PB, et al. Altered profile of human gut microbiome is associated with cirrhosis and its complications. J Hepatol. 2014;60(5):940-947.
  5. Minemura M, Shimizu Y. Gut microbiota and liver diseases. World J Gastroenterol. 2015;21(6):1691-1702.
  6. Boursier J, Mueller O, Barret M, et al. The severity of nonalcoholic fatty liver disease is associated with gut dysbiosis and shift in the metabolic function of the gut microbiota. Hepatology. 2016;63(3):764-775.
  7. Vilstrup H, Amodio P, Bajaj J, et al. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver. Hepatology. 2014;60(2):715-735.