Targeting the Gut Microbiome in Cirrhosis

Abstract

The components of the human gut microbiome are bacteria, viruses, fungi, and archaea. Microbial composition and function are modulated by interventions and medications such as alcohol intake, changes in diet or cultural factors, medications, such as proton pump inhibitors and antibiotics, as well as a liver transplant. Several studies observed a strong association between changes in microbiome and severity of liver disease and complications such as hepatic encephalopathy and acute on chronic liver failure. The chapter includes an overview of (1) methods to measure the presence of gut bacteria in stool samples, (2) approaches to target the gut microbiome, and (3) studies of fecal microbiota transplantation in human cirrhosis. The clinical interest in the microbiome also includes the potential for microbiome-based biomarkers to inform clinical decision-making.