Goyal MK, Goyal P, Goyal O, Sood A. Gut feeling gone wrong: Tangled relationship between disorders of gut-brain interaction and liver disease. World J Hepatol 2025; 17(5): 105582 [DOI: 10.4254/wjh.v17.i5.105582]
Corresponding Author of This Article
Omesh Goyal, Professor, Department of Gastroenterology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana 141001, Punjab, India. dromeshgoyal@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Manjeet Kumar Goyal, Department of Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi 110029, Delhi, India
Prerna Goyal, Department of Medicine, R.G. Stone Super Speciality Hospital, Ludhiana 141001, Punjab, India
Omesh Goyal, Ajit Sood, Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Co-first authors: Manjeet Kumar Goyal and Prerna Goyal.
Author contributions: Goyal MK and Goyal O contributed to conceptualization; Goyal MK contributed to visualization; Goyal MK and Goyal P contributed to literature search, they contributed equally as co-first authors; Goyal O and Sood A contributed to supervision, validation, and visualization; Goyal MK, Goyal P, Goyal O, and Sood A contributed to writing original draft, reviewing and editing.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Omesh Goyal, Professor, Department of Gastroenterology, Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana 141001, Punjab, India. dromeshgoyal@gmail.com
Received: January 30, 2025 Revised: April 3, 2025 Accepted: April 30, 2025 Published online: May 27, 2025 Processing time: 119 Days and 4.5 Hours
Abstract
Functional gastrointestinal disorders, now termed “disorders of gut-brain interaction” (DGBI), are characterized by a spectrum of chronic gastrointestinal symptoms driven by dysregulated gut-brain interaction. DGBIs frequently coexist with liver diseases, including cirrhosis, thereby exacerbating clinical manifestations and complicating management; this overlap is underpinned by shared mechanisms, including gut dysbiosis, increased intestinal permeability, systemic inflammation, and altered neuroimmune signaling. Portal hypertension in cirrhosis promotes small intestinal bacterial overgrowth and microbial translocation, thereby triggering inflammatory pathways that worsen gut and liver function. This minireview explores the gut-liver axis as a central mediator in the interplay between DGBIs and liver disease/cirrhosis. Clinically, these interactions manifest as refractory gastrointestinal symptoms, nutritional deficiencies, and impaired quality of life. Emerging research emphasizes the need for integrative diagnostic approaches, such as combining advanced imaging, microbiome analysis, and biomarker profiling, to unravel the complex interplay between DGBIs and liver disease/cirrhosis. Therapeutic interventions targeting the gut microbiome, neuroimmune pathways, and lifestyle modification can mitigate disease burden. This review underscores the importance of a multidisciplinary framework for enhancing patient outcomes and guiding future research in this intersectional field.
Core Tip: The review highlights the complex bidirectional relationship between disorders of gut-brain interaction and liver diseases, particularly cirrhosis. It emphasizes shared pathophysiological mechanisms such as gut dysbiosis, increased intestinal permeability, and neuroimmune dysregulation, which exacerbate clinical manifestations and complicate management. The article suggests integrative diagnostic approaches and therapeutic strategies targeting the gut microbiome and neuroimmune pathways to improve patient outcomes.
