Dietary approach and gut microbiota modulation for chronic hepatic encephalopathy in cirrhosis

doi:10.4254/wjh.v11.i6.489

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Jun 27, 2019 (publication date) through Feb 26, 2026

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World Journal of Hepatology

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1948-5182

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World J Hepatol. Jun 27, 2019; 11(6): 489-512
Published online Jun 27, 2019. doi: 10.4254/wjh.v11.i6.489

Dietary approach and gut microbiota modulation for chronic hepatic encephalopathy in cirrhosis

Daniela Campion, Ilaria Giovo, Paola Ponzo, Giorgio M Saracco, Federico Balzola, Carlo Alessandria

Daniela Campion, Ilaria Giovo, Paola Ponzo, Giorgio M Saracco, Federico Balzola, Carlo Alessandria, Division of Gastroenterology and Hepatology, Città della Salute e della Scienza di Torino Hospital, University of Turin, 10126 Turin, Italy

Author contributions: Campion D, Giovo I, Ponzo P and Alessandria C drafted and edited the manuscript; Saracco GM and Balzola F supervised the editing of the manuscript.

Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.

Corresponding author: Carlo Alessandria, MD, Doctor, Division of Gastroenterology and Hepatology, Città della Salute e della Scienza di Torino Hospital, University of Turin, C.so Bramante 88, 10126 Turin, Italy. carloalessandria@libero.it

Telephone: +39-011-6335561 Fax: +39-011-6335714

Received: March 15, 2019
Peer-review started: March 15, 2019
First decision: April 22, 2019
Revised: May 15, 2019
Accepted: May 20, 2019
Article in press: May 21, 2019
Published online: June 27, 2019
Processing time: 104 Days and 15.8 Hours

Core Tip

Core tip: Hepatic encephalopathy (HE) is a serious complication of cirrhosis resulting from a multifactorial impairment of gut-liver-brain axis functioning. Multiple interrelated factors (e.g., intestinal hyperpermeability, dysbiosis, hyperammonemia, inflammation) cooperate in its development. “Gut-centric” therapies, including non-absorbable disaccharides, antibiotics, prebiotics, probiotics, and fecal microbiota transplantation have been successfully employed to manage HE: pertinent current knowledge will be reviewed. Furthermore, the utility of dietary modifications in this context is increasingly recognized, thus opening a new promising research path. This review sheds light on dietary therapeutic strategies for HE, exploring how they can target the mechanisms underlying gut-liver-brain axis dysregulation.