Liver diseases
The "gut-liver axis" is a key connection between the microbiome and liver health. FMT is being investigated for non-alcoholic fatty liver disease (NAFLD), cirrhosis, and hepatic encephalopathy.
Experimental field: Liver diseases require a comprehensive approach. FMT is an additional investigational method that does not replace standard therapy.
Liver diseases and the microbiome
The liver receives 70% of its blood supply from the gut via the portal vein. This makes it particularly sensitive to the state of the microbiome.
NAFLD (Non-Alcoholic Fatty Liver Disease)
Accumulation of fat in the liver unrelated to alcohol. It can progress to steatohepatitis (NASH), fibrosis, and cirrhosis.
Epidemic: NAFLD affects up to 30% of the adult population and is becoming a leading cause of liver transplantation.
Liver cirrhosis
- Replacement of normal tissue with scar tissue
- Portal hypertension
- Ascites, variceal bleeding
- Liver failure
Hepatic encephalopathy
Impaired brain function due to the liver's inability to detoxify toxins. Ammonia produced by gut bacteria plays a key role.
- Confusion, disorientation
- Personality and behavioral changes
- In severe cases — coma
Standard treatment
Includes diet, lactulose, rifaximin to reduce ammonia levels, treatment of complications, and in severe cases — transplantation.
Encephalopathy frequently recurs. Standard therapy does not address the root cause — gut dysbiosis.
The gut-liver axis and FMT
Restoring a healthy microbiome may reduce the toxic burden on the liver and improve its function.
Dysbiosis
Excess pathogenic bacteria
Toxins to the liver
Ammonia, endotoxins (LPS), bacteria via the portal vein
FMT transplantation
Restoration of a healthy microbiome
Liver relief
Fewer toxins, improved function
Mechanism of action
A healthy microbiome reduces ammonia production (the main culprit in encephalopathy), decreases intestinal permeability to endotoxins, and restores bile acid metabolism.
Potential effects of FMT
- Reduced blood ammonia levels
- Fewer encephalopathy episodes
- Improved cognitive function
- Reduced liver inflammation markers
Encouraging data: FMT for hepatic encephalopathy is one of the most studied fields after C. difficile. Results are individual.
Research results
Clinical trials of FMT for liver diseases show promising results, especially for encephalopathy.
70%
Reduction in encephalopathy recurrence (Bajaj et al.)
+40%
Improvement in cognitive tests
10+
Clinical trials
VCU
Leading research center (Bajaj lab)
Key studies
- Bajaj et al., Hepatology 2017-2019: A series of studies showed that FMT reduced the frequency of hepatic encephalopathy episodes by 70% and improved cognitive function
- Philips et al., Clinical Gastroenterology 2017: FMT for alcoholic hepatitis showed improved survival and liver function
- NAFLD studies 2020-2024: FMT affects liver inflammation and fibrosis markers; large-scale trials are needed to establish protocols
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Patient story
Experience treating hepatic encephalopathy
"Liver cirrhosis led to frequent episodes of encephalopathy — confusion, forgetfulness, sometimes I couldn't remember what day it was. Lactulose and rifaximin helped, but not for long. After a course of FMT, the episodes became much less frequent, and my head feels clearer. This doesn't cure cirrhosis, but my quality of life has improved significantly."
Sun C.
62 years old, Fuzhou
Name changed. Results are individual.
Related directions
FMT is also being studied for related metabolic conditions
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Liver disease?
If you or your loved ones suffer from liver disease complications, especially hepatic encephalopathy, contact us via Telegram or WhatsApp. A doctor will assess the possibility of using FMT.
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