Expert review of gastroenterology & hepatologyFeb 23, 2019

Gut bacteria as a new treatment target for nonalcoholic fatty liver disease

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 28, 2026

Abstract

Nonalcoholic fatty liver disease (NAFLD) affects 20-33% of the global population.

NAFLD may progress to serious liver conditions, including fibrosis and liver cancer.
Lifestyle modifications, particularly exercise, are currently the only established treatments for NAFLD.
Gut microbiota and their imbalances are identified as potential regulators in the development of NAFLD.
New therapies targeting gut microbiota, such as probiotics and fecal microbiota transplantation, have shown effectiveness in recent studies.
Further research is needed to clarify how manipulating gut microbiota can influence NAFLD.

Simplified

Nonalcoholic fatty liver disease (NAFLD) is one of the most common and increasing liver diseases worldwide with a prevalence of 20-33%. NAFLD may progress to fibrosis, compensated cirrhosis, advanced cirrhosis, or hepatocellular carcinoma. Despite the increasing prevalence of NAFLD, definitive medical treatment has not been established, with the exception of lifestyle modification with exercise. Because of the direct connection via portal vein between the intestines and the liver (gut-gut microbiota-liver axis), gut microbiota and associated dysbiosis have been known as regulators in the pathophysiology of NAFLD. Area covered: New therapeutic approaches for modulation of gut microbiota have been proposed and the effectiveness of new therapies including probiotics, prebiotics, synbiotics, bile acid regulation, absorbent, and fecal microbiota transplantation have been demonstrated in recent several studies. This review focuses on the available evidences for new therapies modulating gut microbiota in the management and the prevention of NAFLD. Expert commentary: Gut-gut microbiota-liver axis may play an important role in the etiology of many liver diseases, including NAFLD. It is logical to seek the manipulation of this axis, and further studies are required to understand the underlying precise mechanisms of microbiota-modulation on NAFLD.

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Gut bacteria as a new treatment target for nonalcoholic fatty liver disease

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