Driving role and related targeted therapeutic strategies of small intestinal bacterial overgrowth in liver cirrhosis

Xianping LI; Yingmei TANG

doi:10.12449/JCH260629

Volume 42 Issue 6

Jun. 2026

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Driving role and related targeted therapeutic strategies of small intestinal bacterial overgrowth in liver cirrhosis

DOI: 10.12449/JCH260629

Xianping LI,
Yingmei TANG^{,
,}

Department of Gastroenterology，The Second Affiliated Hospital of Kunming Medical University，Kunming 650000，China

Research funding:

National Natural Science Foundation of China (82360108);

Medicine Leading Talents of Yunnan Province (L-2019013)

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Corresponding author: TANG Yingmei， tangyingmei_med@kmmu.edu.cn （ORCID： 0000-0002-0731-4198）
Received Date: 2025-09-15
Accepted Date: 2025-12-30
Published Date: 2026-06-25

Abstract

Abstract

Small intestinal bacterial overgrowth （SIBO） is significantly more prevalent in patients with liver cirrhosis. Recent studies indicate that SIBO is not merely a concomitant phenomenon but a key driver of cirrhosis progression via the “gut-liver axis” mechanism. This review innovatively proposes a “microbiota-immunity-fibrosis” pathological positive feedback loop model， systematically elucidating the sequential pathological process through which SIBO drives disease progression via multiple mechanisms—including disruption of intestinal barrier function， facilitation of bacterial and endotoxin translocation， induction of systemic inflammatory responses， and acceleration of hepatic fibrosis. Furthermore， it provides a systematic evaluation of the clinical application value and limitations of current SIBO-targeted therapeutic strategies， such as antibiotic therapy， microbial modulation， herbal medicine interventions， and dietary therapies. This work aims to establish a theoretical foundation and identify future research directions for the development of multi-targeted and personalized comprehensive treatment strategies.
- Liver Cirrhosis,
- Small Intestinal Bacterial Overgrowth,
- Gut-Liver Axis,
- Therapeutics

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References

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Driving role and related targeted therapeutic strategies of small intestinal bacterial overgrowth in liver cirrhosis

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