Abstract
Changes within the brain that result in sickness behaviors and altered mood are highly prevalent in liver diseases of different etiologies. This chapter discusses communication pathways between the liver, the gut, and the brain and changes in brain structure/function observed during liver disease in the absence of cirrhosis. The gut microbiome has a key role in brain development and behavior during health and disease. In liver diseases, gut microbial dysbiosis resulting in impaired intestinal integrity and altered bile acid metabolism can modulate the gut–brain axis, as well as the gut–liver axis, which influences disease pathology and sickness behavior development. Treatments that target the gut microbiome, or inflammatory modulators including specific diets or biologics targeting cytokines or cell adhesion molecules, can have a significant impact on the gut–liver–brain axis.
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