The relevance of the issue of management of patients with decompensated liver cirrhosis (LC) is stipulated by its medical and socioeconomic importance not only in Ukraine, but worldwide due to the high prevalence of etiological factors, as well as the development of severe complications that lead to fatal consequences. Chronic alcohol intoxication is considered the most common cause of LC. The understanding of the etiopathogenetic mechanisms of liver damage and the development of complications is constantly updated, which requires the improvement of approaches to the treatment of such patients. An important role in modern diagnostic and therapeutic interventions is given to the «gut/intestinal microbiota — liver — brain» axis. Today there is evidence that intestinal microbiota indirectly affects intestinal permeability, production of nitric oxide, release of biologically active peptides from enteroendocrine cells, production of short chain fatty acids — the main metabolic product of bacteria that feed cells of the mucous membrane, affect cognitive functions and the activation of the immune system. intestinal system. Research in recent years has proven that it is the liver that takes the leading place in the «gut/intestinal microbiota — liver — brain» axis system. Today, the pathogenesis of alcoholic liver disease is also associated with the hypothesis of «leakage» of the intestine, since alcohol significantly increases its permeability. Special attention in the development of encephalopathy with an imbalance of the microbiome is paid to bacterial translocation into the submucosa due to the violation of the integrity of the tight contacts of epithelial cells, with subsequent stimulation of the release of inflammatory mediators by smooth cells and lymphocytes, which leads to the development of the inflammatory process, increased vascular permeability in the portal, hepatic and systemic networks circulation.
 The authors presented a clinical case of the use of modern possibilities of diagnostic and therapeutic interventions for decompensated liver cirrhosis of the of toxic etiology based on the global and domestic recommendations with a detailed discussion of patient care tactics.