Gut microbiota and dynamics of ammonia metabolism in liver disease

Blood ammonia levels in healthy individuals are low, but they increase in liver disease due to loss of functional liver mass and portosystemic shunting. Hyperammonemia is one of the key factors involved in the prognosis of cirrhosis and its complications. Here we review to establish a connection between alterations in gut microbial communities and intestinal ammonia metabolism, highlighting a key impact of gut dysbiosis on blood ammonia levels during liver disease.