Patients with liver cirrhosis present with several features of gut dysfunction which may play a crucial role in the development of complications of cirrhosis. These characteristics features of gut dysfunction have a significant effect on nutritional status and health-related quality of life.

Gastrointestinal symptoms are frequently encountered in patients with cirrhosis and their pathophysiology is hypothesized to be multifactorial including liver disease severity, psychological distress, and gut dysfunction such as increased gastric sensitivity to distension and delayed gut transit. The other most common finding in these patients is reduced food intake and, which may further leads to the deterioration of nutritional status. Tense ascites tends to have a negative influence on meal-induced accommodation of the stomach; however, evidences evaluating gastric accommodation in cirrhotics without substantial ascites are not consistent. Gastric emptying and small bowel transit have usually reported to be prolonged that is associated with abnormalities in postprandial glucose, insulin, and ghrelin levels, which, in turn, found to be related with insulin resistance, a common finding in cirrhosis. Additionally, small bowel manometry disorders and delayed gut transit may be related to the development of small bowel bacterial overgrowth. 

Thus, several studies have shown evidence of intestinal barrier dysfunction in patients with cirrhosis, especially those with portal hypertension, which is associated with bacterial translocation and permeation of intestinal bacterial products, such as endotoxin and bacterial DNA, suggestive of a potential implication in the pathogenesis of complications of liver cirrhosis.

Source: Kalaitzakis E. Gastrointestinal dysfunction in liver cirrhosis. World J Gastroenterol. 2014;20(40):14686-14695.