There is a lack of study demonstrating the effects of chronic alcohol consumption on the bowel flora and the potential therapeutic role of probiotics in alcohol-induced liver injury. 

So, a prospective, randomized, clinical trial investigated the effects of alcohol and probiotics on bowel flora and alcohol-induced liver injury.

It enrolled 66 adult males with a diagnosis of alcoholic psychosis, who were randomized to receive 5 days of Bifidobacterium bifidum and Lactobacillus plantarum 8PA3 or standard therapy alone (abstinence plus vitamins). 

They were subjected to stool cultures and liver enzymes analysis both at baseline and after therapy. The results were compared between the groups and also with 24 non-alcoholics, healthy, matched controls. 

The observations were as follows-

• Alcoholic patients demonstrated significantly lower numbers of bifidobacteria, lactobacilli and enterococci than the healthy controls. 
• Alcoholic patients demonstrated significantly higher mean baseline alanine aminotransferase (ALT), aspartate aminotransferase (AST), and γ-glutamyl transpeptidase (GGT) activities than the healthy control group, indicating mild alcohol-induced liver injury in these patients. 
• Alcoholic patients demonstrated significantly increased numbers of both bifidobacteria and lactobacilli after 5 days of probiotic therapy, then the standard therapy arm. 
• Despite similar values at baseline, a significantly lower AST and ALT activity was observed at the end of treatment in the probiotics treated group than the standard therapy alone group. 
• A subset of 26 subjects having well-characterized mild alcoholic hepatitis (described as AST and ALT >30 U/L with AST: ALT >1), showed a reduction in ALT, AST, GGT, lactate dehydrogenase, and total bilirubin with probiotic therapy at the end of treatment.
• This subset also demonstrated a significant mean ALT reduction at the end of treatment in the probiotic arm versus the standard therapy arm. 

Thus it was concluded that patients with alcohol-induced liver injury have altered bowel flora than the healthy controls. Short-term oral supplementation with B. bifidum and L. plantarum 8PA3 repairs the bowel flora and improves alcohol-induced liver injury compared to the standard therapy alone.

Source- Alcohol, 2008;42(8):675-682.https://doi.org/10.1016/j.alcohol.2008.08.006.