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Accumulating clinical and experimental evidence indicates that this phenomenon, known as \u201cgut oralization,\u201d plays an important role in the pathogenesis of these diseases. Although several physiological barriers normally restrict the translocation and ectopic colonization of microorganisms from the oral cavity to the gut, certain oral pathobionts\u2014often enriched in individuals with oral diseases such as periodontitis\u2014have evolved specialized strategies to overcome these defenses. This review examines the bidirectional interactions through which bacterial traits, including unique adhesion systems and metabolic adaptations, support colonization and expansion within the gastrointestinal tract, as well as how disease\u2010associated alterations in the gut environment and increased host vulnerability facilitate ectopic colonization by bacteria of oral origin. By integrating clinical and mechanistic evidence, this review highlights the potential of targeting the oral\u2010gut microbial axis as a therapeutic approach for preventing and treating chronic gastrointestinal disorders.<\/jats:p>","DOI":"10.1111\/jre.70116","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T11:50:13Z","timestamp":1777981813000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Oral\u2010Gut Axis: Bidirectional Interactions Between Microbiome and Diseases"],"prefix":"10.1111","author":[{"given":"Shinya","family":"Ebihara","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiko","family":"Kamada","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and 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