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Small intestinal overgrowth, increased intestinal permeability and immunological alterations are the main factors involved in its pathogenesis. <jats:styled-content style=\"fixed-case\">BT<\/jats:styled-content> is obviously difficult to identify in patients with cirrhosis, and alternative methods have been proposed instead. Bacterial DNA detection and species identification in serum or ascitic fluid has been proposed as a reliable marker of <jats:styled-content style=\"fixed-case\">BT<\/jats:styled-content>. Bacterial products, such as endotoxin, or bacterial <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> can translocate to extra\u2010intestinal sites and promote an immunological response similar to that produced by viable bacteria. Therefore, pathological <jats:styled-content style=\"fixed-case\">BT<\/jats:styled-content> plays an important role in the pathogenesis of the complications of cirrhosis, not only in infections, but by exerting a profound inflammatory state and exacerbating the haemodynamic derangement. This may promote in turn the development of hepatorenal syndrome, hepatic encephalopathy and other portal hypertension\u2010related complications. Therapeutic approaches for the prevention of <jats:styled-content style=\"fixed-case\">BT<\/jats:styled-content> in experimental and human cirrhosis are summarized. Finally, new investigations are needed to better understand the pathogenesis and consequences of translocation by viable bacteria (able to grow in culture), or non\u2010viable <jats:styled-content style=\"fixed-case\">BT<\/jats:styled-content> (detection of bacterial fragments with negative culture) and open new therapeutic avenues in patients with cirrhosis.<\/jats:p>","DOI":"10.1111\/liv.12021","type":"journal-article","created":{"date-parts":[[2012,10,11]],"date-time":"2012-10-11T14:06:11Z","timestamp":1349964371000},"page":"31-39","source":"Crossref","is-referenced-by-count":205,"title":["Pathological bacterial translocation in cirrhosis: pathophysiology, diagnosis and clinical implications"],"prefix":"10.1111","volume":"33","author":[{"given":"Pablo","family":"Bellot","sequence":"first","affiliation":[{"name":"Liver Unit Hospital General Universitario de Alicante and Miguel Hern\u00e1ndez University Elche Alicante Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rub\u00e9n","family":"Franc\u00e9s","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital General Universitario de Alicante and Miguel Hern\u00e1ndez University Elche Alicante Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Such","sequence":"additional","affiliation":[{"name":"Liver Unit Hospital General Universitario de Alicante and Miguel Hern\u00e1ndez University Elche Alicante Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd) Instituto de Salud Carlos III Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,11,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.30082"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1590-8658(01)80134-1"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.06.019"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510270504"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.23.2.403-411.1979"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1521-6918(03)00024-6"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.047514"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(00)00013-1"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(94)80241-6"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(95)90147-7"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8278(88)80018-7"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840170622"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23918"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-007-0065-1"},{"key":"e_1_2_6_16_1","first-page":"7","article-title":"Etiology and pathogenesis of bacterial overgrowth. 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