Scientific Publications
Ethanol in biliary atresia.
Archives of disease in childhood
Biliary atresia (BA) is characterised by fibro-obliteration of the biliary tree, presenting in infancy with obstructive jaundice. The Kasai portoenterostomy (Kasai) surgery aims to re-establish bile flow by creating a bilioenteric conduit. However, liver transplantation (LT) is often required; BA remains the lead indication for LT in paediatrics.
Gut dysbiosis is increasingly described in liver disease, and, in BA, is characterised by an increase in potentially pathogenic organisms and fewer beneficial commensal bacteria, associated with poorer outcomes.1 Microbial-produced metabolites (short-chain fatty acids, bile acids) are implicated as disease mediators.2 Under anaerobic conditions, gut bacterial or yeast metabolism of pyruvate, produced during the breakdown of carbohydrates, generates acetaldehyde, further reduced to ethanol3; hence, low levels of ethanol are produced in the healthy human gut. Excessive production, or auto-brewery syndrome, is rarely described, after extensive gut surgery and
Archives of disease in childhood
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