Gut microbiota (GM) is a complex microenvironment characterised by intricate interactions, which might play a pivotal role in the pathogenesis of many autoimmune diseases, including celiac disease (CD). DDysbiosis of gut bacteria can have a wide range of effects; however, whether it is a cause or a consequence of certain diseases and how it evolves during disease progression remains an area of active research. Celiac disease patients appear to have characteristic microbiota patterns, including low levels of beneficial species and high levels of potentially pathogenic species. The use of pro-, pre-, syn- and post-biotics to modulate the GM requires more systematic investigation, to determine the impact of specific species, the optimal dosage and the treatment duration needed to achieve desired results without adverse reactions. Additionally, osteoporosis in the course of CeD ease warrants further investigation. Many factors may contribute to its pathogenesis, including GM. This review summarizes recent literature concerning the role of GM in CeD, highlighting both consistent findings and areas of ongoing debate.

Intestinal-failure-associated liver disease (IFALD) is a common complication of prolonged parenteral nutrition (PN). Risk factors for IFALD include clinical features, as well as medical interventions, and its management was initially based on the decrease or interruption of parenteral nutrition while increasing enteral nutrition. However, the tolerance of full enteral nutrition in children with intestinal failure may require prolonged intestinal rehabilitation over a period of years. As a consequence, infants unable to wean from PN are prone to develop end-stage liver disease. We describe the case of an infant receiving long-term PN who was diagnosed with IFALD wherein we were able to reverse IFALD by switching lipid emulsions to fish oil monotherapy. A systemic review of case reports and case series on reversing IFALD using fish oil lipid emulsion follows the case description.