The Effect of Transjugular Intraheptic Portosystemic Shunt (TIPS) on Gastrointestinal Motility and the Gut Microbiota

Inclusion Criteria: * Patients with either radiographic or biopsy proven decompensated cirrhosis (as determined by ascites, variceal hemorrhage, encephalopathy or jaundice). * Patients undergoing an elective TIPS for any standard of care established indication (examples: worsening ascites, recurrent variceal bleeding). Exclusion Criteria: * Pregnant women. * Patients unwilling or unable to provide informed consent. * Patients undergoing an emergent TIPS for acute or subacute variceal hemorrhage. * Patients with diabetes, significant cardiovascular, renal or other chronic disease which has been known to affect intestinal motility. * Previously diagnosed gastroparesis or other GI dysmotility disorder. * Patients currently taking narcotics, antibiotics excluding rifaximin, prokinetic medications or lactulose. * Patients with a history of gastric bezoar. * Patients with a history of multiple intestinal surgeries or GI surgery within the past 3 months. * Patients with a history of gastrointestinal strictures, fistulas, or physiological or mechanical obstruction. * Patients with a history of gastrointestinal strictures, fistulas, or physiological or mechanical obstruction. * Patients with a history of gastrointestinal strictures, fistulas, or physiological or mechanical obstruction. * Patients with a history of diverticulitis. * Patients with swallowing disorders and increased risk of aspiration (such as prior history of aspiration). * Patient with Celiac disease. * Patients with implanted or portable electro-mechanical medical devices.