Microbial, Immunological, and Environmental Risk Factors for Chronic Erosive-Ulcerative Gastrointestinal Tract Lesions in Children

Introduction: Erosive-ulcerative lesions of the gastrointestinal tract (EUL-GIT) are a growing concern in pediatric populations, particularly in low-income countries. Aim: This retrospective study aimed to identify the risk factors contributing to EUL-GIT advancement in children, measure their predictive significance, and assess therapeutic outcomes. Methods: The study included 2,091 children aged 0–17 years with confirmed EUL-GIT, divided into three groups: oral cavity (n=648), gastroduodenal (n=1,405), and colonic (n=38). A control group of 166 children with functional GI disorders was also assessed. Clinical evaluation, endoscopic assessment, and laboratory tests were performed. A predictive coefficient (PC) was used to evaluate the predictive value of each factor. Results: The key predictors of oral lesions were decreased Lactobacillus spp. (PC=101.7), increased Staphylococcus spp. (PC=95.4), Clostridium spp. (PC=88.9), and Candida albicans (PC=71.0). For gastroduodenal lesions, H. pylori infection (PC=102.0), belching (PC=129.0), epigastric pain (PC=89.7), and heartburn (PC=73.1) were high predictors. In colonic lesions, H. pylori infection (PC=72.7), SIBO (PC=66.8), and elevated IL-4 (PC=68.5) were notable. Conclusion: The PC model effectively assessed the risk and directed treatment strategies. A multidisciplinary approach involving infection management, nutritional support, and immune modulation is essential for high-risk children.