Abstract
<jats:p>Non-malignant diseases of the upper gastrointestinal tract (UGIT) involving the mucosa exhibit significant heterogeneity in clinical manifestations, age, gender, and geography. It is known that the prevalence of H. pylori infection has been declining in recent years, while the incidence of allergic diseases has been steadily increasing. Numerous experimental studies have demonstrated that H. pylori eradication increases the risk of developing allergic pathology. However, scientific opinions on this issue are conflicting, necessitating further analysis. The objective of this study was to determine the possible relationship between food allergies and the clinical and endoscopic features of upper gastrointestinal diseases with mucosal lesions in children. Clinical characteristics of patients and study methods. The study included 64 children aged 7 to 17 years with upper gastrointestinal diseases with mucosal lesions, recurrent over a period of 2 years or more. All children had a comorbid condition— atopic dermatitis (AD) associated with food allergy (FA). Patients underwent a clinical examination, including an analysis of complaints, medical and life history, clinical and laboratory parameters, esophagogastroduodenoscopy (EGD) of the upper gastrointestinal tract using an Olympus EVIS EXERA GIF-Q160 video gastroscope, including collection and analysis of biopsy material, a rapid urease test of the biopsy specimen using specialized biochemical test systems for the presence of Helicobacter pylori, and determination of IgG and IgA antibodies to H. pylori in the blood using an enzyme-linked immunosorbent assay. If a fungal infection of the gastrointestinal tract was suspected, circulating Candida antigen was determined using the detection of Candida mannan antigen in serum/plasma using an enzyme-linked immunosorbent assay (Platelia Candida mannan antigen). Results. A significant correlation was established between the incidence of erosive gastritis and the severity of AD associated with PA. Nineteen patients (29.69 %) had Candida-infected gastrointestinal tract infections, while 15 (23.44 %) had fungal-infected adenomatous gastritis. A significant association was found between mycotic infection of the gastrointestinal tract and the incidence of antral, erosive, and pangastritis gastritis, duodenal ulcers, and bulbitis. Analysis of EGDS data revealed endoscopic features of mucosal lesions in gastrointestinal tract infections complicated by Candida infection, which were similar to those seen in Helicobacter pylori infections. Conclusions. The incidence of erosive gastritis is directly proportional to the severity of adenomatous gastritis associated with pancreatic ulcers. Upper gastrointestinal tract lesions: the development of antral and erosive gastritis, pangastritis, duodenal bulb ulcers, and bulbitis may be accompanied by a mycotic infection in the absence of clinical manifestations of food allergy. Endoscopic features of the mucosal condition in upper gastrointestinal tract diseases complicated by candidal infection are morphologically similar to those seen in Helicobacter pylori lesions. Given the endoscopic signs of mucosal lesions in upper gastrointestinal tract diseases complicated by microbiota imbalances, Helicobacter pylori, or Candida infections, it is advisable to include associated probiotics in the complex therapy of upper gastrointestinal tract diseases with concomitant food allergies.</jats:p>