Early-life gastrointestinal inflammation and the developing brain: Unravelling the pathways to long-term cognitive dysfunction

Table 7 Red flags for neurocognitive risk in gut disorder

Patient group	Gut-related red flag (trigger)	Actionable neurocognitive risk
Infancy/neonatal	Necrotizing enterocolitis, especially requiring surgical intervention	High risk (40% of global neurodevelopmental impairment, intraventricular hemorrhage, periventricular leukomalacia, and attention/executive function deficits
Infancy/early childhood	High burden of early severe enteric infections or chronic diarrheal illness (especially coupled with stunting/low growth)	Long-term risk of Lower intelligence quotient/cognitive scores and poor school performance (independent of malnutrition)
Children/adolescents	Active or newly diagnosed inflammatory bowel disease (especially Crohn’s disease), even with mild symptoms	Deficits in mental processing speed, executive function (attention, memory), and high comorbidity of depression/anxiety
All ages	Unexplained chronic symptoms: Brain fog, memory lapse, severe fatigue, or new-onset psychiatric symptoms (e.g., anxiety, depression)	Possible underlying celiac disease, requiring assessment for cognitive stabilization and screening for white matter changes