Climate Change and Pediatric Gastrointestinal Health: A Narrative Review

In 2025, the United Nations acknowledged that the world has failed to reduce carbon emissions sufficiently to avoid 1.5C warming-the level set by the Paris Accords to avoid devastating consequences. Communities already feel the implications of climate change, and it is creating new challenges for patients and health-care teams. While global efforts to reduce emissions and prevent the worst consequences of climate change persist, efforts to understand and adapt to the current and near-term consequences of climate change are also vital. Climate change is contributing to more frequent and severe weather events and compounding other ecological changes, with immediate and downstream implications for health. Pediatric patients are particularly vulnerable to the impacts of climate change, given their physiology, behaviors, ongoing development, and dependence on caregivers. This narrative review focuses on the implications of climate change for pediatric gastrointestinal (GI) health, elucidating key pathways by which climate change intersects with GI health that emerge from the literature. These pathways include heat-related illness and prenatal exposure to extreme heat, health implications of climate-driven migration and displacement, changing patterns of infectious GI diseases, the effects of pollution on noncommunicable GI diseases, the impacts of climate change on mental health and the gut-brain axis, and exacerbation of food insecurity and malnutrition. By understanding risks to their patients from these pathways, pediatric GI professionals may be better poised to assess for climate-driven exposures and to address patient care needs related to climate change. Pediatric GI professionals also have an opportunity as a community to engage in the needed health-care sector transformation to sustainable care delivery, bolster the resilience of health-care infrastructure, and advocate for policies to protect pediatric patients.