Background: -hepatic manifestations in RDs are not rare, so clinicians should be aware of their existence and the fact that they may occur concomitantly or serially. Furthermore , understanding the range and prevalence of GI manifestations associated with RDs , with related autoimmune disorders and with RDs treatments is essential. Pediatric rheumatic diseases are often associated with gastrointestinal symptoms. Abdominal pain is the most frequently reported complaint .   Gastrointestinal manifestations of chronic rheumatic syndromes include motility disorders of collagenosis , mixed connective tissue disease and Sjögrens syndrome associated with the risk of esophagitis due to gastro-esophageal reflux. This is in addition to the non-steroidal anti-inflammatory drug-induced gastroduodenal lesions in childhood and adolescence. However , the relevance of co-medication with steroids for the pathogenesis of these lesions is controversial. This study aimed to discuss and summarize current data on gastro-intestinal manifestations encountered by rheumatologic diseases in pediatric patients. Conclusion: The importance of the gastrointestinal (GI) tract in development of autoimmunity has been increasingly appreciated in rheumatological diseases. The small intestine is the most commonly affected part of the gastrointestinal system. Abnormalities in liver function tests are very common in patients with rheumatic diseases and should be further evaluated