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Overview of the development of the gastrointestinal tract

Ian Sanderson, MD
Section Editors
Kathleen J Motil, MD, PhD
Melvin B Heyman, MD, MPH
Deputy Editor
Alison G Hoppin, MD


The anatomic formation of the esophagus, stomach, intestine, liver, and pancreas are achieved in the fourth fetal week through a series of evaginations, elongations, and dilatations. Anatomic development progresses through cell proliferation, growth, and morphogenesis.


Three distinct regions of the intestine give rise to specific portions of the gastrointestinal tract:

The foregut is the precursor of the pharynx, esophagus, stomach, liver, gall bladder, pancreas, and the cranial portion of the duodenum (figure 1).

The midgut gives rise to the caudal portion of the duodenum, the jejunum, ileum, the ascending colon, and two-thirds of the transverse colon (figure 2).

The hindgut is the precursor of the distal one-third of the transverse colon, the descending colon, the rectum, and the urogenital sinus (figure 3).


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Literature review current through: Sep 2016. | This topic last updated: May 11, 2016.
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  1. Lebenthal E, Lee PC. Review article. Interactions of determinants in the ontogeny of the gastrointestinal tract: a unified concept. Pediatr Res 1983; 17:19.
  2. Horb ME, Slack JM. Endoderm specification and differentiation in Xenopus embryos. Dev Biol 2001; 236:330.
  3. McLin VA, Henning SJ, Jamrich M. The role of the visceral mesoderm in the development of the gastrointestinal tract. Gastroenterology 2009; 136:2074.
  4. Davis NM, Kurpios NA, Sun X, et al. The chirality of gut rotation derives from left-right asymmetric changes in the architecture of the dorsal mesentery. Dev Cell 2008; 15:134.
  5. Al Alam D, Sala FG, Baptista S, et al. FGF9-Pitx2-FGF10 signaling controls cecal formation in mice. Dev Biol 2012; 369:340.
  6. Lipscomb K, Schmitt C, Sablyak A, et al. Role for retinoid signaling in left-right asymmetric digestive organ morphogenesis. Dev Dyn 2006; 235:2266.
  7. Pácha J. Development of intestinal transport function in mammals. Physiol Rev 2000; 80:1633.
  8. Shepherd AP, Granger HJ. Autoregulatory escape in the gut: a systems analysis. Gastroenterology 1973; 65:77.
  9. Burns AJ, Thapar N. Advances in ontogeny of the enteric nervous system. Neurogastroenterol Motil 2006; 18:876.
  10. Newgreen D, Young HM. Enteric nervous system: development and developmental disturbances--part 1. Pediatr Dev Pathol 2002; 5:224.
  11. Newgreen D, Young HM. Enteric nervous system: development and developmental disturbances--part 2. Pediatr Dev Pathol 2002; 5:329.
  12. Herbst JJ. Development of suck and swallow. J Pediatr Gastroenterol Nutr 1983; 2 Suppl 1:S131.
  13. Omari TI, Miki K, Davidson G, et al. Characterisation of relaxation of the lower oesophageal sphincter in healthy premature infants. Gut 1997; 40:370.
  14. Amarnath RP, Berseth CL, Malagelada JR, et al. Postnatal maturation of small intestinal motility in preterm neonates. J Gastrointest Motil 1989; 1:138.
  15. Berseth CL, Bisquera JA, Paje VU. Prolonging small feeding volumes early in life decreases the incidence of necrotizing enterocolitis in very low birth weight infants. Pediatrics 2003; 111:529.
  16. Simo P, Simon-Assmann P, Arnold C, Kedinger M. Mesenchyme-mediated effect of dexamethasone on laminin in cocultures of embryonic gut epithelial cells and mesenchyme-derived cells. J Cell Sci 1992; 101 ( Pt 1):161.
  17. Lucas A, Bloom SR, Aynsley-Green A. Development of gut hormone responses to feeding in neonates. Arch Dis Child 1980; 55:678.
  18. Berseth CL, Nordyke CK, Valdes MG, et al. Responses of gastrointestinal peptides and motor activity to milk and water feedings in preterm and term infants. Pediatr Res 1992; 31:587.
  19. Bascietto C, Giannini C, D'Adamo E, et al. Implications of gastrointestinal hormones in the pathogenesis of obesity in prepubertal children. J Pediatr Endocrinol Metab 2012; 25:255.
  20. Penders J, Thijs C, Vink C, et al. Factors influencing the composition of the intestinal microbiota in early infancy. Pediatrics 2006; 118:511.
  21. Rieger CH, Rothberg RM. Development of the capacity to produce specific antibody to an ingested food antigen in the premature infant. J Pediatr 1975; 87:515.
  22. Wassenaar TM, Panigrahi P. Is a foetus developing in a sterile environment? Lett Appl Microbiol 2014; 59:572.
  23. Collado MC, Rautava S, Aakko J, et al. Human gut colonisation may be initiated in utero by distinct microbial communities in the placenta and amniotic fluid. Sci Rep 2016; 6:23129.
  24. Verzi MP, Khan AH, Ito S, Shivdasani RA. Transcription factor foxq1 controls mucin gene expression and granule content in mouse stomach surface mucous cells. Gastroenterology 2008; 135:591.
  25. Agostoni C, Axelsson I, Goulet O, et al. Prebiotic oligosaccharides in dietetic products for infants: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr 2004; 39:465.
  26. Macpherson AJ, Uhr T. Induction of protective IgA by intestinal dendritic cells carrying commensal bacteria. Science 2004; 303:1662.
  27. Williams AM, Probert CS, Stepankova R, et al. Effects of microflora on the neonatal development of gut mucosal T cells and myeloid cells in the mouse. Immunology 2006; 119:470.
  28. Mazmanian SK, Liu CH, Tzianabos AO, Kasper DL. An immunomodulatory molecule of symbiotic bacteria directs maturation of the host immune system. Cell 2005; 122:107.
  29. Maynard CL, Elson CO, Hatton RD, Weaver CT. Reciprocal interactions of the intestinal microbiota and immune system. Nature 2012; 489:231.