The article summarizes the results of long-term improvement of differentiated approaches to the treatment of chronic gastroduodenal diseases associated with disorders of other digestive organs. Under supervision there were 1,386 children aged 7 to 15 years with disorders of the digestive system. Examination of patients was complete and included clinical, laboratory and instrumental methods. 100 % of patients were diagnosed with chronic gastroduodenal diseases (982 — chronic gastroduodenitis, 268 — chronic gastritis, 136 — chronic duodenitis). Comprehensive examination of the patients revealed the pathological changes in other digestive organs: in 94.7 %, disease of the biliary system was diagnosed, in 43.6 % — of the pancreas, in 38.1 % — of the colon, in 79.17 % — intestinal dysbiosis. The article describes the differentiated approach to the treatment of combined pathology of the digestive system, depending on the state of the mucous membranes of the upper alimentary canal, acid-forming function of the stomach, pancreas, bile ducts and the intestine. In the comorbidity of gastroduodenal zone and the pancreas, the use of enzyme preparation ­Pangrol® 10000 was effective.