Background <p>Adverse childhood experiences (ACEs) are related to an increased risk of gastrointestinal disorders. However, whether uric acid (UA) affects the development of digestive diseases and its role in the link between ACEs and digestive diseases have not been fully studied.</p> Methods <p>All data for this longitudinal cohort study came from the China Health and Retirement Longitudinal Study (CHARLS). Cox proportional hazards regression model was applied to assess the relationship between ACEs or UA and digestive diseases and the mediating effect of UA between ACEs and digestive diseases. Lastly, subgroup analyses were performed by demographic characteristics and health status grouping.</p> Results <p>The study included 3666 volunteers, of whom 617 had digestive disorders. Using Cox proportional hazards regression model, we analyzed the association between ACE and digestive diseases, and found that household mental illness, and living in an unsafe neighborhood were all obviously associated with disease incidence. Studies have also demonstrated an association between UA and digestive disorders. In the mediation analysis, we found that unsafe neighborhood had a negative indirect effect on digestive system diseases through UA, and this mediating effect was shown to have comparable results in the subgroup analyses.</p> Conclusions <p>We found evidence that ACEs and UA levels are associated with the development of digestive diseases, and that UA levels influence the relationship between one of the ACEs, namely unsafe neighborhood and digestive disease. Further research should address the underlying mechanisms and interventions to prevent childhood adversities and their devastating effects on health.</p> Graphical abstract <p></p>