Today, diseases of the digestive organs remain one of the most urgent problems of modern medicine. Scientists pay considerable attention to the biochemical and molecular mechanisms underlying the development of these pathologies. In recent years, new hormones and neurotransmitters have been discovered that regulate energy metabolism and eating behavior, including ghrelin, a gastrointestinal hormone with various biological features and effects: it stimulates the release of growth hormone, stimulates appetite, has an anabolic effect, and affects carbohydrate metabolism. At the current stage, the biological effects of ghrelin are known, namely appetite regulation, anabolic effects, influence on the secretion of other hormones, and the work of the digestive system. The main expression of the hormone is concentrated in the stomach and decreases along the digestive tract. Patients with inflammatory bowel diseases are characterized by a high level of circulating ghrelin in the blood. Ghrelin protects the gut by reducing pro-inflammatory cytokine release and neutrophil infiltration. Ghrelin exerts an antioxidant effect by increasing the release of nitric oxide in the intestine. This paper describes the main physiological mechanisms of ghrelin action in the gastrointestinal tract