Unlike prior reports that have largely focused on adult IBD or individual molecular components, our work delineates—for the first time—the coordinated regulation of the TPH1/miR-194-5p/NEAT1 and MAOA/miR-1276/NEAT1 axes in the pediatric context, highlighting the contribution of disrupted serotonergic signaling to intestinal inflammation. Here, TPH1 is linked to irritable bowel syndrome.