Artificial intelligence in inflammatory bowel disease: bridging innovation, implementation and impact

Artificial intelligence (AI) is rapidly transforming the management landscape of inflammatory bowel disease (IBD). While early applications in endoscopy, digital pathology and cross-sectional imaging drew substantial attention, next-generation AI systems that enable deeper disease understanding, personalized treatment and streamlined clinical workflows are now emerging. These advances encompass the multimodal integration of endoscopic, histological and molecular data ('endo-histo-omics'); AI-assisted assessment of the intestinal barrier; remote monitoring via wearables; and the incorporation of large language models for decision-making support and patient interactions. This Perspective traces the evolution of AI in IBD from domain-specific tools to foundational platforms supporting data-driven precision medicine. We highlight validated AI applications across diagnosis, monitoring, outcome prediction and neoplasia surveillance. We also explore the expectations of key stakeholders, including clinicians, patients, regulatory bodies and industry, and discuss unresolved challenges such as explainability, integration into workflows, reimbursement and environmental sustainability. By aligning innovation with ethical and clinical priorities, AI holds the potential to redefine IBD care. Its future will be shaped by collaboration, transparency and responsible implementation, ushering in a new era of personalized, efficient and equitable care for individuals with IBD.