Digital biomarkers and artificial intelligence: a new frontier in personalized management of inflammatory bowel disease

Diletta De Deo¹Arianna Dal Buono^1*Roberto Gabbiadini¹Olga Maria Nardone²Rocio Ferreiro-Iglesias³Giuseppe Privitera¹Cristiana Bonifacio⁴Manuel Barreiro-de Acosta³Cristina Bezzio¹Alessandro Armuzzi¹

• ¹Division of Gastroenterology, Humanitas Research Hospital, Rozzano, Italy
• ²Universita degli Studi di Napoli Federico II Dipartimento di Medicina Clinica e Chirurgia, Naples, Italy
• ³Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
• ⁴Radiology Department, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy

Background and aims: Artificial intelligence (AI) is rapidly gaining traction in gastroenterology, particularly in the management of inflammatory bowel disease (IBD). Given the complexity of IBD care, AI offers the potential to enhance diagnosis, monitoring, and treatment. This review aims to summarize recent developments in AI applications for IBD and identify key challenges and opportunities for future research and clinical implementation. Methods: A narrative literature review was conducted, incorporating recent studies utilizing AI —including machine learning (ML) and deep learning (DL) — across various aspects of IBD care. Results: AI has demonstrated utility in multiple domains of IBD management, including endoscopic disease activity assessment, histological evaluation, imaging interpretation, prediction of disease course, treatment response, and real-world data integration. Despite promising accuracy and utility, most models remain in early development stages and lack widespread clinical validation. Major barriers include data heterogeneity, limited generalizability, and regulatory uncertainties. Conclusion: AI has significant potential to revolutionize IBD care. Continued multidisciplinary collaboration, validation in diverse clinical settings, and integration into clinical workflows are critical for realizing its full impact.