5 Forces Shaping the Future of Gastroenterology in 2026
- Stuart Akerman, MD
- Jan 3
- 5 min read
As we start 2026, I can't help but reflect on how much gastroenterology has changed just in the years I've been practicing in Plano. The field is moving faster than ever, and honestly? It's pretty exciting.
As a gastroenterologist who also works as a medical device and software consultant, I get a front-row seat to what's coming next. Here's the thing: these aren't just abstract trends happening in research labs. These are real changes that will affect how we care for patients right here in the Dallas-Fort Worth area.
Let's talk about the five major forces reshaping digestive health care in 2026 and what they mean for you.
1. Early-Onset GI Cancers: A Growing Crisis That's Changing Screening Guidelines
I'm starting with this one because it's the most urgent. We're seeing a dramatic rise in gastrointestinal cancers in people under 50, particularly colorectal cancer. This isn't a small blip; it's a significant trend that has forced us to rethink everything about screening.
The numbers are sobering:
Colorectal cancer rates have increased 1-2% per year in adults under 50 since the mid-1990s
People born in 1990 have double the risk of colon cancer compared to those born in 1950
We're now diagnosing patients in their 30s and 40s with advanced disease
That's why the American College of Gastroenterology changed screening guidelines to start at age 45 instead of 50. Recent studies show this change is working: we're finding more cancers early and saving lives.
What this means for you: If you're 45 or older and haven't had a colonoscopy, don't wait. If you have a family history or symptoms, we need to talk about screening even earlier. The million-dollar
question isn't "Should I get screened?" It's "When should I schedule it?"
2. AI-Assisted Colonoscopy: Better Detection, Fewer Missed Polyps
Artificial intelligence in medicine isn't science fiction anymore. It's happening right now in colonoscopy suites across the country, especially right here in the DFW Metroplex (shoutout to Digestive Health Center of Plano and Digestive Health Center of Allen).
AI systems can analyze the colonoscopy video in real-time, highlighting polyps that the human eye might miss. Think of it this way: even the best gastroenterologist can have a momentary lapse in focus. AI doesn't blink, doesn't get tired, and doesn't miss frames.
The American Gastroenterological Association has published extensively on AI's potential in gastroenterology, and the results are impressive. Studies show AI-assisted colonoscopy can increase polyp detection rates by over 10%.
What this means for you: When you come in for a colonoscopy at my Plano practice, you're getting the benefit of both human expertise and technological assistance. It's not about replacing gastroenterologists; it's about giving us better tools to protect your health.
I'll admit, when I first heard about AI in endoscopy, I was skeptical. But after seeing the data and using these systems, I'm convinced they're making colonoscopies safer and more effective.
3. Breakthrough IBD Therapies: New Hope for Crohn's and Ulcerative Colitis
If you or someone you love has inflammatory bowel disease, you know how challenging it can be. But 2026 is bringing genuinely exciting advances in treatment.
New medication classes are changing the game:
IL-23 selective inhibitors (like risankizumab and mirikizumab): Target specific inflammation pathways with fewer side effects
JAK inhibitors (like upadacitinib): Oral medications that work quickly to reduce inflammation
S1P modulators: A completely new approach to controlling immune responses in the gut
The American College of Gastroenterology released new treatment guidelines in late 2025 that reflect these advances. We now have more options than ever to help patients achieve remission and get back to normal life.
What this means for you: If you've been struggling with IBD and your current medications aren't working well, there are new options we should discuss. The goal isn't just managing symptoms anymore; it's achieving true remission and improving quality of life.
4. The Gut Microbiome Revolution: From Hype to Clinical Reality
Let's talk about gut health. The microbiome has been a hot topic for years, but we're finally moving beyond the hype to real clinical applications.
Research is showing that the trillions of bacteria in your gut influence everything from immune function to mental health. The gut-brain connection isn't just real; it's central to understanding conditions like IBS.
What's new in 2026:
Targeted probiotic therapies for specific conditions
Fecal microbiota transplantation (FMT) expanding beyond C. difficile infections (and we've already moved towards medication -based therapies replacing FMT for C Diff!)
Prebiotic foods and supplements with actual clinical evidence
Understanding how diet affects the microbiome (and your symptoms)
According to the National Institutes of Health, microbiome research is one of the fastest-growing areas in digestive health. We're learning that a healthy gut isn't just about what you avoid eating; it's about feeding the good bacteria.
What this means for you: When we discuss treatment for IBS, bloating, or other functional GI issues, we now have evidence-based approaches that address the microbiome. This isn't about jumping on every probiotic trend; it's about using science to guide treatment.
5. Digital Health and Personalized Medicine: Your Care, Your Way
Healthcare is finally catching up with the rest of our digital lives. Telemedicine, remote monitoring, and personalized treatment plans based on your genetics and lifestyle are becoming standard practice.
The shift happening in 2026:
Virtual follow-up appointments for routine care (and we are proud to say we were at the forefront of this trend way back in 2018!)
Apps that help track symptoms
Genetic testing to predict medication responses (fingers-crossed that we see this for IBD very soon, it would be a game changer for management decisions)
Personalized diet plans based on your specific digestive issues
As someone who works in medical technology consulting, I see the potential here. The goal isn't to replace in-person care but to make healthcare more accessible and responsive to your needs.
What this means for you: If you're in Frisco, McKinney, Allen, or anywhere in the Dallas-Fort Worth area, you don't always need to drive to Plano for a follow-up appointment. We can often handle routine matters through secure video visits (pending insurance approval of course). And when you do need procedures like a colonoscopy or endoscopy, we'll use every available tool to personalize your care.
The Bottom Line: Better Care Through Innovation
Here's what I want you to take away from all this: gastroenterology in 2026 is about precision, prevention, and personalization. We're catching cancers earlier, treating chronic conditions more effectively, and understanding the gut in ways we never could before.
Sound familiar? These aren't futuristic concepts. They're happening right now.
Not always easy in our busy lives to keep up with medical advances, I know. But that's my job. As your Plano gastroenterologist, I stay on top of these developments so you can benefit from them.
Whether you need a screening colonoscopy, help managing a chronic digestive condition, or just want to optimize your gut health, these advances are making it possible to provide better care than ever before.
The future of gastroenterology isn't just about technology; it's about using these tools to give you more years of healthy, comfortable living. And honestly? That's what gets me excited to come to work every day.
If you have questions about any of these topics please schedule an appointment, and let's talk. The future of GI care is here, and it's pretty remarkable.
References
https://www.statnews.com/2025/08/04/colon-cancer-screening-guidelines-age-45-new-studies/
https://gastro.org/news/new-aga-guideline-streamlines-crohns-disease-treatment/
https://gastro.org/news/2026-crohns-colitis-congress-to-showcase-the-latest-ibd-research/
https://www.cancer.gov/news-events/cancer-currents-blog/2020/colorectal-cancer-rising-younger-adults
https://utswmed.org/medblog/targeted-inflammatory-bowel-disease-treatment/
https://www.beckersasc.com/gastroenterology-and-endoscopy/5-forces-shaping-the-future-of-gi-in-2026/
https://www.gastrojournal.org/article/S0016-5085(24)00234-8/fulltext
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DISCLAIMER: Please note that this blog is intended for Informational Use only and is not intended to replace personal evaluation and treatment by a medical provider. The information provided on this website is not intended as a substitute for medical advice or treatment. Please consult your doctor for any information related to your personal care.
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