Advances in Artificial Intelligence for Gastrointestinal Endoscopy: 2026 Update.

Artificial intelligence (AI) is transforming gastrointestinal (GI) endoscopy into a more standardized, data-driven, and workflow-integrated field. Advances in computer-assisted detection (CADe), diagnosis (CADx), quality assessment (CAQ), natural language processing (NLP), and multimodal deep learning have expanded AI applications across colonoscopy, upper endoscopy, endoscopic ultrasound (EUS), ERCP, cholangioscopy, and capsule endoscopy. These systems have demonstrated improvements in lesion detection, procedural quality assessment, workflow efficiency, and diagnostic support. However, current evidence remains largely focused on surrogate outcomes rather than patient-centered clinical benefits, while challenges related to generalizability, explainability, regulatory oversight, automation bias, and workflow integration continue to limit widespread adoption. Future progress will depend on prospective real-world validation, diverse datasets, explainable AI frameworks, and careful integration of human-AI interaction into clinical practice. Overall, AI is evolving from a supportive adjunct into an increasingly integrated component of gastrointestinal endoscopy with the potential to improve procedural quality, diagnostic consistency, and clinical efficiency.