Gastroenterology is standing on the edge of something far bigger than itself. The question is no longer whether disruption is coming. It’s already here. The real question is: what happens when a specialty gets digitized?
This idea didn’t arrive all at once in my mind. It has been quietly brewing over the years—shaped by the writing of Scope Forward and The Shift, by deep listening across GI Mastermind circles, and by recent conversations at Digestive Disease Week 2025. These weren’t just observations; they were signals. And they all point to one insight:
Digitization unlocks latent value. Not incrementally, but exponentially.
History offers a consistent answer. When industries undergo true digital transformation, their addressable market size expands dramatically. Photography was a $2 billion industry before digital cameras and smartphones. Today, the global digital imaging market exceeds $100 billion. The music industry shrank with Napster but exploded with streaming—Spotify alone is worth over $130 billion. Healthcare is following a similar trajectory, and gastroenterology is beginning to show signs that it could lead this transformation.
Right now, the gastroenterology market is often valued at $136 billion. That includes procedural services, diagnostics, therapeutics, devices, and services. But those are conventional definitions. When we digitize and redefine the boundaries of GI—including the microbiome, gut-brain axis, metabolic GI, and decentralized digital care—the picture changes entirely.
The 10x Growth Principle
Digitization doesn’t just make things faster or cheaper. It redefines the very meaning of the work.
In GI, digitization means:
- AI agents reading colonoscopies, synthesizing histories, drafting SOAP notes, and helping physicians see more patients with less burnout
- Remote diagnostics and wearables that monitor gut activity 24/7
- Real-time patient data influencing personalized treatments
- Digital therapeutics replacing certain pharmaceutical regimens
- Home-based testing with adherence rates far above traditional options
The result? Entirely new categories of care.
If we apply the same 10x principle observed in other industries, the GI market could expand from $136 billion to over $1.4 trillion by 2035. That number is not wishful thinking—it reflects how healthcare systems are decentralizing, patients are taking ownership, and technology is shifting the center of care away from facilities and toward real-time, continuous engagement.
Five Converging Trends Fueling This Growth
- The Decline of the Procedure-Led Era: Colonoscopy is being commoditized. With home-based screening and AI-assisted diagnostics, revenue from procedures will decrease. But managing gut health comprehensively—from nutrition to inflammation to systemic disease—will open massive new markets.
- AI-Augmented GI: AI is already enhancing diagnostics, from upper GI malignancies to motility disorders. It’s not just polyp detection anymore. AI agents are poised to assist in endoscopy rooms, clinic notes, prior auths, revenue cycle workflows, and more. The physician becomes augmented—not replaced. Companies like Iterative Health are scaling clinical trials through AI partnerships with groups like GI Alliance. NextServices and 100ms are developing AI agents that automate the back office and financial operations of GI groups. Virgo is launching EndoML, accelerating the AI-native endoscopy ecosystem.
- Microbiome and Metabolic Health: The gut microbiome connects directly to metabolic diseases, neurological disorders, and even mental health. FDA-approved microbiome drugs are already on the market. Startups like Jona are developing microbiome-based diagnostic tools, and its founder even suggests microbiome medicine could become its own specialty. Obesity and liver disease are two of the most urgent public health crises, and both are deeply connected to gut function and microbiome modulation. This convergence repositions GI as a hub for whole-body health.
- Always-On, Decentralized Care: Platforms like Oshi Health, WovenX, and Cylinder are building virtual-first GI models, with care teams spread across the country and services delivered remotely. Patient engagement improves. Adherence goes up. The entire care model shifts—from episodic procedures to proactive, continuous health management. Surgical Automations is building a colonoscopy robot. Geneoscopy is scaling RNA-based diagnostics, while Exact Sciences’ Cologuard Plus and future liquid biopsy platforms are redefining non-invasive screening. Endiatx’s Pillbot is building a swimming micro-drone to image the gut. And what if tomorrow’s place of service is a self-driving car?
- Redefining the GI Physician: The future GI leader isn’t just a proceduralist. They’re a Gut Intelligence Specialist—trained in nutrition, microbiome science, digital health, and systems thinking. This transformation requires rethinking training, incentives, and identity.
Four Caveats Before We Get There
- Business Model Overhaul: This shift can’t be built on fee-for-service logic. New revenue models—bundled outcomes, shared savings, digital subscriptions—must take hold.
- Interdisciplinary Expansion: The next GI clinic might include nutritionists, psychologists, AI operators, and data scientists.
- Infrastructure Shift: We’ll need a new layer of cloud-native GI infrastructure—from interoperable data models to algorithmic regulation.
- Medical Education Reimagined: We need to reimagine GI medical education to align with this future—from residencies to CME, from procedural mastery to systems design. Training must evolve to include data fluency, digital care delivery, and integrative approaches to systemic health.
A $1 trillion vision is not a forecast. It’s a provocation.
It challenges us to reimagine what gastroenterology can become. Not merely to preserve its current form, but to evolve its essence. The gut is central to human health. If we accept that, then GI isn’t a procedural specialty—it’s the operating system for the human body.
This irreversible shift toward the digitization of gastroenterology was at the heart of my recent keynote at DDW 2025. I closed the talk with a fictional conversation between Praveen AI, Dr. William Beaumont AI, and Hippocrates AI—a dialogue across centuries that pointed to something deeper: the future of GI isn’t just about inventing new tools—it’s about remembering why we began.
Imagine it’s 2035. The world has redefined what gastroenterology means. Entirely new industries have spun out from its core. Patients are no longer passive. Data is no longer dormant. And the gut has become the gateway to whole-body health.
The question is—where will you be when this future arrives?
It’s time to LEAD. Boldly.
This research and article was developed through a multi-AI collaboration, with strategic insights drawn from ChatGPT (Deep Research), Grok (Deeper Pattern Recognition), Claude AI (Critical Reasoning), and Perplexity (Source Triangulation).
Praveen Suthrum is the author of The Shift and Scope Forward. He leads the GI Mastermind program, hosts The Scope Forward Show and serves as cofounder of NextServices.