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Their relapsing-remitting nature and variable clinical course challenge the paradigm of long-term continuous therapy, which is associated with adverse effects, poor adherence, and high costs. While dynamic precision therapy (DPT) has emerged as an intuitive solution, its conventional definition\u2014symptom-driven, intermittent drug use\u2014is too narrow and fails to harness the full potential of precision medicine. As a narrative review and perspective article, this paper proposes a paradigm shift by introducing a novel, multidimensional framework for DPT that integrates four synergistic dimensions: symptom-guided relief for acute episodes, disease subtype-guided baseline therapy, pathophysiology-guided dynamic adjustments using biomarkers and smart technologies, and individual patient context-guided shared decision-making. Applying this framework to IBD, GERD, and IBS, we demonstrate how it transforms precision treatment from a simple dosing strategy into a comprehensive platform for precision management. We review cutting-edge tools enabling this vision, from 24-hour pH-impedance monitoring and therapeutic drug monitoring to smart drug delivery systems like MMP-responsive hydrogels. This framework provides a practical guide for transitioning from empirical methods to mechanism-based, patient-centered care, presenting a forward-looking model that could transform future treatment approaches in gastroenterology.<\/jats:p>","DOI":"10.1177\/17562848261483778","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T18:14:01Z","timestamp":1787854441000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic precision therapy in chronic gastrointestinal diseases: A focus on gastroesophageal reflux disease and inflammatory bowel disease\u2014A narrative review and conceptual perspective"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0138-1791","authenticated-orcid":false,"given":"Yi-nan","family":"Qiu","sequence":"first","affiliation":[{"name":"Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2827-6679","authenticated-orcid":false,"given":"Bo-han","family":"Zhong","sequence":"additional","affiliation":[{"name":"Southern Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-hong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6428-3634","authenticated-orcid":false,"given":"Shi-xue","family":"Dai","sequence":"additional","affiliation":[{"name":"Ganzhou Municipal Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"issue":"1","key":"e_1_3_8_2_2","first-page":"S24","article-title":"Review article: irritable bowel syndrome: natural history, bowel habit stability and overlap with other gastrointestinal disorders","volume":"54","author":"Yadav YS","year":"2021","unstructured":"Yadav YS, Eslick GD, Talley NJ. 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