Introduction The two main forms of inflammatory bowel diseases (IBD) are ulcerative colitis (UC) and Crohn's disease (CD). Although these diseases are rare in Singapore, the numbers have been increasing. No clear cause has been identified for IBD. These diseases occur mainly in the younger age groups. IBD must be differentiated from Irritable Bowel Syndrome (IBS) which does not have inflammation in the intestine. Symptoms UC usually presents with symptoms of rectal bleeding, diarrhoea, urgency, abdominal discomfort, decreased appetite and loss of weight. CD presents differently, depending on location of disease. Unlike UC which affects only the large intestine, CD can involve any part of the gastrointestinal tract from the mouth to anus. In CD affecting the junction between the small and large intestine, the main symptoms include diarrhoea, colicky abdominal pains and weight loss. Pure small intestinal CD may present with anorexia and weight loss. Colonic CD alone usually presents with diarrhoea, sometimes with blood. Other complaints seen in both UC and CD include red painful eyes, rashes, joint pains and low grade fever. Investigations A colonoscopy is recommended at initial presentation to establish the diagnosis and document extent of disease in UC. Gastroscopy and colonoscopy/ileoscopy are commonly used to assess the extent and severity of upper and lower intestinal CD. Blood and stool tests also play a role in evaluation of IBD. Special X-Rays of the small intestine are frequently required in CD. Treatment Supportive measures include antispasmodics, antidiarrhoeals, pain killers, and even anxiolytics or antidepressant therapies. Anti inflammatory medications include aminosalicylates either used as tablets or rectally and steroids. Steroids can be used as an intravenous preparation, orally or as rectal foam. For disease difficult to control, agents that modulate the immune sysem, like azathioprine or 6-mercaptopurine are used. More novel antibody treatments are available for some CD patients. Although many doctors and patients, in general, tend to regard surgery in IBD as a 'last resort', surgery can be a form of effective treatment. Surgery, in selected cases, does afford the patient a chance to get well and proceed to achieve a decent quality of life. Prognosis IBD is a chronic disease requiring life long medication. The majority of patients enjoy good quality of life with regular medications. However, disease flares and complications that may require either changes in medications, hospitalisations or surgeries may frequently trouble a small number of patients. Regular follow up with a gastroenterologist is essential.