In the preceding articles (Vol 8(13): 858-62; Vol 8(14): 926-30), the pathogenesis and aetiology of inflammatory bowel disease (IBD) and its medical and surgical treatment options were considered. In this final part of the series, the concept of an alliance between the patient with IBD and healthcare professionals in terms of healthcare choices is examined. The article explores the role of the clinical nurse specialist in IBD in relation to education, psychological support and compliance with treatment regimens. There is also a discussion of the social and psychological impact of IBD on the patient, and an exploration of the positive effects such a participatory relationship may have on health and quality of life.