Standard treatment for IBD with 5-ASA, steroids and immunosuppressants is rather effective and currently optimized using combinations of drugs or application routes. Among the biologics only infliximab has reached the therapeutic arsenal for Crohn's disease--it is as well effective in some patients with ulcerative colitis. Early aggressive treatment thus far is not established. Hormones and growth factors may play a role. Probiotics have a place in the treatment in particular for ulcerative colitis.