The management of the patient with inflammatory bowel disease (IBD) is chal
lenging for both the physician and the patient. IBD imposes both a physical
and emotional burden on patients' lives. Palliative care is important for
IBD patients because it focuses on improving quality of life. While palliat
ive care does not change the natural history of the disease, it provides re
lief from pain and other distressing symptoms. This article focuses on vari
ous aspects of care for IBD patients including pain control, management of
oral and skin ulcerations, stomal problems in IBD patients, control of naus
ea and vomiting, management of chronic diarrhea and pruritus ani, evaluatio
n of anemia, treatment of steroid-related bone disease, and treatment of ps
ychological problems associated with IBD. Each of these areas is reviewed u
sing an evidence-based approach. Evidence in category A refers to evidence
from clinical trials that are randomized and well controlled. Category B Ev
idence refers to evidence from cohere or case-controlled studies. Category
C is evidence from case reports or flawed clinical trials. Evidence from ca
tegory D is limited to the clinical experience of the authors. Evidence lab
elled as category E refers to situations where there is insufficient eviden
ce available to form an opinion. Algorithms for management of pain and naus
ea in IBD patients are presented.