It's been surgery for me. At the time I was 14, got symptoms during 6 months (can't remember of anything being wrong before I first saw blood). They tried some conventional therapies, prednisone, asacol, then purinethol and cyclosporine to which I got a really bad adverse reaction. So the med team judged my situation too critical to try anything else (remicade was no approved for pediatric use back these days) and that surgery(total colectomy in my case) was necessary. It was sometime hard psychologically but on the overall, it allowed me to have a great life for several years (10 years remission). It sucks to go through it, but when it gets to the point of being needed, it's to be looked at positively. Thankfully, the new antibodies (remicade-humira-etc) brings great results now and I am hoping it is just the beginning, I'm hoping for some great therapies in a near future. And I really think Joan marks a point by bringing the food aspect, there is a lot to consider about what we eat. I try to stay as far as I can from gluten, dairy and minimize the red meat and process food. I assume that if we have way much IBD in industrialized countries must be for a reason (or many), but I assume food must be one of them.