Inflammatory bowel diseases (IBD) are currently one of the most difficult problems in modern global internal medicine in general and in gastroenterology in particular. The diseases demonstrate a relapsing, progressive nature, significant decrease in the quality of life, physical activity of patients, complications from other organs and systems of the human body, a decrease or even loss of working capacity, difficulties in socialization and creating a family. An insufficiently predicted course of the disease, acute or chronic intestinal complications can lead to surgical interventions. According to the severity of the course, the frequency of disability, complications, including those, that require surgical intervention; in terms of the economic costs of the health care system, IBDs are ahead of a number of other widespread diseases of digestive organs. The variety of clinical, anatomical (in particular, localization and extend of damage to the Gut), endoscopic signs of the disease in combination with different degrees of severity and activity of the disease, the presence of local and systemic extraintestinal manifestations determine difficulties in early establishing the diagnosis, in differential diagnosis and in choosing an effective and safe therapy, which is prescribed for the purpose of not only achieving, but also further maintaining a stable remission of the disease.In the vast majority of patients, the disease is characterized by a chronic relapsing course and requires longterm, constant, often lifelong drug treatment with the use of drugs from various pharmacological groups, including combination therapy. An active search for predictably effective drugs for the treatment for IBD continues at the present time. According to the new International Classification of Diseases, 11th revision (2022), three diseases are included in the IBD group: ulcerative colitis (UC), Crohn’s disease (CD) and indeterminate colitis, i.e. a disease in which it is impossible to clearly determine whether it is UC or CD of the colon. In modern medicine, there is a tendency towards greater clarity and conciseness in the formulation of diagnoses, examination algorithms and treatment regimens. Inflammatory bowel disease remains diseases with many unknowns, both in terms of establishing a clear diagnosis and in terms of prognosis and predictability of the consequences of drug therapy.