Psychological factors play a major part in inflammatory bowel disease (I.B.D.). Stress influences motility, secretion and vascularity of the gastrointestinal tract and may produce functional disorders. Stressful events, which in childhood might be family tensions, separation or major changes such as that of school or house, may aggravate or even cause I.B.D. Physical symptoms of the active disease are distressing and can lead to stress and even behaviour problems. Stress and distress can themselves produce physical symptoms and aggravate pre-existing organic pathology, whilst behaviour problems such as non-compliance with treatment or diet can aggravate the organic pathology and/or the physical symptoms so setting up and maintaining a vicious circle. Not only the child, but also his family are affected. Taking into account the complex interaction between psychosocial and organic aspects of I.B.D. a comprehensive approach is essential for optimal care of the child with I.B.D. and his family.