Inflammatory bowel disease (IBD) is a chronic progressive disease. While current therapeutic strategies aim to control symptoms, these have not significantly altered the natural history of IBD. To that end, Dr Colombel proposes treating IBD to the target of endoscopic healing, together with tight control of inflammation. To achieve this target, optimization of current therapies is required. A thorough understanding of pharmacokinetics is also important. Knowledge about the predictors of disease progression is also important to avoid under- and over-treatment. In time to come, Dr Colombel is optimistic that an integrated approach incorporating genetics with clinical and environmental data will help clinicians to develop personalized, targeted therapies for patients. In this era of increasing complexity of care, patient education is also vital. Involving patients while making treatment decisions is mandatory for the success of any management strategy.