Adolescence is a time of profound change for individuals. It is a period that witnesses biologic, social, and psychological change in the individual as well as role changes within the family and peer groups. Compounding these difficult transitions with the onset of inflammatory bowel disease leads to additional problems with adolescence adjustment. In the limited studies that have addressed the adolescent and inflammatory bowel disease, several key concepts emerge that point to ways for successfully dealing with these adolescent adjustment problems. Roy's Adaptation Model provides a foundation for identifying and selecting interventions in working with adolescents and chronic illness. A review of the literature finds the need for further study of the difficulties encountered by the changes of adolescence coupled with the onset of inflammatory bowel disease.