OBJECTIVES: According to previous data only 30% to 60% of patients with inflammatory bowel disease (IBD) take their medication as prescribed. While objective predictors of nonadherence are relatively well studied, there is little data regarding what IBD patients think about their medications and their reasons for nonadherence. METHODS: A total of 22 consecutive patients with IBD from the University of Maryland Inflammatory Bowel Disease Program were interviewed.. We collected data on the patients' sociodemographic profile, their medications, and asked them to complete the Medication Attitude Survey (MAS). The MAS has 24 questions asking why patients may incorrectly take their medications. The nonadherence reasons were identified from a literature review. RESULTS: Fifteen patients were female (68.2%), and the average age was 37.4±13 years. Ten patients had Crohn's disease (45.5%), 6 had ulcerative colitis (27.3%), and 5 had indeterminate colitis (22.7%). Most of the patients (90.9%) selected at least one reason for nonadherence. The main reasons (selected by more than 25% of patients) were “I forget to take my medication”(72.7% of patients), “I feel better” (40.9%), “My medications are too expensive” and “I feel very bad”(both 36.6%), “I want to avoid side effects” and “I want to feel healthy” (both 31.8%), “I want to forget about my disease” and “I think that the prescribed dose of my medication is too much” (both 27.3%). The sets of reasons were different for adherent and nonadherent patients (the degree of nonadherence was assessed using patient self-report). The MAS has shown good initial psychometric properties with Cronbach Alpha 0.91 and mean inter-item correlations 0.32. CONCLUSIONS: The identified reasons for patient nonadherence suggest that patient education and other interventions are needed to increase medication adherence. The scale used in the study can be useful in routine clinical practice to identify possible problems with patient adherence.