Treatment algorithms of Crohn’s disease (CD) and ulcerative colitis (UC) share a lot of similarities. However, despite a variety of common therapeutic pathways, there are a few differences between both diseases that require different treatment approaches. Even if there is no standardized definition, most authors regard the use of steroids and mesalamine in different formulas and various applications as conventional therapy in IBD. The gold standard in the treatment of mild to moderate active UC is still mesalamine. Mesalamine also plays an important role in maintenance treatment of UC. Rectal application should always be considered, as much higher concentration of mesalamine can be obtained within the mucosa compared to the oral application. In contrast, mesalamine plays little to no role in patients with CD, either for induction or for maintenance therapy. Budesonide is used as standard treatment for mild to moderate CD with ileocaecal involvement. Budesonide MMX exerts a continuous release within the whole colon and can be considered in UC patients refractory to mesalamine. Rectal application of budesonide can also be used in patients with left-sided UC or patients with proctitis. Conventional steroids are only used in severe UC and CD. Long-term steroid use should be avoided in patients with IBD. For maintenance therapy in CD, immunosuppressive drugs or biologicals should be used. In the following chapter, we present a therapeutic algorithm on how to use conventional drugs in patients with UC and CD.