Abstract Background Effective communication between adolescents with inflammatory bowel disease (IBD) and their parents is essential for disease understanding, emotional adjustment, and a successful transition to adult care. Yet, the developmental changes of adolescence and the unpredictable nature of IBD can make these interactions challenging. This study explored how adolescents with IBD communicate with their parents and the factors shaping these communication patterns. Methods A descriptive qualitative design was employed. Twelve parent-adolescent dyads were recruited, each including an adolescent with IBD and one of their parents. Semi-structured interviews were conducted separately with adolescents and parents. Data were analysed using conventional content analysis, followed by dyadic analysis to identify convergent and divergent perspectives within each pair. Results Four distinct parent–adolescent communication patterns were identified: avoidant, strategic, conflictual, and open. (1) Avoidant communication: Both parents and adolescents avoided discussing IBD due to difficulty accepting the illness, fear of causing distress, or limited understanding of the disease. Adolescents also withheld discussion to avoid blame or criticism. (2) Strategic communication: Parents managed disclosure selectively or gradually, adapting to the adolescent’s age, emotional readiness, or disease severity to minimise worry. Adolescents similarly shared information strategically to preserve autonomy or protect parents from anxiety. (3) Conflictual communication: Misunderstandings and contrasting coping styles led to frustration, anger, and mutual blame. The adolescent’s disease burden, combined with parental caregiving stress triggered arguments, while developmental drives for independence sometimes resulted in silence or withdrawal. (4) Open communication: Dyads characterised by mutual respect and empathy engaged in open discussion of IBD-related issues, promoting trust, collaboration, and adolescents’ confidence in self-management. Conclusion Parent-adolescent communication in IBD varies along a continuum from avoidance to openness. These patterns are influenced by both shared and individual factors, including emotional protection, cognitive readiness, disease burden, and developmental stage. Interventions that foster mutual understanding and strengthen communication skills may help families move towards more open, supportive dialogue and reduce conflict. Conflict of interest: Chen, Lingxi:Zhou, Yunxian: No conflict of interest Jewell, Tom: No conflict of interest Rowland, Emma: No conflict of interest Czuber-Dochan, Wladyslawa: Grant: National Institute of Health Research, Bristol Myers Squibb, and Crohn’s and Colitis UK Personal Fees: Dr Falk Pharma UK and PharmaCosmos
Chen et al. (Thu,) studied this question.