An effective low energy field theory is developed for a system of two chains.  The main novelty of the approach is that it allows to treat generic intrachain repulsive interactions of arbitrary strength.   The chains are coupled by a direct tunneling and four-fermion  interactions.  At low energies the individual chains are described as   Luttinger liquids with an arbitrary ratio of spin $v_s$ and charge $v_c$ velocities.  A judicious choice of the basis for the decoupled chains greatly  simplifies the description and allows one to separate high and low energy degrees of freedom.  In a direct analogy to the bulk cuprates the resulting effective field theory distinguishes  between three qualitatively different regimes: (i) small doping ($v_c << v_s$), (ii) optimal doping ($v_s \approx v_c$) and (iii) large doping ($v_s << v_c$). I discuss the excitation spectrum and derive expressions for the electron spectral function which turns out to be highly incoherent. The degree of incoherence increases when one considers an array of ladders (stripe phase).