The objective of a new study published in Clinical Gastroenterology and Hepatology was to describe key principles in diagnosis and management of functional gastrointestinal (GI) symptoms in patients with inflammatory bowel disease (IBD). Evidence based on relevant scientific publications, systematic reviews, and expert opinion were summarized. It was stated that a stepwise approach to rule-out ongoing inflammatory activity should be followed in IBD patients with persistent (GI) symptoms; in patients with indeterminate fecal calprotectin levels and mild symptoms, serial calprotectin monitoring must be considered to facilitate anticipatory management; anatomic abnormalities or structural complications should be investigated in patients with obstructive symptoms including abdominal distention, pain, nausea and vomiting, obstipation or constipation; alternative pathophysiologic mechanisms should be evaluated, such as small intestinal bacterial overgrowth, bile acid diarrhea, carbohydrate intolerance, chronic pancreatitis based on predominant symptom patterns; a low FODMAP diet can be offered for management of functional GI symptoms in IBD with careful attention to nutritional adequacy; psychological therapies should be considered in IBD patients with functional symptoms; osmotic and stimulant laxative should be given to IBD patients with chronic constipation; hypomotility agents or bile-acid sequestrants may be used for chronic diarrhea in quiescent IBD; antispasmodics, neuropathic-directed agents, and anti-depressants should be prescribed for functional pain in IBD while the use of opiates should be avoided; probiotics may be considered for the treatment of functional symptoms in IBD; pelvic floor therapy can be suggested for IBD patients with evidence of an underlying defecation disorder; physical exercise should be encouraged in IBD patients with functional GI symptoms; whereas, complementary and alternative therapies should not be routinely offered for functional symptoms in IBD, unless further evidence is available.